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.