ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1591653
This article is part of the Research TopicGlobal Perspectives and Improvements on Mechanical Circulatory Support and Cardiac TransplantationView all articles
Impact of pump position on postoperative outcomes in less invasive left ventricular assist device implantation
Provisionally accepted
Tomoyuki Suzuki1
Hayato Ise1
Robin Döpp2Patric Kröpil3Yoshikatsu Saiki4Artur Lichtenberg2Udo Boeken2
Hug Aubin2
Payam Akhyari1*
Yukiharu Sugimura1- 1Essen University Hospital, Essen, Germany
- 2University Hospital of Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
- 3Heinrich Heine University of Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
- 4Graduate School of Medicine, Tohoku University, Sendai, Japan
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Introduction: less invasive approach (LIS) has recently become increasingly used for left ventricular assist device (LVAD) implantation. However, the impact of surgical access on pump position and clinical outcomes comparing LIS-LVAD implantation to full sternotomy (ST) has not been well discussed. Methods: Between April 2010 and February 2021, a total of 237 consecutive patients received a LVAD, 76 (32.1%) of whom underwent the LIS approach and 161 (67.9%) of whom underwent ST. The clinical outcomes were retrospectively reviewed, and data of 66 comparable patients from each group extracted by propensity score matching were analyzed. For the analysis of pump position, cannula coronal angle (CCA, °) and pump diaphragm depth (PDD, mm) of LVAD were measured according to postoperative chest X ray. Results:. The mean age of all patients was 57.7±11.3 years, 204 cases were male (86.1%), and 48 cases resulted in in-hospital death (20.3%). There was no significant impact on clinical outcomes according to surgical approach in matched groups. There was also no significant difference regarding pump position between two different access groups. A larger PDD was associated with both in-hospital death (60.2±25.8 vs. 43.4±31.3, P<0.01) and death on LVAD (55.4±28.1 vs. 41.7±31.5, P<0.01). Receiver operating characteristic (ROC) curve analyses revealed that PDD was a significant predictor of mortality in LIS approach. Conclusions: Our results indicate that LVAD implantation via LIS approach is safe yielding the comparable outcomes with sternotomyST approach. Regarding spatial positioning of LVAD via LIS approach, larger PDD, may predict worse clinical outcomes.
Keywords: left ventricular assist device (LVAD)1, pump position2, less invasive approach (LIS)3, cannula coronal angle (CCA)4, pump diaphragm depth (PDD)5
Received: 02 Apr 2025; Accepted: 01 Aug 2025.
Copyright: © 2025 Suzuki, Ise, Döpp, Kröpil, Saiki, Lichtenberg, Boeken, Aubin, Akhyari and Sugimura. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Payam Akhyari, Essen University Hospital, Essen, Germany
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