Surgical indication and procedure
Indications for LVAD implantation were determined based on the European Association for Cardio-Thoracic Surgery guidelines. Three therapy concepts were documented in this study: “bridge to transplant,” “bridge to candidacy,” and “destination therapy.” All patients underwent LVAD implantation via sternotomy. In 31 patients (26.1%), the LVAD was implanted without a heart-lung machine (HLM), i.e., the off-pump technique, whereas in 88 patients (73.9%), it was implanted with HLM. For intracorporeal LVAD, we implanted three different devices: HeartWare HVAD (Medtronic, Minneapolis, MN), Heartmate (HM) 2 (Abbott, Inc., Chicago, IL, USA), and HM 3. Only one patient underwent paracorporeal LVAD implantation using EXCOR (Berlin Heart, Inc., The Woodlands, TX, USA). Concomitant operations were performed in 11 patients: aortic valve replacement (AVR), n = 3; atrial septum defect closure, n = 3; left atrial appendage closure, n = 2; AVR + LAA closure, n = 1; AVR + tricuspid valve repair, n = 1; and another n = 1. Despite these differences associated with surgical indications and procedures, all 119 patients were considered to be homogeneous cases for the analysis in this study.