Do Concomitant Procedures Worsen LVAD Outcomes in Long-Term?

The long-term outcomes of concomitant cardiovascular procedures in left ventricular assist device (LVAD) surgery are controversial. We report our clinical outcomes of concomitant cardiovascular procedures with LVAD surgery. From January 2013 to August 2022, 220 adult patients (mean age 46±13, male 84%) who underwent LVAD implantation (HeartMate 3 50%; HeartWare 46%; HeartMate II 3%; The ReliantHeart aVAD 1%) with or without concomitant procedures were included. Of the patients, 83% had isolated LVAD implantation, while the other patients (17%) had a concomitant procedure with LVAD implantation. Primary end-point was mortality and secondary end-points were intensive care unit (ICU) stay, and late right ventricular failure (RVF). 37 concomitant procedures were aortic valve replacement with bioprosthesis (37%), tricuspid valve annuloplasty (21%), secundum atrial septal defect repair (16%). Temporary right-sided VAD was required in 8% of patients and Levitronix was implanted. Moreover, coronary artery bypass grafting (5%), LV aneurysmectomy (5%) and carotid endarterectomy (2%) were also performed. Although there was no significant difference between the groups in terms of ICU stay (p=0.367) and late RVF (p=0.732), the mortality of concomitant procedures with LVAD was higher than that of isolated LVAD (log-rank: 0.034) in long-term follow-up (Figure 1). Concomitant procedures with LVAD appear to increase mortality in long-term. [ABSTRACT FROM AUTHOR]