Effect of cardiac arrest with aortic cross-clamping during left ventricular assist device implantation
| Autor: | Qianzi Zhang, Masashi Kawabori, Yuji Kaku, Chitaru Kurihara, Andrew B. Civitello, Brendan Chou, Jeffrey A. Morgan, Andre C. Critsinelis |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Adult Male medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications law Risk Factors Internal medicine medicine Cardiopulmonary bypass Humans 030212 general & internal medicine Stroke Aorta Aged Proportional Hazards Models Retrospective Studies Heart Failure Proportional hazards model business.industry Mortality rate Hazard ratio Middle Aged medicine.disease Constriction medicine.anatomical_structure Treatment Outcome Ventricular assist device Heart failure Cardiology Heart Arrest Induced Surgery Female Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interactive cardiovascular and thoracic surgery. 30(1) |
| ISSN: | 1569-9285 |
| Popis: | OBJECTIVES Some patients who undergo continuous-flow left ventricular assist device (CF-LVAD) implantation require concomitant procedures that can be performed with or without cardiac arrest under aortic cross-clamping (AXC). Procedures normally performed with cardiac arrest are sometimes avoided or performed without cardiac arrest because it may be detrimental to right heart function. However, the effects of cardiac arrest on patients with advanced heart failure necessitating CF-LVAD support have not been thoroughly studied. We examined our single-centre experience to determine whether cardiac arrest during CF-LVAD implantation was associated with worse patient outcomes. METHODS From November 2003 to March 2016, a total of 526 patients with chronic end-stage heart failure underwent primary CF-LVAD implantation. Preoperative demographics, postoperative complications and mortality rates were compared between patients who required cardiac arrest with AXC (n = 50) and those who did not (n = 476). RESULTS The most frequently performed procedure requiring AXC was aortic valve closure (n = 23, 26.1%). Although the AXC group had longer cardiopulmonary bypass times (P CONCLUSIONS Cardiac arrest with AXC during CF-LVAD implantation did not negatively affect long-term survival or the incidence of right ventricular failure or stroke. These findings should be considered in deciding surgical strategies. Additional investigation may be warranted to further understand the effects of cardiac arrest during LVAD implantation. |
| Databáze: | OpenAIRE |
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