Joint Arthroplasty in Patients With Left Ventricular Assist Devices

There have been limited case series describing joint arthroplasty (JA) in patients with left ventricular assist devices (LVADs). In the largest retrospective matched cohort study to date, we compared the postoperative complications of JA among patients with and without LVADs.

A retrospective study from January 1, 2014, to December 31, 2023, was conducted comparing patients undergoing JA with LVADs to controls without LVADs matched for gender, age, body mass index, history of myocardial infarction, arthroplasty type, year of surgery, and Elixhauser Comorbidity Index in a 3:1 fashion. There were 13 JA procedures in the LVAD group and 39 in the control group. Postoperative complications of interest included emergency department visits within 90 days, any postoperative infection within 1 year, postoperative thrombosis within 1 year, need for transfusion within 1 year, Patient-Reported Outcomes Measurement Information System physical function scores, as well as 2-year survival from revision and 2-year mortality.

LVAD patients had similar rates of 90-day emergency department visits (7.7% vs 23.1%; P = .42), thrombosis (7.6% vs 2.6%; P = .44), transfusion (30.8% vs 23.1%; P = .71), and any infection (7.6% vs 23.1%; P = .41) as control patients without LVADs. The proportion of patients reporting improvement in Patient-Reported Outcomes Measurement Information System physical function scores was similar (83% LVAD group vs 72% control; P = 1.00). There was one reoperation (7.7%) in the LVAD group and 7 reoperations (17.9%) in the control group (P = .66). Kaplan-Meier analysis demonstrated similar 5-year survival from reoperation (P = .12) and mortality (P = .95) between the 2 groups.

This is the largest series of patients undergoing JA after an LVAD procedure. JA patients with LVADs had similar 1-year postoperative complications to their matched counterparts.