A pilot study on the efficacy and safety of a minimally invasive surgical and anesthetic approach for ventricular assist device implantation

2017 ◽  
Vol 41 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Jonida Bejko ◽  
Demetrio Pittarello ◽  
Gianclaudio Falasco ◽  
Guido Di Gregorio ◽  
Vincenzo Tarzia ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ventricular Assist Device ◽  
Surgical Techniques ◽  
Minimally Invasive Approach ◽  
Assist Device ◽  
Ventricular Assist ◽  
Invasive Approach ◽  
Invasive Group ◽  
Device Implantation ◽  
Duration Of Surgery

Background: The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation. Methods: 68 patients (50.4 ± 17.1 years old) were supported with the HeartWare® HVAD (32 patients) and the Jarvik 2000 VAD (36 patients) between January 2010 and August 2016. Two surgical techniques were applied: a minimally invasive approach with the aid of paravertebral-block (mini-invasive group, 41 patients) and a standard-surgical-approach with the aid of general anesthesia (27 patients). Results: The minimally invasive approach allowed faster postoperative recovery by significantly reducing the duration of surgery (p<0.05), anesthesia (p<0.05), mechanical ventilation (p<0.05), inotropic support (p<0.05), ICU and in-hospital stay (p<0.05), and time to first mobilization (p<0.05). No case of epidural hematoma was observed. Eleven patients died (16%) at 30 days, 3 in the mini-invasive group (7.3%) and 8 in the invasive group (29.6%). Conclusions: Minimally invasive approaches play a substantial role in VAD surgery by facilitating faster recovery, which is important for patients at very high risk.

A Minimally Invasive Approach to Left Ventricular Assist Device Insertion Facilitates Subsequent Explant

2020 ◽  
pp. 155698452097400
Author(s):  
Luke A. Ziegler ◽  
Gregory J. Bittle ◽  
Wyatt J. Klass ◽  
Erik N. Sorensen ◽  
Ronson J. Madathil ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Minimally Invasive Approach ◽  
Assist Device ◽  
Ventricular Assist ◽  
Invasive Approach ◽  
Left Ventricular Assist ◽  
Left Ventricular Recovery

A minimally invasive approach to left ventricular assist device (LVAD) insertion may benefit patients at the time of implant, but whether the approach to LVAD insertion influences the outcome of subsequent cardiovascular reoperations is unknown. Here we present the case of a 50-year-old male who underwent LVAD insertion through a minimally invasive approach and subsequently had left ventricular recovery. LVAD explant was performed without the use of any blood products or inotropic support. This case demonstrates that a minimally invasive approach to LVAD insertion may also facilitate subsequent device explant.

Minimally Invasive Left Ventricular Assist Device

2018 ◽  
Vol 13 (3) ◽  
pp. 218-221 ◽  
Author(s):  
Hannah J. Voorhees ◽  
Erik N. Sorensen ◽  
Chetan Pasrija ◽  
Francesca M. Boulos ◽  
Si M. Pham ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
First Year ◽  
Assist Device ◽  
Ventricular Assist ◽  
Invasive Approach ◽  
Device Implantation ◽  
Left Ventricular Assist

Objective Several centers have presented minimally invasive surgical approaches to centrifugal left ventricular assist device implantation. Although minimally invasive implantation has been successfully performed by experienced surgeons, at large implanting centers, it is unknown whether these techniques are widely adoptable. We evaluated the experience of a surgeon early in his career with conventional and minimally invasive approaches to device implantation. Methods All consecutive left ventricular assist device implantations by a single surgeon in the first year of practice (2015–2016) were retrospectively reviewed. Patients were stratified by standard approach, conventional full sternotomy versus a minimally invasive approach, left anterior thoracotomy and upper hemisternotomy. Demographics, perioperative variables, and short-term outcomes were compared using Wilcoxon rank-sum test. Results Thirteen patients were identified: six performed via the standard approach and seven performed via the minimally invasive approach. Preoperative demographics were comparable in both groups. However, there was significantly more preoperative right ventricle dysfunction in the minimally invasive group ( P = 0.01). Although operative time was significantly longer in the minimally invasive cohort, there was a trend toward decreased cardiopulmonary bypass time. Six-month survival in both groups was 100%. Conclusions Compared with conventional sternotomy, minimally invasive ventricular assist device implantation, performed by a surgeon in his first year of practice, had similar perioperative outcomes and excellent survival. Based on these data, minimally invasive implantation may be a feasible strategy for device implantation even early in a surgeon's career.

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