ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Off-pump implantation of left ventricular assist device via minimally invasive left thoracotomy: Our single-center experience
Mehmet Karahan1, Ümit Kervan1, Sinan Sabit Kocabeyoğlu1, Doğan Emre Sert1, Mustafa Akdi1, Abdülkadir Yılmaz1, Can Koçak1, Zeki Çatav
1Department of Cardiovascular Surgery, Ankara City Hospital, Ankara, Türkiye
DOI : 10.5606/tgkdc.dergisi.2023.23370
Background: The aim of this study was to compare our experience of left ventricular assist device implantation via minimally invasive left thoracotomy with off-pump versus on-pump technique.

Methods: Between June 2013 and April 2020, nine patients (8 males, 1 female; mean age: 47±11.9 years; range, 30 to 61 years) who underwent off-pump left ventricular assist device implantation and nine patients (8 males, 1 female; mean age: 47±11.4 years; range, 29 to 60 years) who underwent on-pump minimally invasive left thoracotomy were retrospectively analyzed. Postoperative outcomes and mid-term results of both groups were evaluated.

Results: Outflow graft was anastomosed to the ascending aorta with J-sternotomy in all patients. The median duration of intubation and intensive care unit stay were one (IQR: 1.5) day and eight (IQR: 6.5) days in the off-pump group, respectively and one (IQR: 0) day and seven (IQR: 7) days in the on-pump group, respectively. Intra-aortic balloon pump was needed during the weaning of cardiopulmonary bypass in one (11%) of the patients in both groups. Postoperative right ventricular failure was observed in two (22%) patients in the offpump group who were treated medically and recovered. There was no need for revision due to bleeding or postoperative extracorporeal membrane oxygenator implantation in either group. In the off-pump group, three patients underwent heart transplantation after median 854 (IQR: 960) days. Three patients died one month, two and four years after implantation. Three patients were still alive with left ventricular assist device and were being uneventfully followed for 365, 400, and 700 days after implantation.

Conclusion: Off-pump technique is safe and feasible option for implantation of left ventricular assist device via minimally invasive left thoracotomy.

Keywords : Left ventricular assist device, minimally invasive, off-pump, thoracotomy
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