Introduction: In order to provide sufficient time for heart transplantation and to maintain life, a left ventricular support device (LVAD) is fitted to patients with heart failure. This bridge mechanism in heart transplantation imposes some burdens on the patient. These can be seen starting from the postoperative period and beyond. We examined the relationship between the negativities and complications that occur in this process and mortality and morbidity.
Methods: 72 patients who received LVAD implants between January 2003 and December 2023 were recorded. Demographic data, comorbidities, smoking and alcohol using, cardiac operation history, EUROSCORE II, intraoperative inotrope use and type of inotrope, ECMO, IABP and hemodialysis requirement in the first 48 hours of postoperative period, brand of the device, history of re-sternotomy, etiology of heart failure, preoperative ejection fraction, cardiopulmonary bypass and crossclamping time, postoperative blood transfusion, extubation time, duration of stay in intensive care and hospital, need for tracheostomy, 28-day survival and survival up to the study period, postop 0,1 and 2. day the turnover and flow parameters and complications related to the support device were recorded. Statistical analyses were performed with SPSS version 25.0 program.
Results: Seventy two patients (61 male) were included in the study. The frequency of intraoperative norepinephrine use was significantly higher in the non-survival group. The need for postoperative IABP, ECMO and and hemodialysis were significantly lower in the survival group (p<0.001). As the hospital and ICU stay time increased, the need for tracheostomy increased significantly. The median life expectancy from the date of operation to the follow-up period is 99.0±11.2 months. In the period from the date of operation to the follow-up period, the median survival time differs significantly according to LVAD brand groups. The 28-day survival rate was calculated as 90.8±0.1%.
Conclusions: There are many factors that affect mortality and morbidity after LVAD implantation. In this process extending to heart transplantation, the mortality and morbidity of this process can be reduced by controlling the preoperative, intraoperative and postoperative parameters.