Association of previous cardiac surgery with outcomes in left ventricular assist device patients.
Publication/Presentation Date
7-1-2020
Abstract
OBJECTIVES: History of prior cardiac surgery has traditionally been considered a risk factor for subsequent cardiac procedures. The aim of this study was to investigate the outcomes of patients implanted with a left ventricular assist device via redo sternotomy.
METHODS: Prospectively collected data were reviewed for all patients implanted with a continuous-flow left ventricular assist device at a single institution from December 2006 through June 2018. Patients were separated into 2 cohorts: those with a history of prior cardiac surgery (redo sternotomy) and those undergoing primary sternotomy at the time of left ventricular assist device implantation. The primary outcome was overall survival.
RESULTS: Of the 321 patients included in the study, 77 (24%) were implanted via redo sternotomy and 244 (76%) via primary sternotomy. The redo sternotomy cohort was generally older (59 ± 10 vs 57 ± 12 years, P = 0.050) and had a higher incidence of ischaemic disease (70% vs 49%, P = 0.002). The Kaplan-Meier survival analysis demonstrated that overall survival was not significantly different between the redo sternotomy and primary sternotomy groups (6-month survival: 86% vs 92%; 5-year survival: 53% vs 51%; log-rank P = 0.590 for overall difference during follow-up). The propensity score analysis consistently showed that redo sternotomy was not significantly associated with mortality risk (hazard ratio 1.19, 95% confidence interval 0.73-1.93; P = 0.488). Redo sternotomy patients were more likely to require rehospitalization during their first year postoperatively (P = 0.020) and spent less time out of the hospital during the first year (P = 0.046).
CONCLUSIONS: The redo sternotomy cohort represents a more technically challenging patient population, but overall survival similar to that of primary sternotomy patients can be achieved.
Volume
31
Issue
1
First Page
1
Last Page
8
ISSN
1569-9285
Published In/Presented At
Ayers, B. C., Wood, K., McNitt, S., Goldenberg, I., Chen, L., Alexis, J., Vidula, H., Thomas, S., Storozynsky, E., Barrus, B., Prasad, S., & Gosev, I. (2020). Association of previous cardiac surgery with outcomes in left ventricular assist device patients. Interactive cardiovascular and thoracic surgery, 31(1), 1–8. https://doi.org/10.1093/icvts/ivaa055
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
32248242
Department(s)
Administration and Leadership
Document Type
Article