Assistances circulatoires monoventriculaires gauches implantées par thoracotomie postérolatérale sans circulation extracorporelle : expérience monocentrique

JCTCV:21(3)
Aim: Long-term mechanical circulatory support is increasingly being used to deal with end-stage heart failure. The objective of this retrospective monocentric study was to evaluate the short- and mid-term evolution of patients receiving left ventricular assist device (LVAD) implanted by left thoracotomy without cardiopulmonary bypass at our center. Methods and results: Eighteen patients (17 males) aged 63.3 ± 7.3 years received LVAD between November 2012 and August 2016 (15 [83%] as destination therapy and 3 [17%] as a bridge to transplant). Aetiology was ischemic cardiopathy for 13 (72%) cases and dilated cardiomyopathy for 5 (28%) cases. The follow-up time was 17 months and survival at 12 months was 66% (73% in the subgroup of patients implanted as destination therapy), with acceptable postoperative complications. Conclusion: This approach is technically feasible without cardiopulmonary bypass and is a potential alternative to conventional medial sternotomy, especially for redo patients. However, its place has yet to be defined, in particular in patients who require a subsequent heart transplant.