Technology and technique for left ventricular assist device optimization: A Bi-Tech solution.

Autor: Tarzia V; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy., Ponzoni M; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy., Giammarco GD; Cardiac Surgery, University of Chieti, Chieti, Italy., Maccherini M; Cardiac Surgery, University of Siena, Siena, Italy., Maiani M; Cardiac Surgery, University of Udine, Udine, Italy., Agostoni P; Cardiac Surgery, University of Milan, Milan, Italy., Bagozzi L; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy., Marinelli D; Cardiac Surgery, University of Chieti, Chieti, Italy., Apostolo A; Cardiac Surgery, University of Milan, Milan, Italy., Bernazzali S; Cardiac Surgery, University of Siena, Siena, Italy., Ortis H; Cardiac Surgery, University of Udine, Udine, Italy., Mauro MD; Cardiac Surgery, University of Chieti, Chieti, Italy., Bortolussi G; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy., Sani G; Cardiac Surgery, University of Siena, Siena, Italy., Bottio T; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy., Scuri S; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy., Livi U; Cardiac Surgery, University of Udine, Udine, Italy., Alamanni F; Cardiac Surgery, University of Milan, Milan, Italy., Gerosa G; Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2022 Dec; Vol. 46 (12), pp. 2486-2492. Date of Electronic Publication: 2022 Aug 30.
DOI: 10.1111/aor.14368
Abstrakt: Background: We investigated the synergistic effect of the new cone-bearing design of Jarvik 2000 (Jarvik Heart Inc., NY) together with a minimally-invasive approach to outcomes of LVAD patients.
Methods: We retrospectively reviewed all patients from 5 institutions involved in the Jarvik 2000 Italian Registry, from October 2008 to October 2016. Patients were divided into three groups according to pump design and implantation technique: pin-bearing design and conventional approach (Group 1); cone-bearing and conventional approach (Group 2); cone-bearing and minimally-invasive implantation (Group 3).
Results: A total of 150 adult patients with end-stage heart failure were enrolled: 26 subjects in Group 1, 74 in Group 2, and 50 in Group 3. Nineteen patients (73%) in Group 1, 51 (69%) in Group 2, and 36 (72%) in Group 3 were discharged. During follow-up, 22 patients underwent transplantation, while in 3 patients the LVAD was explanted. The overall 1-year survival was 58 ± 10%, 64 ± 6%, and 74% ± 7% in Groups 1, 2, and 3, respectively (p = 0.034). The competing-risks-adjusted cumulative incidence rate for adverse events was 42.1 [27-62.7] per 100 patient-years in Group 1, 35.4 [25.3-48.2] in Group 2, and 22.1 [12.4-36.4] in Group 3 (p = 0.046 for Group 1 vs. 3).
Conclusions: The association of the modern cone-bearing configuration of Jarvik 2000 and minimally invasive surgery improved survival and minimized the risk for cardiovascular events, as a result of combining technology and technique.
(© 2022 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.)
Databáze: MEDLINE
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