The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation.
Methods:
68 patients (50.4 ± 17.1 years old) were supported with the HeartWare® HVAD (32 patients) and the Jarvik 2000 VAD (36 patients) between January 2010 and August 2016. Two surgical techniques were applied: a minimally invasive approach with the aid of paravertebral-block (mini-invasive group, 41 patients) and a standard-surgical-approach with the aid of general anesthesia (27 patients).
Results:
The minimally invasive approach allowed faster postoperative recovery by significantly reducing the duration of surgery (p<0.05), anesthesia (p<0.05), mechanical ventilation (p<0.05), inotropic support (p<0.05), ICU and in-hospital stay (p<0.05), and time to first mobilization (p<0.05). No case of epidural hematoma was observed. Eleven patients died (16%) at 30 days, 3 in the mini-invasive group (7.3%) and 8 in the invasive group (29.6%).
Conclusions:
Minimally invasive approaches play a substantial role in VAD surgery by facilitating faster recovery, which is important for patients at very high risk.
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