The Annals of thoracic surgery · 2025
An Institutional Comparison of Patients Supported With Surgical vs Percutaneous Biventricular Assist Devices.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Clothier Jessica S, Kobsa Serge, Bojko Markian, Lester Lynette, Rajeev Nithya, Praeger Jonathan, Patel Sanjeet, Dhillon Anahat, Vaidya Ajay, Wolfson Aaron, Nattiv Jonathan, Barr Mark, Hackmann Amy, Lee Raymond
Аннотация
BACKGROUND: Surgical (sBiVADs) are well established in end-stage heart failure, whereas newer and less invasive percutaneous biventricular assist devices (pBiVADs) are understudied. These 2 approaches are reported in a large series of patients with pBiVADs.
METHODS: All consecutive biventricular assist device (BiVAD)-supported patients at a single institution (Keck Hospital of USC, Los Angeles, CA) from 2014 to 2023 were retrospectively reviewed (n = 46). Patients with sBiVADs (n = 27) and pBiVADs (n = 19) (defined as Impella 5.5 with Impella RP [Abiomed; n = 4] or percutaneous oxygenated right ventricular assist devices [n = 15]) were compared.
RESULTS: There were no significant differences in preoperative risk factors. Patients with pBiVADs required fewer intraoperative packed red blood cell (2.0 vs 6.0; P < .001), fresh frozen plasma (0.0 vs 4.0; P = .001), and platelet (0.0 vs 4.0; P = .001) transfusions. Patients with pBiVADs had fewer unanticipated returns to the operating room (0.47 [SD 0.70] vs 2.22 [1.87] per patient; P < .001) and fewer postoperative packed red blood cell (8.0 vs 27.0; P < .001), fresh frozen plasma (1.0 vs 8.0; P < .001), and platelet (0.0 vs 10.0; P < .001) transfusions. Thirty-day survival was not significantly different between patients with sBiVADs and those with pBiVADs (56.6% vs 36.8%; P = .341).
CONCLUSIONS: The study investigators consider pBiVAD to be a less invasive, viable bridge to transplantation, durable left ventricular assist device therapy, or recovery.
METHODS: All consecutive biventricular assist device (BiVAD)-supported patients at a single institution (Keck Hospital of USC, Los Angeles, CA) from 2014 to 2023 were retrospectively reviewed (n = 46). Patients with sBiVADs (n = 27) and pBiVADs (n = 19) (defined as Impella 5.5 with Impella RP [Abiomed; n = 4] or percutaneous oxygenated right ventricular assist devices [n = 15]) were compared.
RESULTS: There were no significant differences in preoperative risk factors. Patients with pBiVADs required fewer intraoperative packed red blood cell (2.0 vs 6.0; P < .001), fresh frozen plasma (0.0 vs 4.0; P = .001), and platelet (0.0 vs 4.0; P = .001) transfusions. Patients with pBiVADs had fewer unanticipated returns to the operating room (0.47 [SD 0.70] vs 2.22 [1.87] per patient; P < .001) and fewer postoperative packed red blood cell (8.0 vs 27.0; P < .001), fresh frozen plasma (1.0 vs 8.0; P < .001), and platelet (0.0 vs 10.0; P < .001) transfusions. Thirty-day survival was not significantly different between patients with sBiVADs and those with pBiVADs (56.6% vs 36.8%; P = .341).
CONCLUSIONS: The study investigators consider pBiVAD to be a less invasive, viable bridge to transplantation, durable left ventricular assist device therapy, or recovery.