From bench to bedside: Impact of left ventricular assist device outflow conduit anastomosis position on outcome.
Aged
Anastomosis, Surgical
/ adverse effects
Aorta
/ physiopathology
Creatinine
/ blood
Female
Heart Failure
/ blood
Heart-Assist Devices
/ adverse effects
Hemodynamics
/ physiology
Hemolysis
/ physiology
Hospital Mortality
Humans
Male
Middle Aged
Postoperative Complications
/ blood
Prosthesis Design
Prosthesis Implantation
/ adverse effects
Treatment Outcome
aortic anastomosis
heart failure
outflow graft
ventricular assist device
Journal
Artificial organs
ISSN: 1525-1594
Titre abrégé: Artif Organs
Pays: United States
ID NLM: 7802778
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
05
05
2020
revised:
18
08
2020
accepted:
19
08
2020
pubmed:
30
8
2020
medline:
21
10
2021
entrez:
30
8
2020
Statut:
ppublish
Résumé
Continuous flow left ventricular assist devices (LVADs) have become a valuable therapy for end-stage heart failure. In vitro research highlighted a role of outflow cannula position on the pattern of blood flow in the aorta. However, the clinical effects of the alterations of flow remain unclear. We investigate short- and long-term outcomes of patients implanted with Jarvik 2000 LVAD, according to the ascending (Group 1) versus descending (Group 2) outflow graft connection to the aorta in a multicenter study. From May 2008 to October 2014, 140 consecutive end-stage heart failure patients underwent Jarvik 2000 LVAD implantation in 17 Italian centers. According with a preliminary multivariate analysis, we selected the 90 patients implanted in the four high-volume centers to avoid bias (Group 1 n = 39, Group 2 n = 51). Among the groups, no differences were recorded in the hospital mortality and the main complications occurring after LVAD implantation were similar. In multivariable analysis, the ascending aorta outflow cannula position and higher creatinine at discharge were significant predictors for long-term survival. Postimplant hemolysis was more pronounced in descending aorta outflow graft anastomosis. Outflow graft anastomosis to the ascending aorta is associated with better long-term survival, independent of age and perfusion techniques, reflecting the previous in vitro results.
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
236-243Informations de copyright
© 2020 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.
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