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Tarzia V, Ponzoni M, Di Giammarco G, Maccherini M, Maiani M, Agostoni P, Bagozzi L, Marinelli D, Apostolo A, Bernazzali S, Ortis H, Di Mauro M, Bortolussi G, Sani G, Bottio T, Scuri S, Livi U, Alamanni F, Gerosa G. Technology and Technique for left ventricular assist device optimization: A Bi-Tech solution. Artif Organs 2022; 46:2486-2492. [PMID: 35866429 DOI: 10.1111/aor.14368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/18/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND We investigated the synergistic effect of the new cone-bearing design of Jarvik 2000 (Jarvik Heart Inc., NY) together with a minimally-invasive approach on outcomes of LVAD patients. METHODS We retrospectively reviewed all patients from 5 institutions involved in the Jarvik 2000 Italian Registry, from October-2008 to October-2016. Patients were divided into three groups according to pump design and implantation technique: pin-bearing design and conventional approach (Group 1); cone-bearing and conventional approach (Group 2); cone-bearing and minimally-invasive implantation (Group 3). RESULTS A total of 150 adult patients with end-stage heart failure were enrolled: 26 subjects in Group 1, 74 in Group 2, and 50 in Group 3. Nineteen patients (73%) in Group 1, 51 (69%) in Group 2, and 36 (72%) in Group 3 were discharged. During follow-up, 22 patients underwent transplantation, while in 3 patients the LVAD was explanted. Overall 1-year survival was 58±10%, 64±6% and 74%±7% in Group 1, 2 and 3, respectively (p=0.034). The competing-risks-adjusted cumulative incidence rate for adverse events was 42.1 [27-62.7] per 100 patient-years in Group 1, 35.4 [25.3-48.2] in Group 2, and 22.1 [12.4-36.4] in Group 3 (p=0.046 for Group 1 vs 3). CONCLUSIONS The association of the modern cone-bearing configuration of Jarvik 2000 and minimally-invasive surgery improved survival and minimized the risk for cardiovascular events, as a result of combining technology and technique.
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Affiliation(s)
- Vincenzo Tarzia
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Matteo Ponzoni
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | | | | | - Massimo Maiani
- Cardiac Surgery, University of Udine, Udine, Italy; 5Cardiac Surgery, University of Milan, Milan, Italy
| | | | - Lorenzo Bagozzi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | | | | | | | - Helena Ortis
- Cardiac Surgery, University of Udine, Udine, Italy; 5Cardiac Surgery, University of Milan, Milan, Italy
| | | | - Giacomo Bortolussi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Guido Sani
- Cardiac Surgery, University of Siena, Siena, Italy
| | - Tomaso Bottio
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Silvia Scuri
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Ugolino Livi
- Cardiac Surgery, University of Udine, Udine, Italy; 5Cardiac Surgery, University of Milan, Milan, Italy
| | | | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
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