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Left thoracotomy vs full sternotomy for centrifugal durable LVAD implantation: 1-year outcome comparison post-LVAD and post-heart transplantation

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  • Artificial Heart (Clinical)
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Abstract

Left ventricular assist device (LVAD) implantations have traditionally been approached through a full median sternotomy (FS). Recently, a minimally invasive left thoracotomy (LT) approach has been popularized. This study sought to compare the outcomes of FS and LT patients post-primary LVAD implantation and post-subsequent heart transplant (HT). This was a single-center retrospective study. 83 patients who underwent primary centrifugal durable LVAD implantation from January 2014 to June 2018 were included (FS, n = 41; LT, n = 42). 41 patients had a subsequent HT (FS, n = 19; LT, n = 22). Pre-operative patient demographics, intraoperative variables, post-operative 1-year survival, length of hospital stay, complications, and outcomes for LVAD implantation and following HT were analyzed. Intraoperative data showed that the LT group had a 23.4% longer mean LVAD implant surgical time (p < 0.01). One-year post-LVAD survival was similar between the two groups (p = 0.05). Complication rates, with the exception of the rate of hemorrhagic stroke (p = 0.04) post-LVAD implant were similar. One-year survival post-HT was similar between groups (p = 0.35). Complication rates and mean length of hospital stay were also similar (p = 1.0) post-HT. Our study demonstrated that LT approach does not negatively affect post-LVAD implantation or post-HT outcomes. Further, larger studies may determine more detailed effects of LT approach.

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Author notes

  1. Camille E. Hironaka and Bowei Deng contributed equally to this work.

Authors and Affiliations

  1. Tufts University School of Medicine, 145 Harrison Ave., Boston, MA, 02111, USA

    Camille E. Hironaka & Bowei Deng

  2. Division of Cardiac Surgery, Tufts Medical Center, 800 Washington St., South Building, 6th Floor, Boston, MA, 02111, USA

    Masashi Kawabori, Yong Zhan, Frederick Y. Chen & Gregory S. Couper

  3. Division of Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA

    Andre C. Critsinelis

  4. Division of Cardiology, Tufts Medical Center, 800 Washington St., Boston, MA, 02111, USA

    Amanda Vest, David DeNofrio & Michael S. Kiernan

Authors
  1. Camille E. Hironaka
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  2. Bowei Deng
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  3. Masashi Kawabori
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  4. Andre C. Critsinelis
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  5. Yong Zhan
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  6. Frederick Y. Chen
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  7. Amanda Vest
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  8. David DeNofrio
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  9. Michael S. Kiernan
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  10. Gregory S. Couper
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Correspondence to Camille E. Hironaka or Masashi Kawabori.

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Hironaka, C.E., Deng, B., Kawabori, M. et al. Left thoracotomy vs full sternotomy for centrifugal durable LVAD implantation: 1-year outcome comparison post-LVAD and post-heart transplantation. J Artif Organs 24, 312–319 (2021). https://doi.org/10.1007/s10047-021-01250-y

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  • DOI: https://doi.org/10.1007/s10047-021-01250-y

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