Cardiothoracic & vascular anesthesia
Right Ventricular Function Following Sternotomy Versus a Less-Invasive Approach for Left Ventricular Assist Device Implant: Retrospective Cohort Study
Main findingResult — go to the resultAdjusted odds ratio 0.53 95% CI 0.20–1.44Authors' conclusion
There was no reduction in the odds of severe RVF following LVAD implantation using less-invasive approaches versus MS. However, we found improved odds of 30-day survival in the less-invasive group.
Study context
- Population
- Adults undergoing durable left ventricular assist device (LVAD) implantation, St. Paul's Hospital, Vancouver, January 2008 to August 2021172 analysed
- Participants
- 198 adults
- Exposure
- Less-invasive LVAD implantation vs median sternotomy
- Less-invasiven = 78
- Median sternotomy (MS)n = 94reference
- Outcome
- Severe right ventricular failure (RVF)
Methodological detailssingle-centre, multivariable logistic regression, inverse probability of treatment weighting sensitivity analysis
- Single-centre
- Multivariable logistic regression
- Inverse probability of treatment weighting sensitivity analysis
Main finding
As reported in the abstract
Adjusted odds ratio
0.53
95% CI 0.20–1.44
P = 0.21
Less-invasive vs MS
aOR 0.53 (95% CI 0.20–1.44); P = 0.21
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| 30-day mortality · adjusted | 0.29 (0.09–0.99) | P = 0.049 | |
| 0.050.21520Odds ratio (log scale) |
Major bleeding, blood product transfusion, listing for transplantation
- No observed benefit of less-invasive approaches over MS
Original publication
Right Ventricular Function Following Sternotomy Versus a Less-Invasive Approach for Left Ventricular Assist Device Implant: Retrospective Cohort Study. J Cardiothorac Vasc Anesth. Published 27 April 2024. doi:10.
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