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Outcomes of obese patients undergoing less invasive LVAD implantation
Author(s) -
Voorhees Hannah J.,
Sorensen Erik N.,
Pasrija Chetan,
Kaczorowski David,
Griffith Bartley P.,
Kon Zachary N.
Publication year - 2019
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14307
Subject(s) - medicine , contraindication , perioperative , cohort , body mass index , ventricular assist device , surgery , heart failure , retrospective cohort study , population , thoracotomy , alternative medicine , environmental health , pathology
Summary Background Obesity and heart failure rates continue to rise, confronting heart failure centers with challenging left ventricular assist device (LVAD) implantations. Although less invasive approaches to implantation have been successfully implemented by many centers, this surgical approach has not yet been well evaluated in the obese population. Therefore, we sought to describe our experience with less invasive device implantation in this patient cohort. Methods All implants of centrifugal ventricular assist devices were retrospectively reviewed. Patients implanted with a less invasive approach via a left thoracotomy and upper hemisternotomy were included. Patients were stratified by body mass index (<30 vs ≥30 kg/m 2 ). Perioperative and short‐term outcomes were evaluated. Results Forty‐two patients implanted with the less invasive approach (BMI <30: 27 vs. BMI ≥30 kg/m 2 : 15) were identified. The obese cohort was significantly younger (58.5 vs 46.1 years, P = .022), while other preoperative demographics were similar. Postoperative mechanical ventilator time was longer in the obese cohort (22.9 vs 46.1 hour, P = .045). However, other perioperative and short‐term outcomes were comparable. Wound dehiscence occurred in one obese patient. Six‐month survival was also comparable between cohorts (96.3% vs 86.7%, P = .264). Conclusions In this limited patient series, outcomes appear to be comparable in nonobese and obese patients undergoing less invasive LVAD implantation. Therefore, obesity should perhaps not be viewed as a lone contraindication to the application of this surgical approach.