Preoperative Left Ventricular Thrombus and Midterm Outcomes Following Left Ventricular Assist Device Support.

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Devices

Background:

• Preoperative left ventricular thrombus (LVT) poses potential risks during left ventricular assist device (LVAD) implantation.
• The clinical impact of LVT in LVAD patients requires further investigation.

Purpose of the Study:

• To assess the influence of preoperative LVT on early and mid-term outcomes after LVAD implantation.
• To compare adverse events between LVAD patients with and without preoperative LVT.

Main Methods:

• Retrospective cohort study of 81 adult LVAD patients (21 with LVT).
• Propensity score matching (1:1) created 21 matched pairs.
• Intraoperative thrombectomy was performed for all LVT patients.

Main Results:

• No significant difference in ischemic stroke rates between groups (4.8% vs. 4.8%).
• Pump thrombosis was numerically higher in the LVT group (9.5% vs. 4.8%), but not statistically significant.
• Similar rates of hemorrhagic stroke, infections, and ventricular arrhythmias were observed.

Conclusions:

• Preoperative LVT, when managed with thrombectomy and anticoagulation, did not lead to statistically significant adverse outcomes post-LVAD.
• Small cohort size necessitates caution; larger prospective studies are required for definitive conclusions.