Complete Sternal-Sparing Approach Improves Outcomes for Left Ventricular Assist Device Implantation in Patients With History of Prior Sternotomy
OBJECTIVE: Early reports of less invasive techniques for left ventricular assist device (LVAD) implantation have demonstrated promising results. We sought to investigate the safety and feasibility of implementing the complete sternal-sparing (CSS) approach for LVAD implantation in patients with a history of prior cardiac operation.
METHODS: This was a retrospective review of prospectively collected data for all patients implanted with a fully magnetically levitated LVAD from April 2017 through December 2018. Patients were dichotomized based on surgical approach: CSS or full median sternotomy (FS). Perioperative complications and overall survival were compared between cohorts.
RESULTS: Of the 29 eligible patients, 15 (52%) were implanted via the CSS approach and 14 (48%) via FS. Preoperative characteristics were similar between cohorts. Overall survival to discharge was 93% for CSS compared to 71% for FS (P = 0.169). The CSS cohort demonstrated fewer postoperative complications, including fewer cases of severe right ventricular failure (P = 0.006) and less blood product utilization (P = 0.015). Median hospital length of stay was significantly shorter for the CSS cohort (median 13 vs 32.5 days, P = 0.016). Neither cohort had any 30-day readmissions.
CONCLUSIONS: Early data suggest that the CSS technique is a safe and effective technique for patients with a history of prior sternotomy. Further studies are needed to validate this single-center experience.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
Innovations (Philadelphia, Pa.) - 15(2020), 1 vom: 03. Jan., Seite 51-56 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ayers, Brian [VerfasserIn] |
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| Links: |
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| Themen: |
Adult cardiac |
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| Anmerkungen: |
Date Completed 31.12.2020 Date Revised 31.12.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/1556984519886282 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM305034170 |
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|---|---|---|---|
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| 245 | 1 | 0 | |a Complete Sternal-Sparing Approach Improves Outcomes for Left Ventricular Assist Device Implantation in Patients With History of Prior Sternotomy |
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| 500 | |a Date Completed 31.12.2020 | ||
| 500 | |a Date Revised 31.12.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: Early reports of less invasive techniques for left ventricular assist device (LVAD) implantation have demonstrated promising results. We sought to investigate the safety and feasibility of implementing the complete sternal-sparing (CSS) approach for LVAD implantation in patients with a history of prior cardiac operation | ||
| 520 | |a METHODS: This was a retrospective review of prospectively collected data for all patients implanted with a fully magnetically levitated LVAD from April 2017 through December 2018. Patients were dichotomized based on surgical approach: CSS or full median sternotomy (FS). Perioperative complications and overall survival were compared between cohorts | ||
| 520 | |a RESULTS: Of the 29 eligible patients, 15 (52%) were implanted via the CSS approach and 14 (48%) via FS. Preoperative characteristics were similar between cohorts. Overall survival to discharge was 93% for CSS compared to 71% for FS (P = 0.169). The CSS cohort demonstrated fewer postoperative complications, including fewer cases of severe right ventricular failure (P = 0.006) and less blood product utilization (P = 0.015). Median hospital length of stay was significantly shorter for the CSS cohort (median 13 vs 32.5 days, P = 0.016). Neither cohort had any 30-day readmissions | ||
| 520 | |a CONCLUSIONS: Early data suggest that the CSS technique is a safe and effective technique for patients with a history of prior sternotomy. Further studies are needed to validate this single-center experience | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a adult cardiac | |
| 650 | 4 | |a minimally invasive surgery | |
| 650 | 4 | |a operative surgical procedure | |
| 650 | 4 | |a ventricular assist devices | |
| 700 | 1 | |a Sagebin, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, Katherine |e verfasserin |4 aut | |
| 700 | 1 | |a Barrus, Bryan |e verfasserin |4 aut | |
| 700 | 1 | |a Thomas, Sabu |e verfasserin |4 aut | |
| 700 | 1 | |a Storozynsky, Eugene |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Leway |e verfasserin |4 aut | |
| 700 | 1 | |a Bernstein, Wendy |e verfasserin |4 aut | |
| 700 | 1 | |a Lebow, Brandon |e verfasserin |4 aut | |
| 700 | 1 | |a Prasad, Sunil |e verfasserin |4 aut | |
| 700 | 1 | |a Gosev, Igor |e verfasserin |4 aut | |
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