Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices

Zhigalov, Konstantin; Eynde, Jef Van den; Chrosch, Thomas; Goerdt, Lukas; Rad, Arian Arjomandi; Vardanyan, Robert; Luedike, Peter; Pizanis, Nikolaus; Koch, Achim; Schmack, Bastian; Kamler, Markus; Ruhparwar, Arjang; Weymann, Alexander

doi:10.1111/aor.14099

Cited by 13 publications

(16 citation statements)

References 21 publications

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“…We recently read with interest the study by Zhigalov et al about CytoSorb during left ventricular assist device (LVAD) implantation. 1 The rather unexpected, unfavorable results presented and the concurrent lack of CytoSorb's efficacy in diminishing the inflammation postoperatively temper the previous enthusiasm. In our opinion, several points of this study should be clarified when interpreting its results.…”

Section: E T T E R T O T H E E D I T O R Unexpected Negative Results ...mentioning

confidence: 99%

Unexpected negative results for CytoSorb during left ventricular assist device implantation: interpret with caution

2022

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Section: E T T E R T O T H E E D I T O R Unexpected Negative Results ...mentioning

confidence: 99%

Unexpected negative results for CytoSorb during left ventricular assist device implantation: interpret with caution

2022

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“…There is a lack of data on patient‐focused parameters such as quality‐of‐life and functional status, and systematic collection of this information is necessary to support this unique patient population effectively 52 . Future efforts should focus on reducing adverse outcomes in high‐risk groups, 53 such as those with concomitant TR 54 . Zuberevich et al 8 suggested the potential benefits of operative TR resolution in cases where it accompanies severe levels of pre‐operative MR.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of mitral regurgitation in patients undergoing left ventricular assist device deployment: A systematic review and meta‐analysis

et al. 2023

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BackgroundLeft ventricular assist devices (LVADs) represent an important therapeutic option for patients progressing to end‐stage heart failure. LVAD has previously been shown to have a promising role in improving mitral regurgitation (MR). Nevertheless, the prognostic value of preoperative uncorrected MR in this population remains unclear.MethodsA systematic database search with meta‐analysis was conducted of comparative original articles of patients with preoperative mild MR (Grade 0–I) versus moderate–severe MR (Grade II–III) undergoing LVAD implantation, in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to June 2022. Primary outcomes were overall and operative mortality. Secondary outcomes were neurological dysfunction, gastrointestinal bleeding, right heart failure, LVAD thrombosis, and driveline infection.ResultsOur search yielded 2228 relevant studies. A total of 19 studies met the inclusion criteria with a total of 11 873 patients. LVAD caused a statistically significant decrease of 35.9% in the number of patients with moderate–severe MR (grade II–III) postoperatively. No significant difference was observed in terms of overall mortality, operative mortality, GI bleeding, LVAD thrombosis, and driveline infection rates between mild and moderate–severe MR. An increased rate of right heart failure was seen among patients with moderate–severe MR, while lower rates of neurological events were also observed.ConclusionLVAD improves the haemodynamics of the left ventricle, to promote resolution of MR. Nevertheless, the severity of preoperative mitral regurgitation in patients undergoing LVAD deployment does not seem to affect mortality.

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“…One article, published in 2022, reported on hemoadsorption use intraoperatively during left ventricular assist device (LVAD) implantation (28). A propensity score-matched comparison of 72 patients who received intraoperative hemoadsorption and 40 who did not, revealed a significantly higher incidence of respiratory failure within the intervention group, and higher rates of prolonged mechanical ventilation and tracheostomy.…”

Section: Lvadmentioning

confidence: 99%

The role of hemoadsorption in cardiac surgery – a systematic review

Matejic-Spasic,

Lindstedt,

Lebreton

et al. 2024

Preprint

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Background Despite advancements, cardiopulmonary bypass-assisted cardiac surgery still carries a significant risk for morbidity and mortality, often related to postoperative hyperinflammation. Hemoadsorption of cytokines and various exogenous and endogenous inflammation triggers has been increasingly used in cardiac surgery to mitigate the risk of inflammation-mediated complications. Clinical evidence so far has not provided definite answers concerning this adjunctive treatment. The current systematic review aimed to assess the role of perioperative hemoadsorption in cardiac surgery critically. Methods A PubMed literature search with predefined criteria was conducted. The screening and selection process followed rigorous scientific principles (PRISMA statement). The search resulted in 29 publications that were grouped and descriptively analyzed due to the remarkable variability in study designs, however, they all reported exclusively on CytoSorb® therapy. Results CytoSorb® use was proven feasible and safe with no unanticipated device-related adverse events reported in the retrieved articles. The most frequently reported clinical outcome associated with hemoadsorption was reduced vasopressor demand resulting in better hemodynamic stability. Conclusions The role of hemoadsorption in cardiac surgery seems to be justified in selected high-risk cases in infective endocarditis, aortic surgery, heart transplantation, and emergency surgery of patients under antithrombotic therapy, as well as in those who develop a dysregulated inflammatory response, vasoplegia, or septic shock postoperatively. Current evidence suggests limited value from CytoSorb® use in routine elective surgery and low-risk patients. Further evaluation in more extensive prospective trials is required concerning proper patient selection and postoperative timing and administration.

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Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 13 publications

References 21 publications

Unexpected negative results for CytoSorb during left ventricular assist device implantation: interpret with caution

Unexpected negative results for CytoSorb during left ventricular assist device implantation: interpret with caution

Prognostic value of mitral regurgitation in patients undergoing left ventricular assist device deployment: A systematic review and meta‐analysis

The role of hemoadsorption in cardiac surgery – a systematic review

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