Novel Plug Device for HeartMate 3 Explantation

Autor: Silvia Mariani, Tong Li, Anna Lassia Meyer, Tracy Geoffrion, Matthias Fittkau, Alexandra Schöde, Jasmin S. Hanke, Antonio Loforte, Axel Haverich, Jan D. Schmitto, Günes Dogan
Přispěvatelé: CTC, RS: Carim - V04 Surgical intervention
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Asaio Journal, 68(12), E262-E267. LIPPINCOTT WILLIAMS & WILKINS
ISSN: 1058-2916
DOI: 10.1097/MAT.0000000000001760
Popis: Patients undergoing explantation of left ventricular assist devices (LVADs) after improvement of myocardial function remain a minority. Nevertheless, considering the growing population of LVAD patients, increasing demand for new explantation strategies is expected. Herein, we present a retrospective review of seven patients undergoing HeartMate3 explantation with the use of a custom-made apical ring plug in four medical centers. The primary outcome was status at intensive care unit discharge. Secondary outcomes included perioperative complications and transfusions. Six out of seven patients were males. The median age at explantation and time on LVAD support was 35 years (range:13-73) and 10 months (range:9-24), respectively. No technical difficulties were experienced during plug implantation via a conventional sternotomy or through a left lateral thoracotomy, either with or without cardiopulmonary bypass. Perioperative transfusions ranged from 0 to 3 units/patient. No re-operations for bleeding, hemorrhagic, embolic, or plug-related infective events were observed. Heparin was started 6 hours after surgery as a bridge to oral anticoagulation (international normalized ratio: 2-2.5). All patients were discharged alive from intensive care unit. This novel plug device for HeartMate3 explantation was successfully and safely implanted in this first patient series. Notwithstanding, its use should still be considered off-label and larger studies are required to investigate its long-term results.
Databáze: OpenAIRE