Naslov
Bridging INTERMACS Profile 1 Patients to Left Ventricular Assist Device: The Right Device, the Right Time, and the Best Surgical Approach

Autori
Bjelic, M. ; Wood, K.L. ; Paić, Frane ; Louis, C. ; Cheyne, C. ; Goodman, A. ; Gu, Y. ; Chase, K. ; Vidula, H. ; Gosev, I.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
The journal of heart and lung transplantation, 41 (2022), 4 / - , 2022, S471-S472

Skup
ISHLT2022: 42nd Annual Meeting & Scientific Sessions

Mjesto i datum
Boston (MA), Sjedinjene Američke Države, 27.04.2022. - 30.04.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
INTERMACS ; LVAD ; surgical approach

Sažetak
Purpose: The purpose of this study was to investigate the factors related to temporary mechanical support (tMCS) and surgical approach influencing post-LVAD outcomes in INTERMACS 1 patients. Methods: We performed a retrospective review of all INTERMACS 1 patients implanted with the fully magnetically levitated LVAD in our insti- tution from September 2015 through March 2021. Influence of the follow- ing factors on in- hospital survival were analyzed: type and time on tMCS ; change in the tMCS level (step- up: IABP!ECMO and/or Impella, Impella! ECMO§Impella ; step- down: ECMO+Impella! ECMO or Impella) ; heart failure acuity ; and surgical approach. Results: Of 287 implanted patients, 102 (35.5%) were INTERMACS pro- file 1 and included in the study. Full sternotomy (FS) was used in 25 (24.5%) patients and less invasive surgery (LIS) in 77 (75.5%) patients. Patients in the FS group were more frequently bridged with IABP in con- trast to LIS patients supported with Impella. Postoperatively, LIS patients bled less, required shorter mechanical ventilation, and had a lower inci- dence of severe right ventricular failure. In-hospital survival was similar (Table 1). Multivariate analysis demonstrated a positive correlation between IABP and in-hospital survival while FS demonstrated a negative effect (Figure 1). Conclusion: Patients presenting with cardiogenic shock should be expedi- tiously evaluated for LVAD therapy while supported with adequate tMCS tailored to the patient’s requirements. Less invasive LVAD implantation may alleviate some of the perioperative risks. Future trials are required to confirm our data.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA