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dc.contributor.authorPasrija, C.
dc.contributor.authorSawan, M.A.
dc.contributor.authorSorensen, E.
dc.contributor.authorVoorhees, H.
dc.contributor.authorShah, A.
dc.contributor.authorStrauss, E.
dc.contributor.authorTon, V.-K.
dc.contributor.authorDiChiacchio, L.
dc.contributor.authorKaczorowski, D.J.
dc.contributor.authorGriffith, B.P.
dc.date.accessioned2019-10-03T14:14:46Z
dc.date.available2019-10-03T14:14:46Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85072687417&doi=10.1093%2ficvts%2fivz143&partnerID=40&md5=c3de9ebea293d6a8064fa37c58594745
dc.identifier.urihttp://hdl.handle.net/10713/11042
dc.description.abstractOBJECTIVES: Right ventricular (RV) failure after left ventricular assist device (LVAD) implantation continues to be a morbid complication. In this study, we hypothesized that a less invasive approach to implantation would preserve RV function relative to a conventional sternotomy (CS) approach. METHODS: All patients (2013–2017) who underwent LVAD implantation were reviewed. Patients were stratified by surgical approach: less invasive left thoracotomy with hemi-sternotomy (LTHS) and CS. The primary outcome was severe RV failure. RESULTS: Eighty-three patients (LTHS: 37, CS: 46) were identified. The median Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score was significantly worse in the LTHS compared to the CS cohort, and there was a trend towards higher RV failure scores and HeartMate II mortality scores. Preoperative RV dysfunction, in pulmonary artery pulsatility index and RV stroke work index were similar between the 2 groups. Though operative time did not significantly differ between the 2 groups, cardiopulmonary bypass time was significantly shorter in the LTHS group (61 vs 95 min, P < 0.001). The incidence of postoperative severe RV failure was significantly reduced in the LTHS group (16% vs 39%, P = 0.030), along with the need for temporary right ventricular assist device (3% vs 26%, P = 0.005). Improvement in RV function, along with a change in pulmonary artery pulsatility index, was significantly greater in the LTHS cohort. There was a trend towards improved Kaplan–Meier 1-year survival in the LTHS cohort (91% vs 56%, P = 0.056). CONCLUSIONS: In this cohort, less invasive LVAD implantation appears to be associated with reduced postoperative RV failure, and equivalent or improved survival compared to conventional LVAD implantation. Copyright The Author(s) 2019.en_US
dc.description.urihttps://doi.org/10.1093/icvts/ivz143en_US
dc.language.isoen-USen_US
dc.publisherOxford University Pressen_US
dc.relation.ispartofInteractive cardiovascular and thoracic surgery
dc.subjectLess invasive left ventricular assist device implantationen_US
dc.subjectMinimally invasive ventricular assist device implantationen_US
dc.subjectPostoperative right ventricular failureen_US
dc.subjectRight ventricular failure after left ventricular assist device implantationen_US
dc.titleLess invasive left ventricular assist device implantation may reduce right ventricular failureen_US
dc.typeArticleen_US
dc.identifier.doi10.1093/icvts/ivz143
dc.identifier.pmid31326991


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