Propensity score-based comparison of high-risk coronary artery bypass grafting vs. left ventricular assist device implantation in patients with coronary artery disease and advanced heart failure

Autor: Gaik Nersesian, Alaa Abd El Al, Felix Schoenrath, Armin Zittermann, Laurenz Hell, Volkmar Falk, Theo M. M. H. de By, Henrik Fox, Rene Schramm, Michiel Morshuis, Jan Gummert, Evgenij Potapov, Sebastian V. Rojas
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Frontiers in Cardiovascular Medicine, Vol 11 (2024)
Druh dokumentu: article
ISSN: 2297-055X
DOI: 10.3389/fcvm.2024.1430560
Popis: ObjectivesRevascularization in patients with severely reduced left ventricular function and coronary artery disease (CAD) is associated with a high perioperative risk. In this setting, implantation of a durable left ventricular assist device (LVAD) might be an alternative.MethodsWe retrospectively compared the outcomes of adult patients with CAD and a left ventricular ejection fraction (LVEF) ≤ 25% who underwent coronary artery bypass grafting (CABG) vs. LVAD implantation. Propensity score (PS) matching was performed for statistical analysis, resulting in 168 pairs.ResultsIn the PS-matched cohorts, the mean age was 62 years; one third had a history of myocardial infarction, 11% were resuscitated, half of the patients were on inotropic support, and 20% received preoperative mechanical circulatory support. LVAD patients required significantly longer ventilation (58 h [21, 256] vs. 16 h [9, 73], p
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