The influence of less invasive ventricular assist device implantation on renal function

Ricklefs, Marcel; Heimeshoff, J.; Hanke, Jasmin S.; Chatterjee, Arijit; Doğan, Güneş; Shrestha, Malakh; Feldmann, C.; Wert, Leonhard; Haverich, Axel; Schmitto, Jan D.

doi:10.21037/jtd.2017.10.03

Cited by 15 publications

(8 citation statements)

References 25 publications

(28 reference statements)

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“…Therefore, the higher eGFR values in the LVAD group compared with the non-LVAD group at the time of waitlisting can reliably be explained by an LVAD-induced increase in eGFR values. Similar results have been reported by others [ 21 – 23 ]. Moreover, earlier studies also provided evidence that the increase in eGFR after LVAD implantation may be transient, but long-term data were limited.…”

Section: Discussionsupporting

confidence: 93%

Renal Function in Patients with or without a Left Ventricular Assist Device Implant During Listing for a Heart Transplant

et al. 2020

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Section: Discussionsupporting

confidence: 93%

Renal Function in Patients with or without a Left Ventricular Assist Device Implant During Listing for a Heart Transplant

et al. 2020

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“…Schmitto et al were the first to describe a minimally approach for LVAD implantation (6,9) using a left mini-thoracotomy and a J-shaped hemisternotomy (6,9). This less invasive technique for LVAD implantation is increasingly used worldwide, and there is now growing evidence of its benefits compared to the full sternotomy approach (10)(11)(12)(13)(14)(15). These studies have demonstrated the feasibility of this technique.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive surgery for left ventricular assist device implantation is safe and associated with a decreased risk of right ventricular failure

Carmona

Minh²,

Perrier³

et al. 2020

J Thorac Dis

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Background: Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is associated with significant mortality and morbidity. The objective of this study was to determine pre-and postoperative risk factors associated with the occurrence of RVF after LVAD implantation.Methods: This retrospective study included 68 patients who received LVADs between 2010 and 2018 either for bridge to transplant (40 patients, 58.8%) or bridge to destination therapy (28 patients, 41.2%). RVF after LVAD implantation was defined according to the INTERMACS classification. The primary endpoint was the occurrence of RVF. The secondary endpoints were hospital mortality and morbidity and long-term survival. Results:The majority of patients (61.8%) had an INTERMACS profile 1 (36.8%) or 2 (25.0%). The LVAD was implanted either by sternotomy (37 patients, 54.4%) or thoracotomy (31 patients, 45.6%). RVF after LVAD implantation was observed in 32 patients (47.1%). In univariate analysis, an elevated serum glutamic oxaloacetic transaminase (SGOT) (P=0.028) and a high preoperative vasoactive inotropic score (VIS) (P=0.028) were significantly associated with an increased risk of RVF, whereas the implantation of LVAD through a thoracotomy approach was associated with a significant reduction in this risk (P=0.006).The multivariate analysis demonstrated that only the thoracotomy approach was significantly associated with decreased risk of RVF (odds ratio =0.33, 95% confidence interval: 0.17-0.96; P=0.042). Hospital mortality was 53.1% and 5.6% in the RVF and control groups, respectively (P<0.0001). The incidence of stroke and postoperative acute renal failure were significantly increased in the RVF group compared with the control group. The survival after LVAD implantation was 33.5%±9.0% and 85.4%±6.0% at 1 year in the RVF and control groups, respectively (P<0.0001).Conclusions: LVAD implantation by thoracotomy significantly reduced the risk of postoperative RVF.This surgical approach should, therefore, be favored.

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“…Some demonstrated benefits to this approach have been decreased bleeding, improved renal function, and decreased right heart dysfunction. [32][33][34] . Most recently, the HeartWare Lateral Trial was reported.…”

Section: Minimally Invasive Left Ventricular Assist Device Placementmentioning

confidence: 99%

Noteworthy Cardiac Surgical Literature 2018: Value-Based Bundled Payments, Opioid Crisis and Cardiac Surgery, Percutaneous Suction Thrombectomy for Intracardiac/Caval Thrombus and Vegetations, and Minimally Invasive Left Ventricular Assist Device Placement

Aftab

Reece

Cleveland

et al. 2019

Semin Cardiothorac Vasc Anesth

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There has been tremendous evolution in the care of cardiac surgical patients in 2018. In this article, 4 topics of considerable impact on cardiac surgical care in the current landscape are reviewed based on recent publications. The first topic reviews the recent paradigm shift to value-based payments and the potential role of bundled payments on health care and physician reimbursement. The second topic highlights the impact of the opioid crisis on cardiac surgery. The third topic demonstrates the increasing utilization and expanding role of novel percutaneous suction thrombectomy technique in the extraction of caval and right-sided intracardiac thrombi and vegetations with veno-venous bypass. The final topic reviews the current trend of minimally invasive left ventricular assist device placement. Each of these topics addresses the contemporary issues in cardiac surgery with the reasoning for evolution in our current practices in 2018.

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The influence of less invasive ventricular assist device implantation on renal function

Abstract: LVAD implantation improves kidney function in patients with renal dysfunction. A considerable difference in the change of renal parameters was detected in patients with LIS as compared to SAS, which was not significant possibly due to the limited size of the patient cohort (n=13).

Cited by 15 publications

References 25 publications

Renal Function in Patients with or without a Left Ventricular Assist Device Implant During Listing for a Heart Transplant

Renal Function in Patients with or without a Left Ventricular Assist Device Implant During Listing for a Heart Transplant

Minimally invasive surgery for left ventricular assist device implantation is safe and associated with a decreased risk of right ventricular failure

Noteworthy Cardiac Surgical Literature 2018: Value-Based Bundled Payments, Opioid Crisis and Cardiac Surgery, Percutaneous Suction Thrombectomy for Intracardiac/Caval Thrombus and Vegetations, and Minimally Invasive Left Ventricular Assist Device Placement

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