Abstract:
OBJECTIVES:Some patients who undergo continuous-flow left ventricular assist device (CF-LVAD) implantation require concomitant procedures that can be performed with or without cardiac arrest under aortic cross-clamping (AXC). Procedures normally performed with cardiac arrest are sometimes avoided or performed without cardiac arrest because it may be detrimental to right heart function. However, the effects of cardiac arrest on patients with advanced heart failure necessitating CF-LVAD support have not been thoroughly studied. We examined our single-centre experience to determine whether cardiac arrest during CF-LVAD implantation was associated with worse patient outcomes. METHODS:From November 2003 to March 2016, a total of 526 patients with chronic end-stage heart failure underwent primary CF-LVAD implantation. Preoperative demographics, postoperative complications and mortality rates were compared between patients who required cardiac arrest with AXC (n = 50) and those who did not (n = 476). RESULTS:The most frequently performed procedure requiring AXC was aortic valve closure (n = 23, 26.1%). Although the AXC group had longer cardiopulmonary bypass times (P < 0.01), long-term (5-year) survival was similar in AXC and non-AXC patients (P = 0.13). Also, postoperative right heart failure (P = 0.15) and neurological dysfunction (P = 0.89) rates were not significantly different between the 2 groups. Cox proportional hazards analysis showed that cardiac arrest with AXC was not an independent predictor of mortality (hazard ratio, 0.89; P = 0.73). CONCLUSIONS:Cardiac arrest with AXC during CF-LVAD implantation did not negatively affect long-term survival or the incidence of right ventricular failure or stroke. These findings should be considered in deciding surgical strategies. Additional investigation may be warranted to further understand the effects of cardiac arrest during LVAD implantation.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Kawabori M,Kurihara C,Critsinelis A,Chou BP,Zhang Q,Kaku Y,Civitello AB,Morgan JAdoi
10.1093/icvts/ivz223subject
Has Abstractpub_date
2020-01-01 00:00:00pages
47-53issue
1eissn
1569-9293issn
1569-9285pii
5571461journal_volume
30pub_type
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journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
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更新日期:2016-07-01 00:00:00
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更新日期:2016-09-01 00:00:00