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Single center outcomes after temporary mechanical circulatory assist device prior to Heartmate 3 implantation - a retrospective cohort study.
- Source :
-
Scandinavian cardiovascular journal : SCJ [Scand Cardiovasc J] 2024 Dec; Vol. 58 (1), pp. 2353066. Date of Electronic Publication: 2024 Jul 04. - Publication Year :
- 2024
-
Abstract
- Objectives . Temporary mechanical circulatory support (TMCS) has become a component in the therapeutic strategy for treatment of cardiogenic shock as a bridge-to-decision. TMCS can facilitate recovery of cardiopulmonary function, end-organ function, and potentially reduce the surgical risk of left ventricular assist device (LVAD) implantation. Despite the improvements of hemodynamics and end-organ function, post-LVAD operative morbidity might be increased in these high-risk patients. The aim of the study was to compare outcomes after Heartmate 3 (HM3) implantation in patients with and without TMCS prior to HM3 implant. Methods. In this retrospective cohort study of all HM3 patients in the period between November 2015 and October 2021, patients with and without prior TMCS were compared. Patients' demographics, baseline clinical characteristics, laboratory tests, intraoperative variables, postoperative outcomes, and adverse events were collected from patient records. Results. The TMCS group showed an improvement in hemodynamics prior to LVAD implantation. Median TMCS duration was 19.5 (14-26) days. However, the TMCS group were more coagulopathic, had more wound infections, neurological complications, and more patients were on dialysis compared with patient without TMCS prior to HM3 implantation. Survival four years after HM3 implantation was 80 and 82% in the TMCS ( N = 22) and non-TMCS group ( N = 41), respectively. Conclusion . Patients on TMCS had an acceptable short and long-term survival and comparable to patients receiving HM3 without prior TMCS. However, they had a more complicated postoperative course.
- Subjects :
- Humans
Retrospective Studies
Male
Female
Middle Aged
Time Factors
Treatment Outcome
Risk Factors
Adult
Aged
Prosthesis Implantation instrumentation
Prosthesis Implantation adverse effects
Prosthesis Implantation mortality
Risk Assessment
Prosthesis Design
Heart-Assist Devices
Hemodynamics
Shock, Cardiogenic physiopathology
Shock, Cardiogenic mortality
Shock, Cardiogenic therapy
Shock, Cardiogenic diagnosis
Ventricular Function, Left
Recovery of Function
Heart Failure physiopathology
Heart Failure therapy
Heart Failure mortality
Heart Failure diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1651-2006
- Volume :
- 58
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scandinavian cardiovascular journal : SCJ
- Publication Type :
- Academic Journal
- Accession number :
- 38962929
- Full Text :
- https://doi.org/10.1080/14017431.2024.2353066