Abstract
BackgroundResternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients.MethodsThe study included adult patients receiving a continuous-flow LVAD at our institution during the period 2010–2016. Postoperative adverse events and length of stay were analyzed. Survival was assessed at 6 months and by the end of the study. Multivariate risk factor analysis was conducted for independent predictors of death.ResultsOne hundred twelve patients, who received an intrapericardial LVAD (HVAD, HeartWare), were included in our analysis. Twenty-four patients (21.4%) had a history of previous sternotomy. These patients were older and non-eligible for bridging, and had more frequently coronary heart disease. Univariate analysis demonstrated no differences in the observed complications postoperatively. Survival was similar among groups. Destination therapy was the only predictor of mortality in our analysis (p = 0.02).ConclusionsResternotomy was not associated with worse outcomes after LVAD implantation in our cohort.
Highlights
Resternotomy in cardiac surgery is considered a risk factor for postoperative complications
Following device approval for destination therapy (DT), left ventricular assist device (LVAD) implantations have dramatically increased with nearly half of all implants currently assigned to DT [1, 2]
Previous studies investigating the prognostic significance of resternotomy in non-LVAD procedures have yielded controversial results [3,4,5,6,7,8,9,10,11]
Summary
Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients. Previous studies investigating the prognostic significance of resternotomy in non-LVAD procedures have yielded controversial results [3,4,5,6,7,8,9,10,11]. The largest registry of durable mechanical circulatory support (MCS) devices reported an association between previous cardiac surgery and mortality risk in patients receiving LVAD. Our study aimed to evaluate the impact of previous sternotomy on postoperative outcome and survival in a homogenous cohort consisting exclusively of intrapericardial, continuous-flow LVAD recipients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
