Objective To explore the perioperative therapeutic effects and follow-up management in 16 patients with left ventricular assist device (LVAD) implantation.
Methods A retrospective analysis was conducted in data of 16 patients who underwent LVAD implantation in the department of cardiovascular surgery. Data of 6-minute walk test (6MWT), European Quality of Life-5 Dimension-5 Levels (EQ-5D-5L), New York Heart Association (NYHA) classification, echocardiography, chest radiography, cardiothoracic ratio, and occurrence of complications (infection, bleeding, thrombosis, right heart failure, neurological issues) were collected via the electronic medical record system before surgery and at 30, 60, and 90 days postoperatively.
Results All patients survived with the pump at 90 days postoperatively. One patient with preoperative renal insufficiency underwent dialysis and received a heart transplant after 8 months. One patient developed a sterile granuloma at the percutaneous lead site on the abdominal wall, which improved after treatment, no complications occurred in other patients. At 90 days postoperatively, there was no statistically significant difference in the right ventricular area change fraction and tricuspid annular plane systolic excursion compared with preoperative values (P>0.05). The left ventricular ejection fraction, left ventricular end-diastolic diameter, and cardiothoracic ratio showed significant improvement compared with preoperative levels (P < 0.05). At 30 days postoperatively, 30% of patients recovered to NYHA class Ⅰ and 70% to class Ⅱ; at 60 days, 80% of patients to class Ⅰ and 20% to class Ⅱ; at 90 days, 90% to class Ⅰ and 10% to class Ⅱ. The 6MWT and EQ-5D-5L scores of patients significantly increased within 90 days postoperatively (P < 0.01).
Conclusion Through rigorous preoperative assessment by a multidisciplinary LVAD team, refinement of surgical techniques, and comprehensive management during hospitalization, self-management before discharge, daily follow-up after discharge, and follow-up management upon returning to the hospital for patients with LVAD implantation, the cardiac function and quality of life of patients are significantly improved at 90 days postoperatively.
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