Finding a proper "Mate": Comparison of left ventricular assist devices using cerebral oximetry.

The International Journal of Artificial Organs
Morgan L MontgomeryMuoi Trinh

Abstract

Axial-flow and centrifugal-flow left ventricular assist devices (LVAD) have been utilized in the management of heart failure, but it remains unknown whether these devices differ in end-organ perfusion. Our goal was to evaluate the association between device type and regional cerebral oxygen saturation (rSO2), and determine if this confers any benefit in short-term postoperative outcomes. Adult patients who underwent primary LVAD implantation at our institution from 2014 to 2019 were retrospectively analyzed. Patients were stratified into axial-flow and centrifugal-flow groups. Intraoperative rSO2 readings were used to calculate the change in mean rSO2 from pre- to post-bypass. Multivariable modeling was performed to compare delta rSO2 between groups, and to analyze the association between LVAD type and postoperative outcomes. There were 152 patients included, of which 76 had an axial-flow device and 76 had a centrifugal-flow device implanted. The rSO2 level increased from pre-bypass to post-bypass on average 3.5% (CI: 2.1 to 5.0) for the axial group compared to 0.1% (CI: -1.2 to 1.4) for the centrifugal group, which was a significant difference (β = -2.22, CI: -4.21 to -0.32, p = 0.022). Axial devices approached significance fo...Continue Reading

References

Dec 21, 2006·Anesthesia and Analgesia·John M MurkinStephanie Fox
Feb 16, 2017·European Journal of Heart Failure·Finn Gustafsson, Joseph G Rogers
Nov 22, 2017·Journal of Cardiothoracic and Vascular Anesthesia·Soutik GhosalJiapeng Huang
Dec 28, 2018·Circulation·Paolo C ColomboDouglas A Horstmanshof
Mar 19, 2019·The New England Journal of Medicine·Mandeep R MehraUNKNOWN MOMENTUM 3 Investigators
Mar 3, 2020·The Annals of Thoracic Surgery·Jeffrey J TeutebergPavan Atluri

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