-
Je něco špatně v tomto záznamu ?
Influence of implant strategy on the transition from temporary left ventricular assist device to durable mechanical circulatory support
AL. Meyer, D. Lewin, M. Billion, S. Hofmann, I. Netuka, J. Belohlavek, K. Jawad, D. Saeed, B. Schmack, SV. Rojas, J. Gummert, A. Bernhardt, G. Färber, J. Kooij, B. Meyns, A. Loforte, M. Pieri, AM. Scandroglio, P. Akhyari, MK. Szymanski, CH....
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články, multicentrická studie
NLK
Free Medical Journals
od 1987
Medline Complete (EBSCOhost)
od 2012-11-01 do Před 1 rokem
PubMed
39259187
DOI
10.1093/ejcts/ezae333
Knihovny.cz E-zdroje
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- podpůrné srdeční systémy * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- srdeční selhání * chirurgie terapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
OBJECTIVES: Bridging from a temporary microaxial left ventricular assist device (tLVAD) to a durable left ventricular assist device (dLVAD) is playing an increasing role in the treatment of terminally ill patients with heart failure. Scant data exist about the best implant strategy. The goal of this study was to analyse differences in the dLVAD implant technique and effects on patient outcomes. METHODS: Data from 341 patients (19 European centres) who underwent a bridge-to-bridge implant from tLVAD to dLVAD between January 2017 and October 2022 were retrospectively analysed. The outcomes of the different implant techniques with the patient on cardiopulmonary bypass, extracorporeal life support or tLVAD were compared. RESULTS: A durable LVAD implant was performed employing cardiopulmonary bypass in 70% of cases (n = 238, group 1), extracorporeal life support in 11% (n = 38, group 2) and tLVAD in 19% (n = 65, group 3). Baseline characteristics showed no significant differences in age (P = 0.140), body mass index (P = 0.388), creatinine level (P = 0.659), the Model for End-Stage Liver Disease (MELD) score (P = 0.190) and rate of dialysis (P = 0.110). Group 3 had significantly fewer patients with preoperatively invasive ventilation and cardiopulmonary resuscitation before the tLVAD was implanted (P = 0.009 and P < 0.001 respectively). Concomitant procedures were performed more often in groups 1 and 2 compared to group 3 (24%, 37% and 5%, respectively, P < 0.001). The 30-day mortality data showed significantly better survival after an inverse probability of treatment weighting in group 3, but the 1-year mortality showed no significant differences among the groups (P = 0.012 and 0.581, respectively). Postoperative complications like the rate of right ventricular assist device (RVAD) implants or re-thoracotomy due to bleeding, postoperative respiratory failure and renal replacement therapy showed no significant differences among the groups. Freedom from the first adverse event like stroke, driveline infection or pump thrombosis during follow-up was not significantly different among the groups. Postoperative blood transfusions within 24 h were significantly higher in groups 1 and 2 compared to surgery on tLVAD support (P < 0.001 and P = 0.003, respectively). CONCLUSIONS: In our analysis, the transition from tLVAD to dLVAD without further circulatory support did not show a difference in postoperative long-term survival, but a better 30-day survival was reported. The implant using only tLVAD showed a reduction in postoperative transfusion rates, without increasing the risk of postoperative stroke or pump thrombosis. In this small cohort study, our data support the hypothesis that a dLVAD implant on a tLVAD is a safe and feasible technique in selected patients.
Department of Anesthesia and Intensive Care IRCCS San Raffaele Scientific Institute Milan Italy
Department of Cardiac and Vascular Surgery University of Mainz Mainz Germany
Department of Cardiac Surgery Heart Center Bonn University Hospital Bonn Bonn Germany
Department of Cardiac Surgery Heidelberg University Hospital Heidelberg Germany
Department of Cardiac Surgery Leipzig Heart Center Leipzig Germany
Department of Cardiac Surgery Schüchtermann Clinic Bad Rothenfelde Germany
Department of Cardiac Surgery University Hospital Leuven Leuven Belgium
Department of Cardiology Rigshospitalet Copenhagen Denmark
Department of Cardiology University Medical Center Utrecht Utrecht Netherlands
Department of Cardiothoracic and Vascular Surgery Deutsches Herzzentrum der Charité Berlin Germany
Department of Cardiothoracic Surgery Rigshospitalet Copenhagen Denmark
Department of Cardiothoracic Surgery University Hospital Cologne Cologne Germany
Department of Cardiothoracic Surgery University Hospital RTWH Aachen Aachen Germany
Department of Cardiovascular Surgery University Heart Center Hamburg Hamburg Germany
Department of Cardiovascular Surgery University Hospital Schleswig Holstein Kiel Germany
Department of Surgical Sciences University of Turin Turin Italy
Division of Cardiac Surgery Department of Surgery Medical University of Vienna Vienna Austria
Citace poskytuje Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc25004008
- 003
- CZ-PrNML
- 005
- 20250206105035.0
- 007
- ta
- 008
- 250121s2024 gw f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1093/ejcts/ezae333 $2 doi
- 035 __
- $a (PubMed)39259187
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a gw
- 100 1_
- $a Meyer, A L $u Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany $1 https://orcid.org/0000000248338014
- 245 10
- $a Influence of implant strategy on the transition from temporary left ventricular assist device to durable mechanical circulatory support / $c AL. Meyer, D. Lewin, M. Billion, S. Hofmann, I. Netuka, J. Belohlavek, K. Jawad, D. Saeed, B. Schmack, SV. Rojas, J. Gummert, A. Bernhardt, G. Färber, J. Kooij, B. Meyns, A. Loforte, M. Pieri, AM. Scandroglio, P. Akhyari, MK. Szymanski, CH. Moller, F. Gustafsson, M. Medina, M. Oezkur, D. Zimpfer, I. Krasivskyi, I. Djordjevic, A. Haneya, J. Stein, P. Lanmueller, EV. Potapov, J. Kremer
- 520 9_
- $a OBJECTIVES: Bridging from a temporary microaxial left ventricular assist device (tLVAD) to a durable left ventricular assist device (dLVAD) is playing an increasing role in the treatment of terminally ill patients with heart failure. Scant data exist about the best implant strategy. The goal of this study was to analyse differences in the dLVAD implant technique and effects on patient outcomes. METHODS: Data from 341 patients (19 European centres) who underwent a bridge-to-bridge implant from tLVAD to dLVAD between January 2017 and October 2022 were retrospectively analysed. The outcomes of the different implant techniques with the patient on cardiopulmonary bypass, extracorporeal life support or tLVAD were compared. RESULTS: A durable LVAD implant was performed employing cardiopulmonary bypass in 70% of cases (n = 238, group 1), extracorporeal life support in 11% (n = 38, group 2) and tLVAD in 19% (n = 65, group 3). Baseline characteristics showed no significant differences in age (P = 0.140), body mass index (P = 0.388), creatinine level (P = 0.659), the Model for End-Stage Liver Disease (MELD) score (P = 0.190) and rate of dialysis (P = 0.110). Group 3 had significantly fewer patients with preoperatively invasive ventilation and cardiopulmonary resuscitation before the tLVAD was implanted (P = 0.009 and P < 0.001 respectively). Concomitant procedures were performed more often in groups 1 and 2 compared to group 3 (24%, 37% and 5%, respectively, P < 0.001). The 30-day mortality data showed significantly better survival after an inverse probability of treatment weighting in group 3, but the 1-year mortality showed no significant differences among the groups (P = 0.012 and 0.581, respectively). Postoperative complications like the rate of right ventricular assist device (RVAD) implants or re-thoracotomy due to bleeding, postoperative respiratory failure and renal replacement therapy showed no significant differences among the groups. Freedom from the first adverse event like stroke, driveline infection or pump thrombosis during follow-up was not significantly different among the groups. Postoperative blood transfusions within 24 h were significantly higher in groups 1 and 2 compared to surgery on tLVAD support (P < 0.001 and P = 0.003, respectively). CONCLUSIONS: In our analysis, the transition from tLVAD to dLVAD without further circulatory support did not show a difference in postoperative long-term survival, but a better 30-day survival was reported. The implant using only tLVAD showed a reduction in postoperative transfusion rates, without increasing the risk of postoperative stroke or pump thrombosis. In this small cohort study, our data support the hypothesis that a dLVAD implant on a tLVAD is a safe and feasible technique in selected patients.
- 650 _2
- $a lidé $7 D006801
- 650 12
- $a podpůrné srdeční systémy $7 D006353
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a retrospektivní studie $7 D012189
- 650 _2
- $a lidé středního věku $7 D008875
- 650 12
- $a srdeční selhání $x chirurgie $x terapie $7 D006333
- 650 _2
- $a senioři $7 D000368
- 650 _2
- $a výsledek terapie $7 D016896
- 650 _2
- $a dospělí $7 D000328
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a multicentrická studie $7 D016448
- 700 1_
- $a Lewin, D $u Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany
- 700 1_
- $a Billion, M $u Department of Cardiac Surgery, Schüchtermann Clinic, Bad Rothenfelde, Germany
- 700 1_
- $a Hofmann, S $u Department of Cardiac Surgery, Schüchtermann Clinic, Bad Rothenfelde, Germany
- 700 1_
- $a Netuka, I $u Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- 700 1_
- $a Belohlavek, J $u Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic $u Second Department of Internal Medicine, Cardiovascular Medicine, General Teaching Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic $1 https://orcid.org/0000000194559224 $7 xx0077681
- 700 1_
- $a Jawad, K $u Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany
- 700 1_
- $a Saeed, D $u Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany $1 https://orcid.org/0000000174499455 $7 xx0321697
- 700 1_
- $a Schmack, B $u Department of Cardiothoracic, Transplantation and Vascular Surgery, Hanover Medical School, Hanover, Germany
- 700 1_
- $a Rojas, S V $u Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center of North Rhine-Westphalia, Bad Oeynhausen, Germany $1 https://orcid.org/0000000295051358
- 700 1_
- $a Gummert, J $u Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center of North Rhine-Westphalia, Bad Oeynhausen, Germany $1 https://orcid.org/0000000269569110
- 700 1_
- $a Bernhardt, A $u Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
- 700 1_
- $a Färber, G $u Department of Cardiac Surgery, Saarland University Medical Center and Saarland University Homburg/Saar, Homburg, Germany
- 700 1_
- $a Kooij, J $u Department of Cardiac Surgery, University Hospital Leuven, Leuven, Belgium
- 700 1_
- $a Meyns, B $u Department of Cardiac Surgery, University Hospital Leuven, Leuven, Belgium $1 https://orcid.org/0000000281104009
- 700 1_
- $a Loforte, A $u Department of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy $u Department of Surgical Sciences, University of Turin, Turin, Italy $1 https://orcid.org/0000000236890477
- 700 1_
- $a Pieri, M $u Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
- 700 1_
- $a Scandroglio, A M $u Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
- 700 1_
- $a Akhyari, P $u Department of Cardiothoracic Surgery, University Hospital RTWH Aachen, Aachen, Germany
- 700 1_
- $a Szymanski, M K $u Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
- 700 1_
- $a Moller, C H $u Department of Cardiothoracic Surgery Rigshospitalet, Copenhagen, Denmark
- 700 1_
- $a Gustafsson, F $u Department of Cardiology, Rigshospitalet, Copenhagen, Denmark $1 https://orcid.org/000000032144341X
- 700 1_
- $a Medina, M $u Department of Cardiac and Vascular Surgery, University of Mainz, Mainz, Germany
- 700 1_
- $a Oezkur, M $u Department of Cardiac and Vascular Surgery, University of Mainz, Mainz, Germany $1 https://orcid.org/000000021284066X
- 700 1_
- $a Zimpfer, D $u Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria $1 https://orcid.org/0000000221854895
- 700 1_
- $a Krasivskyi, I $u Department of Cardiac Surgery, Heart Center Bonn, University Hospital Bonn, Bonn, Germany
- 700 1_
- $a Djordjevic, I $u Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany
- 700 1_
- $a Haneya, A $u Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
- 700 1_
- $a Stein, J $u Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany
- 700 1_
- $a Lanmueller, P $u Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany $u DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany
- 700 1_
- $a Potapov, E V $u Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany $u DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany
- 700 1_
- $a Kremer, J $u Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
- 773 0_
- $w MED00001607 $t European journal of cardio-thoracic surgery $x 1873-734X $g Roč. 66, č. 4 (2024)
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/39259187 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y - $z 0
- 990 __
- $a 20250121 $b ABA008
- 991 __
- $a 20250206105030 $b ABA008
- 999 __
- $a ok $b bmc $g 2263634 $s 1240015
- BAS __
- $a 3
- BAS __
- $a PreBMC-MEDLINE
- BMC __
- $a 2024 $b 66 $c 4 $e 20241001 $i 1873-734X $m European journal of cardio-thoracic surgery $n Eur J Cardiothorac Surg $x MED00001607
- LZP __
- $a Pubmed-20250121
