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Thorac Cardiovasc Surg 2019; 67(03): 183-190
DOI: 10.1055/s-0038-1676841
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Impact of Previous Sternotomy on Outcome after Left Ventricular Assist Device Implantation

Konstantin Zhigalov
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
,
Marcin Szczechowicz
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
,
Ahmed Mashhour
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
,
Sabreen Mkalaluh
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
,
Maxim Isaev
2   Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
,
Bakitbek Kadyraliev
3   Federal Center of Cardiovascular Surgery Named after S.G. Sukhanov, Perm State Medical University, Perm, Russian Federation
,
Jerry Easo
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
,
Juergen Ennker
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
,
Harald Eichstaedt
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
,
Alexander Weymann
1   Department of Cardiac Surgery, Klinikum Oldenburg, Carl-von-Ossietzky University Oldenburg, Oldenburg, Germany
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Publikationsverlauf

29. Juli 2018

19. November 2018

Publikationsdatum:
08. Januar 2019 (online)

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Abstract

Background The main purpose of this article is to investigate the impact of previous sternotomy (PS) on the outcome of three different left ventricular assist devices (LVAD).

Methods Between June 2007 and February 2018, a total of 121 patients received HeartMate II (60.3%), HeartWare (12.4%), or HeartMate III (27.3%), with or without previous sternotomy (PS and non-PS groups, respectively). Propensity matching resulted in 44 patient pairs. The primary end point was overall survival at 30 days, 1 year, 2, and 5 years, postoperatively. Secondary end points were adverse events.

Results The overall cumulative survival rates for the two study groups were significantly different (77, 63, 54, and 38% for non-PS group vs 64, 39, 27, and 24% for PS group, p = 0.036). In the PS group, there was a higher need for intraoperative implantation of short-term right ventricular assist device (22.7 vs 6.8%, p = 0.034) and a higher incidence of hepatic dysfunction (20.5 vs 4.5%, p = 0.025) and acute kidney dysfunction (40.9 vs 20.5%, p = 0.032).

Conclusion PS is a reliable predictor of mortality and morbidity after LVAD implantation.

Keywords

left ventricular assist device - heart failure - previous sternotomy
 

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