Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Pappalardo, F; Potapov, E; Loforte, A; Morshuis, M; Schibilsky, D; Zimpfer, D; Riebandt, J; Etz, C; Attisani, M; Rinaldi, M; Haneya, A; Ramjankhan, F; Donker, D; Jorde, UP; Lewin, D; Wieloch, R; Ayala, R; Cremer, J; Bertoldi, L; Borger, M; Lichtenberg, A; Gummert, J; Saeed, D, , Durable, MCS, after, ECLS, study, group.
Left ventricular assist device implants in patients on extracorporeal membrane oxygenation: do we need cardiopulmonary bypass?
Interact Cardiovasc Thorac Surg. 2022; 34(4): 676-682.
Doi: 10.1093/icvts/ivab311
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- Co-authors Med Uni Graz
- Zimpfer Daniel
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- Abstract:
- OBJECTIVES: Implanting a durable left ventricular assist device (LVAD) in a patient on extracorporeal life support (ECLS) is challenging. The goal of this study was to compare the results of patients from a European registry who had a durable LVAD implanted with or without transition from ECLS to cardiopulmonary bypass (CPB). METHODS: A total of 531 patients on ECLS support who had an LVAD implant between January 2010 and August 2018 were analysed; after 1:1 propensity score matching, we identified and compared 175 patients in each group. RESULTS: The duration of preoperative ECLS was 7 [standard deviation (SD) 6] vs 7 (SD 6) days in patients with or without CPB (P = 0.984). The surgical time was longer in the CPB group [285 (SD 72) vs 209 [SD 75] min; P ≤ 0.001). The postoperative chest tube output was comparable [1513 (SD 1311) vs 1390 (SD 1121) ml; P = 0.3]. However, re-exploration for bleeding was necessary in 41% vs 29% of patients with or without CPB (P = 0.01) and a significantly higher number of packed red blood cells and fresh frozen plasma [8 (SD 8) vs 6 (SD 4) units; P = 0.001 and 6 (SD 7) vs 5 (SD 5) units; P = 0.03] were administered to patients operated on with CPB. A postoperative mechanical right ventricular support device was necessary in 50% vs 41% of patients (P = 0.08). The stroke rate was not significantly different (P 0.99). No difference in survival was observed. CONCLUSIONS: Omitting CPB for an LVAD implant in patients on ECLS is safe and results in shorter operating time, less re-exploration for bleeding and fewer blood products. However, no survival benefit is observed.
- Find related publications in this database (using NLM MeSH Indexing)
- Cardiopulmonary Bypass - adverse effects
- Extracorporeal Membrane Oxygenation - methods
- Heart Failure - diagnosis, surgery
- Heart-Assist Devices - administration & dosage
- Humans - administration & dosage
- Propensity Score - administration & dosage
- Retrospective Studies - administration & dosage
- Treatment Outcome - administration & dosage
- Find related publications in this database (Keywords)
- ECLS
- CPB
- assist device
- outcome
- mechanical circulatory support