Less invasive implantation of third-generation left ventricular assist devices: a single center experience.

IF 1.8 4区医学 Q2 SURGERY

Minimally Invasive Therapy & Allied Technologies Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI:10.1080/13645706.2025.2597749

Antonio Spitaleri, Giuseppe Monteleone, Paola Abbà, Barbara Parrella, Guglielmo Gallone, Simone Frea, Anna Chiara Trompeo, Massimo Boffini, Mauro Rinaldi, Antonio Loforte

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引用次数: 0

Abstract

Background: This study evaluates outcomes of less invasive surgery (LIS) versus full sternotomy (FS) for left ventricular assist device (LVAD) implantation.

Methods: We retrospectively analyzed 115 consecutive adult patients receiving HeartMate 3 (HM3) or HeartWare (HVAD) intrapericardial centrifugal left ventricular assist device (LVAD) implantation (2010-2023) stratified by LIS vs. FS. Primary endpoint was one-year survival; secondary endpoints included right heart failure (RHF), temporary right ventricular assist device (t-RVAD) use, rethoracotomy for bleeding, driveline infection (DLI), cerebral stroke (CS), pump thrombosis (PT), gastrointestinal bleeding (GIB), and extubation time.

Results: The cohort included 24 LIS and 91 FS patients. LIS patients exhibited higher pulmonary artery pressures, pulmonary vascular resistance, and tricuspid regurgitation rate, along with lower pulmonary artery compliance index (all p < 0.05). LIS had significantly lower cardiopulmonary bypass (CPB) use (62.5% vs. 100%), and duration (60 vs. 92.5 min), and reduced blood product utilization (all p < 0.05). No cases of rethoracotomy for bleeding occurred (p = 0.037). A trend toward lower RHF and t-RVAD use was observed. Kaplan-Meier analysis revealed no significant differences in one-year survival and LVAD-related adverse events.

Conclusions: LIS showed comparable outcomes to FS, representing a potential alternative for selected LVAD recipients.

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第三代左室辅助装置的微创植入：单中心体验。

背景：本研究评估了微创手术（LIS）与全胸骨切开术（FS）在左心室辅助装置（LVAD）植入中的效果。方法：我们回顾性分析了2010-2023年连续115例接受心脏伴侣3 （HM3）或心脏软件（HVAD）心包内离心式左心室辅助装置（LVAD）植入的成人患者，采用LIS和FS分层。主要终点为1年生存率；次要终点包括右心衰（RHF）、临时右心室辅助装置（t-RVAD）的使用、因出血而开胸、传动系统感染（DLI）、脑卒中（CS）、泵血栓形成（PT）、胃肠道出血（GIB）和拔管时间。结果：该队列包括24例LIS和91例FS患者。LIS患者肺动脉压、肺血管阻力、三尖瓣返流率较高，肺动脉顺应性指数较低（p < 0.05）。观察到有降低RHF和t-RVAD使用的趋势。Kaplan-Meier分析显示一年生存率和lvad相关不良事件无显著差异。结论：LIS显示出与FS相当的结果，代表了LVAD受者的潜在选择。

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

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.