An Institutional Comparison of Patients Supported with Surgical versus Percutaneous Biventricular Assist Devices.

IF 3.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery Pub Date : 2025-05-21 DOI:10.1016/j.athoracsur.2025.04.038

Jessica S Clothier, Serge Kobsa, Markian Bojko, Lynette Lester, Nithya Rajeev, Jonathan Praeger, Sanjeet Patel, Anahat Dhillon, Ajay Vaidya, Aaron Wolfson, Jonathan Nattiv, Mark Barr, Amy Hackmann, Raymond Lee

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引用次数: 0

Abstract

Background: Surgical Biventricular Assist Devices (sBiVADs) are well-established in end-stage heart failure, while newer and less-invasive percutaneous BiVADs (pBiVADs) are understudied. We report these two approaches in the largest pBiVAD patient series to date METHODS: All consecutive BiVAD-supported patients at our institution from 2014 to 2023 were retrospectively reviewed (n=46). sBiVAD (n=27) and pBiVAD patients (n=19) (defined as Impella 5.5 with Impella RP [n = 4] or percutaneous oxygenated-right ventricular assist device [n = 15]) were compared.

Results: There were no significant differences in preoperative risk factors. pBiVAD patients required fewer intraoperative packed red blood cells (2.0 vs 6.0, p <0.001), fresh frozen plasma (0.0 vs 4.0, p=0.001), and platelet (0.0 vs 4.0, p=0.001) transfusions. pBiVADs had fewer unanticipated returns to the operating room (0.47 ± 0.70 vs 2.22 ± 1.87 per patient, p < 0.001) and fewer postoperative packed red blood cells (8.0 vs 27.0, p<0.001), fresh frozen plasma (1.0 vs 8.0, p<0.001) and platelet (0.0 vs 10.0, p<0.001) transfusions. Thirty-day survival was not significantly different between sBiVADs and pBiVADs (56.6% vs 36.8%, p = 0.341).

Conclusions: We consider pBiVAD a less invasive, viable bridge to transplant, durable left ventricular assist device, or recovery.

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手术与经皮双心室辅助装置支持患者的制度比较。

背景：外科双心室辅助装置（sBiVADs）在终末期心力衰竭中已经建立，而更新的、侵入性更小的经皮双心室辅助装置（pBiVADs）还在研究中。我们在迄今为止最大的pBiVAD患者系列中报告了这两种方法。方法：回顾性分析2014年至2023年在我们机构连续接受bivad治疗的患者（n=46）。比较sBiVAD （n=27）和pBiVAD患者（n=19）（定义为Impella 5.5与Impella RP [n = 4]或经皮充氧-右心室辅助装置[n = 15]）。结果：两组术前危险因素无显著差异。pBiVAD患者需要更少的术中填充红细胞（2.0 vs 6.0, p）。结论：我们认为pBiVAD是一种侵入性更小、可行的移植桥、耐用的左心室辅助装置或恢复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Thoracic Surgery 医学-呼吸系统

CiteScore

6.40

自引率

13.00%

发文量

1235

审稿时长

42 days

期刊介绍： The mission of The Annals of Thoracic Surgery is to promote scholarship in cardiothoracic surgery patient care, clinical practice, research, education, and policy. As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards. The Annals of Thoracic Surgery features: • Full-length original articles on clinical advances, current surgical methods, and controversial topics and techniques • New Technology articles • Case reports • "How-to-do-it" features • Reviews of current literature • Supplements on symposia • Commentary pieces and correspondence • CME • Online-only case reports, "how-to-do-its", and images in cardiothoracic surgery. An authoritative, clinically oriented, comprehensive resource, The Annals of Thoracic Surgery is committed to providing a place for all thoracic surgeons to relate experiences which will help improve patient care.