Open AccessCombined Left Ventricular Assist Device and Coronary Artery Bypass Grafting Surgery: Should We Bypass the Bypass?
Author(s) -
Priya Mehta,
Teruhiko Imamura,
C. Juricek,
Gene Kim,
J. Raikhelkar,
Tae Ho Song,
Takeyoshi Ota,
Valluvan Jeevanandam,
Gabriel Sayer,
Nir Uriel
Publication year - 2020
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000000956
Subject(s) - medicine , concomitant , cardiology , perioperative , cardiopulmonary bypass , artery , bypass grafting , ischemic cardiomyopathy , heart failure , cardiac surgery , ventricular assist device , surgery , ejection fraction
Left ventricular assist devices (LVADs) have become a mainstay of therapy for advanced heart failure. Although selected patients undergo concomitant coronary artery bypass grafting (CABG) at the time of LVAD implantation, the detailed implication of this combined surgical approach is not yet well studied. In this study, all ischemic cardiomyopathy patients who underwent concomitant CABG during LVAD implantation between 2010 and 2016 were enrolled. A control group matching for age, gender, and device type, were selected. Of 79 LVAD patients finally included, 28 patients underwent concomitant CABG (CABG group); whereas 51 did not (non-CABG group). There was no difference in the baseline characteristics between groups. There was a trend toward longer cardiopulmonary bypass time in the CABG group (169 vs. 147 min; p = 0.09). One month survival in the CABG group was significantly lower than the non-CABG group (75.0% vs. 94.1%; p = 0.014). No difference in the occurrence of ventricular arrhythmias was detected between the groups, nor was there a difference in the incidence or severity of right ventricular failure. Concomitant CABG surgery during LVAD implantation may carry significant perioperative mortality, and addition of CABG to LVAD surgery may be performed only in strictly selected cases.