Less Invasive Left Ventricular Assist Device Implantation is Safe and Feasible in Patients with Smaller Body Surface Area

Abstract

<h3>Purpose</h3> Smaller body surface area (BSA) frequently precludes patients for Left Ventricular Assist Device (LVAD) therapy. We sought to investigate the clinical outcomes in patients with small BSA undergoing less invasive LVAD implantation. <h3>Methods</h3> We conducted a retrospective review of 216 patients implanted with HeartMate 3 LVAD via less invasive surgery (LIS) at our institution. Patients were dichotomized and compared based on their pre-implant BSA: small BSA (BSA≤1.8 m²) and normal/large BSA (BSA>1.8 m²). We analyzed patients' perioperative characteristics and outcomes. <h3>Results</h3> In our study, small BSA was found in 32 (14.8%) patients, while 184 (85.2%) had normal/large BSA (Table 1). Women were more prevalent in the small BSA group (50.0% vs. 13.0%, p<0.001). Preoperative and intraoperative data showed comparable results. Major complications and hospital length of stay did not differ by BSA group. Patients with smaller BSAs had significantly decreased pump parameters at discharge, this includes LVAD flow (4.11±0.49 vs.4.60±0.54, L/min, p<0.001) and pump speed (5200 vs. 5400, rpm, p<0.001). Survival to discharge and within 6 post-implantation months were similar between the groups (Figure 1). <h3>Conclusion</h3> Our study results suggest that less invasive HeartMate 3 implantation can be safely performed and demonstrates equivalent outcomes in patients with smaller body habitus. Randomized trials are required to confirm our data.