Complete sternal-sparing left ventricular assist device implantation is associated with improved postoperative mobility

• Published in: Interactive cardiovascular and thoracic surgery Vol. 32; no. 6; pp. 878 - 881
• Main Authors: Ayers, Brian C, Bjelic, Milica, Wood, Katherine, Sheen, Soun, Morrison, Eric, Prasad, Sunil, Gosev, Igor
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 27.05.2021
• Subjects: Adult Cardiac; Heart-Assist Devices; Humans; Postoperative Period; Retrospective Studies; Sternotomy - adverse effects; Sternum; Left ventricular assist device; Postoperative rehabilitation; Cardiac; Minimally invasive
• ISSN: 1569-9285; 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivab017

Abstract Left ventricular assist device (LVAD) implantation via a complete sternal-sparing (CSS) technique is gaining interest due to several potential benefits. We hypothesized that the CSS approach for HeartMate 3 (HM3) LVAD implantation improves postoperative mobility and physical independence compared to full sternotomy (FS). We retrospectively reviewed patients who were implanted with a commercial HM3 at our institution from September 2017 to August 2018. The Activity Measure for Post-Acute Care short forms and Functional Independence Measure scores were used to assess the patient’s physical limitations postoperatively. A total of 43 patients were included in the study: 27 (63%) CSS patients and 16 (37%) FS patients. At postoperative day 3, the CSS cohort demonstrated improved mobility based on Activity Measure for Post-Acute Care scores compared to the FS group; 40% of the CSS cohort versus 67% of the FS cohort remained 100% impaired. The CSS cohort also demonstrated greater postoperative independence in the Functional Independence Measure sit-to-stand metric with 78% of the CSS cohort achieving modified or complete independence by postoperative day 15 compared to only 21% of the FS patients. These early data suggest that the CSS approach for HM3 LVAD implantation improves postoperative mobility and functional independence compared to FS.