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Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?

Background and Objectives: Since the first use of ventricular assist devices (VADs) as bridge to recovery and bridge to cardiac transplantation in the early 1990s, significant technological advances have transformed VAD implantation into a routine destination therapy. With improved survival, many pa...

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Autores principales: Berger, Rafal, Nemeth, Attila, Salewski, Christoph, Sandoval Boburg, Rodrigo, Acharya, Metesh, Weymann, Alexander, Zhigalov, Konstantin, Schmack, Bastian, Sá, Michel Pompeu B. O., Schlensak, Christian, Popov, Aron-Frederik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559908/
https://www.ncbi.nlm.nih.gov/pubmed/32842512
http://dx.doi.org/10.3390/medicina56090424
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author Berger, Rafal
Nemeth, Attila
Salewski, Christoph
Sandoval Boburg, Rodrigo
Acharya, Metesh
Weymann, Alexander
Zhigalov, Konstantin
Schmack, Bastian
Sá, Michel Pompeu B. O.
Schlensak, Christian
Popov, Aron-Frederik
author_facet Berger, Rafal
Nemeth, Attila
Salewski, Christoph
Sandoval Boburg, Rodrigo
Acharya, Metesh
Weymann, Alexander
Zhigalov, Konstantin
Schmack, Bastian
Sá, Michel Pompeu B. O.
Schlensak, Christian
Popov, Aron-Frederik
author_sort Berger, Rafal
collection PubMed
description Background and Objectives: Since the first use of ventricular assist devices (VADs) as bridge to recovery and bridge to cardiac transplantation in the early 1990s, significant technological advances have transformed VAD implantation into a routine destination therapy. With improved survival, many patients present for cardiac surgery for conditions not directly related to their permanent mechanical circulatory support. The aim of this study was to analyze the indications and outcomes of non-cardiac surgeries (NCSs) of left ventricular assist device (LVAD) patients in tertiary center. Material and Methods: We present a single-center experience after 151 LVAD implantations in 138 consecutive patients between 2012–2019 who had to undergo NCS during a follow-up period of 37 +/− 23.4 months on left ventricular assist device (LVAD). Results: A total of 105 procedures was performed in 63 LVAD recipients, resulting in peri-operative mortality of 3.8%. Twenty-five (39.7%) of patients underwent multiple surgeries. We found no significant difference in cumulative survival associated with the performed surgical interventions (p = 0.469). Conclusion: We demonstrated good overall clinical outcomes in LVAD patients undergoing NCS. With acceptable peri-operative mortality, NCS can be safely performed in LVAD patients on long-term support.
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spelling pubmed-75599082020-10-22 Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery? Berger, Rafal Nemeth, Attila Salewski, Christoph Sandoval Boburg, Rodrigo Acharya, Metesh Weymann, Alexander Zhigalov, Konstantin Schmack, Bastian Sá, Michel Pompeu B. O. Schlensak, Christian Popov, Aron-Frederik Medicina (Kaunas) Article Background and Objectives: Since the first use of ventricular assist devices (VADs) as bridge to recovery and bridge to cardiac transplantation in the early 1990s, significant technological advances have transformed VAD implantation into a routine destination therapy. With improved survival, many patients present for cardiac surgery for conditions not directly related to their permanent mechanical circulatory support. The aim of this study was to analyze the indications and outcomes of non-cardiac surgeries (NCSs) of left ventricular assist device (LVAD) patients in tertiary center. Material and Methods: We present a single-center experience after 151 LVAD implantations in 138 consecutive patients between 2012–2019 who had to undergo NCS during a follow-up period of 37 +/− 23.4 months on left ventricular assist device (LVAD). Results: A total of 105 procedures was performed in 63 LVAD recipients, resulting in peri-operative mortality of 3.8%. Twenty-five (39.7%) of patients underwent multiple surgeries. We found no significant difference in cumulative survival associated with the performed surgical interventions (p = 0.469). Conclusion: We demonstrated good overall clinical outcomes in LVAD patients undergoing NCS. With acceptable peri-operative mortality, NCS can be safely performed in LVAD patients on long-term support. MDPI 2020-08-23 /pmc/articles/PMC7559908/ /pubmed/32842512 http://dx.doi.org/10.3390/medicina56090424 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Berger, Rafal
Nemeth, Attila
Salewski, Christoph
Sandoval Boburg, Rodrigo
Acharya, Metesh
Weymann, Alexander
Zhigalov, Konstantin
Schmack, Bastian
Sá, Michel Pompeu B. O.
Schlensak, Christian
Popov, Aron-Frederik
Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?
title Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?
title_full Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?
title_fullStr Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?
title_full_unstemmed Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?
title_short Is it Safe for Patients with Left Ventricular Assist Devices to Undergo Non-Cardiac Surgery?
title_sort is it safe for patients with left ventricular assist devices to undergo non-cardiac surgery?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559908/
https://www.ncbi.nlm.nih.gov/pubmed/32842512
http://dx.doi.org/10.3390/medicina56090424
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