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Resternotomy does not adversely affect outcome after left ventricular assist device implantation
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688731/ https://www.ncbi.nlm.nih.gov/pubmed/29141690 http://dx.doi.org/10.1186/s40001-017-0289-2 |
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author | Papathanasiou, Maria Tsourelis, Loukas Pizanis, Nikolaus Koch, Achim Kamler, Markus Rassaf, Tienush Luedike, Peter |
author_facet | Papathanasiou, Maria Tsourelis, Loukas Pizanis, Nikolaus Koch, Achim Kamler, Markus Rassaf, Tienush Luedike, Peter |
author_sort | Papathanasiou, Maria |
collection | PubMed |
description | BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients. METHODS: The study included adult patients receiving a continuous-flow LVAD at our institution during the period 2010–2016. Postoperative adverse events and length of stay were analyzed. Survival was assessed at 6 months and by the end of the study. Multivariate risk factor analysis was conducted for independent predictors of death. RESULTS: One hundred twelve patients, who received an intrapericardial LVAD (HVAD, HeartWare), were included in our analysis. Twenty-four patients (21.4%) had a history of previous sternotomy. These patients were older and non-eligible for bridging, and had more frequently coronary heart disease. Univariate analysis demonstrated no differences in the observed complications postoperatively. Survival was similar among groups. Destination therapy was the only predictor of mortality in our analysis (p = 0.02). CONCLUSIONS: Resternotomy was not associated with worse outcomes after LVAD implantation in our cohort. |
format | Online Article Text |
id | pubmed-5688731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56887312017-11-24 Resternotomy does not adversely affect outcome after left ventricular assist device implantation Papathanasiou, Maria Tsourelis, Loukas Pizanis, Nikolaus Koch, Achim Kamler, Markus Rassaf, Tienush Luedike, Peter Eur J Med Res Research BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients. METHODS: The study included adult patients receiving a continuous-flow LVAD at our institution during the period 2010–2016. Postoperative adverse events and length of stay were analyzed. Survival was assessed at 6 months and by the end of the study. Multivariate risk factor analysis was conducted for independent predictors of death. RESULTS: One hundred twelve patients, who received an intrapericardial LVAD (HVAD, HeartWare), were included in our analysis. Twenty-four patients (21.4%) had a history of previous sternotomy. These patients were older and non-eligible for bridging, and had more frequently coronary heart disease. Univariate analysis demonstrated no differences in the observed complications postoperatively. Survival was similar among groups. Destination therapy was the only predictor of mortality in our analysis (p = 0.02). CONCLUSIONS: Resternotomy was not associated with worse outcomes after LVAD implantation in our cohort. BioMed Central 2017-11-15 /pmc/articles/PMC5688731/ /pubmed/29141690 http://dx.doi.org/10.1186/s40001-017-0289-2 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Papathanasiou, Maria Tsourelis, Loukas Pizanis, Nikolaus Koch, Achim Kamler, Markus Rassaf, Tienush Luedike, Peter Resternotomy does not adversely affect outcome after left ventricular assist device implantation |
title | Resternotomy does not adversely affect outcome after left ventricular assist device implantation |
title_full | Resternotomy does not adversely affect outcome after left ventricular assist device implantation |
title_fullStr | Resternotomy does not adversely affect outcome after left ventricular assist device implantation |
title_full_unstemmed | Resternotomy does not adversely affect outcome after left ventricular assist device implantation |
title_short | Resternotomy does not adversely affect outcome after left ventricular assist device implantation |
title_sort | resternotomy does not adversely affect outcome after left ventricular assist device implantation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688731/ https://www.ncbi.nlm.nih.gov/pubmed/29141690 http://dx.doi.org/10.1186/s40001-017-0289-2 |
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