초록접수 현황
| 21F-183 | 구연 발표 |
Surgical outcomes of mechanical circulatory support bridged heart transplantation : Extra-corporeal membranous oxygenation vs Implantable left ventricular assist device
Jung Hyeon Lim, Jae Joong Kim, Ho Jin Kim, Tae Jin Yun, Jae Won Lee
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
Purpose : Implantable left ventricular assist device(LVAD), recently, have begun to be used in korea. So we have another option for bridging cardiac transplantation, in addition to extra-corporeal membranous oxygenation(ECMO). We compared LVAD bridge group and ECMO bridge group.
Methods : Between March 2018 and July 2021, 16 cases of heart transplantation performed to patient bridged by LVAD. These group compared with contemporary 38 cases ECMO bridged patients, retrospectively.
Results : LVAD group have less cases need preoperative ventilator [0 vs 65.8%(25), p <0.001] and Inotropics [6.3%(1) vs 55.3%(21), p :0.001]. Duration for waiting cardiac transplantation after bridge was longer in LVAD group [217.8(±133.7) days17 vs (±13.0) days, p<0.001]. Operation time in LVAD group was longer than ECMO group [427.8(±84.5)minute vs 352.4(±76.8)minute, p :0.005]. Cold ischemic time [163.5(±84.5)minute vs 153.5(±61.0)minute, p :0.589], warm ischemic time [122.3(±59.9)minute vs 113.2(±61.0)minute, p :0.676], and anastomosis time [65.4(±20.0)minute vs 61.9(±17.2)minute, p : 0.554] were not significantly different. LVAD group stayed shorter in intensive care unit(ICU) [9.8(±8.6)days vs 17.3(±16.4)days, p :0.034] and hospital [34.8(±16.0)days vs 66.1(±53.7)days, p :0.027]. Short-term morbidities occurred less in LVAD group [25%(4) vs 39.5%(15), p :0.365). There were less short-term mortalities in LVAD group[0 vs 3(7.9%), p :0.547]. Each cause of death were primary graft dysfunction, bleeding and pneumonia.
Conclusion : LVAD group shows better postoperative course such as shorter ICU and hospital stay. Short-term mortality and morbidity rates were lower in LVAD group. Although it wasn’t statistically significant, LVAD can be good option for bridging to cardiac transplantation
Methods : Between March 2018 and July 2021, 16 cases of heart transplantation performed to patient bridged by LVAD. These group compared with contemporary 38 cases ECMO bridged patients, retrospectively.
Results : LVAD group have less cases need preoperative ventilator [0 vs 65.8%(25), p <0.001] and Inotropics [6.3%(1) vs 55.3%(21), p :0.001]. Duration for waiting cardiac transplantation after bridge was longer in LVAD group [217.8(±133.7) days17 vs (±13.0) days, p<0.001]. Operation time in LVAD group was longer than ECMO group [427.8(±84.5)minute vs 352.4(±76.8)minute, p :0.005]. Cold ischemic time [163.5(±84.5)minute vs 153.5(±61.0)minute, p :0.589], warm ischemic time [122.3(±59.9)minute vs 113.2(±61.0)minute, p :0.676], and anastomosis time [65.4(±20.0)minute vs 61.9(±17.2)minute, p : 0.554] were not significantly different. LVAD group stayed shorter in intensive care unit(ICU) [9.8(±8.6)days vs 17.3(±16.4)days, p :0.034] and hospital [34.8(±16.0)days vs 66.1(±53.7)days, p :0.027]. Short-term morbidities occurred less in LVAD group [25%(4) vs 39.5%(15), p :0.365). There were less short-term mortalities in LVAD group[0 vs 3(7.9%), p :0.547]. Each cause of death were primary graft dysfunction, bleeding and pneumonia.
Conclusion : LVAD group shows better postoperative course such as shorter ICU and hospital stay. Short-term mortality and morbidity rates were lower in LVAD group. Although it wasn’t statistically significant, LVAD can be good option for bridging to cardiac transplantation
책임저자: Sung-Ho Jung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
발표자: 임정현, E-mail : hwoarang_10@naver.com