Outcomes Among Patients Bridged to Heart Transplant with Microaxial Flow Versus Durable Left Ventricular Assist Device Support.

IF 4.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-10-07 DOI:10.1016/j.jtcvs.2025.09.050

Alejandro Alvarez, Krish C Dewan, Carmelo A Milano, Oliver K Jawitz, Abigail R Benkert, Jacqueline K Olive, Allison Berryan, Isabella Peralta, Chetan B Patel, Richa Agarwal, Adam D DeVore, Sharon McCartney, Jacob N Schroder, Jeffrey E Keenan

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引用次数: 0

Abstract

Objective: To evaluate characteristics and outcomes of patients bridged to OHT with microaxial (ma-LVAD) versus durable (d-LVAD) left ventricular assist devices.

Methods: This was a single-center retrospective cohort study in which characteristics outcomes of patients undergoing OHT between May 2019 and May 2024 who were bridged with ma-LVAD versus d-LVAD, were compared.

Results: Over the study period, the percentage of patients bridged with ma-LVAD increased from 0% to 20%. Patients bridged with d-LVAD were more likely to have history of hypertension (80% vs 65%; p=0.03), a higher BMI (32.53 kg/m2 vs 28.15 kg/m2; p=<0.0001), and anti-HLA antibodies (54% vs 36%; p=0.02) prior to transplant, otherwise groups were similar in their baseline characteristics. Unadjusted Kaplan-Meier analysis demonstrated no difference in survival between these two bridging strategies. However, postoperative blood product usage (3 units vs 0 units, p<0.0001), moderate or severe primary graft dysfunction (27% vs 14%; p=0.04), and delayed sternal closure (45% vs 9%, p=<0.0001) were all higher among those bridged with d-LVAD versus ma-LVAD. Rejection on the first postoperative biopsy was reported in a 60% in the d-LVAD group versus 33% in the ma-LVAD group (p=0.0006). Postoperative intensive care unit (7 days vs 6 days, p=0.03) and overall postoperative length of stay (17 days vs 12 days, p=0.002) were greater in patients bridged with d-LVAD versus ma-LVAD, respectively.

Conclusion: The use of ma-LVAD compared to d-LVAD as a bridging strategy was not associated with differences in survival. However, bridging with ma-LVAD compared to d-LVAD was associated with lower post-OHT morbidity.

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微轴流与持久左心室辅助装置支持的心脏移植桥接患者的结果

目的：评估使用微轴左心室辅助装置（ma-LVAD）与耐用左心室辅助装置（d-LVAD）桥接OHT患者的特征和结果。方法：这是一项单中心回顾性队列研究，比较2019年5月至2024年5月期间接受OHT的ma-LVAD与d-LVAD桥接的患者的特征结局。结果：在研究期间，ma-LVAD桥接的患者比例从0%增加到20%。用d-LVAD桥接的患者更有可能有高血压史（80% vs 65%; p=0.03）， BMI更高(32.53 kg/m2 vs 28.15 kg/m2; p=结论：使用ma-LVAD与使用d-LVAD作为桥接策略与生存率差异无关。然而，与d-LVAD相比，ma-LVAD桥接与oht后发病率较低相关。

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

Journal of Thoracic and Cardiovascular Surgery 医学-呼吸系统

CiteScore

11.20

自引率

10.00%

发文量

1079

审稿时长

68 days

期刊介绍： The Journal of Thoracic and Cardiovascular Surgery presents original, peer-reviewed articles on diseases of the heart, great vessels, lungs and thorax with emphasis on surgical interventions. An official publication of The American Association for Thoracic Surgery and The Western Thoracic Surgical Association, the Journal focuses on techniques and developments in acquired cardiac surgery, congenital cardiac repair, thoracic procedures, heart and lung transplantation, mechanical circulatory support and other procedures.