Abstract
Background and Objectives: Since the first use of ventricular assist devices (VADs) as bridge to recovery and bridge to cardiac transplantation in the early 1990s, significant technological advances have transformed VAD implantation into a routine destination therapy. With improved survival, many patients present for cardiac surgery for conditions not directly related to their permanent mechanical circulatory support. The aim of this study was to analyze the indications and outcomes of non-cardiac surgeries (NCSs) of left ventricular assist device (LVAD) patients in tertiary center. Material and Methods: We present a single-center experience after 151 LVAD implantations in 138 consecutive patients between 2012–2019 who had to undergo NCS during a follow-up period of 37 +/− 23.4 months on left ventricular assist device (LVAD). Results: A total of 105 procedures was performed in 63 LVAD recipients, resulting in peri-operative mortality of 3.8%. Twenty-five (39.7%) of patients underwent multiple surgeries. We found no significant difference in cumulative survival associated with the performed surgical interventions (p = 0.469). Conclusion: We demonstrated good overall clinical outcomes in LVAD patients undergoing NCS. With acceptable peri-operative mortality, NCS can be safely performed in LVAD patients on long-term support.
Highlights
Ventricular assist devices (VADs, Table 1) were originally introduced in 1990s as bridge to recovery and bridge to cardiac transplantation [1]
A total of 151 left ventricular assist device (LVAD) implantations in 138 patients were performed in our center in the study period with 113 (81.88%) patients surviving to hospital discharge
LVAD models were encountered in the study population: Heartmate 2 (St Jude Medical, St Paul, MN, USA), Heart Mate 3 (St Jude Medical), and Heartware HeartWare left ventricular assist device (HVAD) (Heartware, Framingham, MA, USA)
Summary
Ventricular assist devices (VADs, Table 1) were originally introduced in 1990s as bridge to recovery and bridge to cardiac transplantation [1]. As a consequence of technological advances, left ventricular assist devices (LVADs) are commonly utilized in patients with chronic left heart failure refractory to maximal medical management as destination therapy [2]. Medicina 2020, 56, 424 size and high durability of the system, LVAD patients nowadays achieve many years of follow-up in the destination-therapy population [3]. Since the first use of ventricular assist devices (VADs) as bridge to recovery and bridge to cardiac transplantation in the early 1990s, significant technological advances have transformed VAD implantation into a routine destination therapy. The aim of this study was to analyze the indications and outcomes of non-cardiac surgeries (NCSs) of left ventricular assist device (LVAD) patients in tertiary center
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