Abstract
(1127) - Prevalence, Risk Factors and Prognostic Implications of Intraoperative Bleeding during CF LVAD Implant
The Journal of heart and lung transplantation, Vol.44(4 Supplement), pp.S529-S529
04/2025
DOI: 10.1016/j.healun.2025.02.1137
Abstract
Purpose: The use of continuous flow left ventricular assist device (CF LVAD) has revolutionized the management of advanced heart failure. One of the major complications associated with its use is their risk of bleeding, especially in the early post operative period. Early events of postoperative bleeding have been associated with higher morbidity and mortality rates.
Methods: Our study aims at identifying potential predictors of intraoperative bleeding, defined as 4 or more units of packed RBCs transfused during surgery. Methods: Single center retrospective cohort study of adult patients older than 18 years old underwent to CF LVAD implantation between 2009 and 2024. Data were collected for the duration of implant hospitalization, including perioperative invasive hemodynamics, echocardiography, operative details, mechanical circulatory support, antiplatelets, inotropes, bleeding events and blood product use, in addition to patient history and baseline characteristics.
Results: A total of 208 patients were included in the analysis. Intraoperative bleeding occurred in 43 (20.67%) patients while 165 (79.33%) patients did not experience bleeding. Multi Logistic regression analysis showed that artery bypass grafting pre LVAD (OR 2.98, CI 1.2-7.42, P=0.01) and tMCS pre-LVAD (OR 3.67, 95%CI 1.72-7.85, P<0.001) were independent predictors of intraoperative bleeding during hospitalization. Intra operative bleeding is also corelated with worse clinical outcomes, higher 90-days mortality (HR 10.4, P<0.01, CI 95% 3.28-33.38) 206 subjects with 14 failures.
Conclusion: History of CABG, mechanical circulatory support before the implantation of LVAD are independent predictors of intraoperative bleeding during hospitalization in these patients. Intra operative bleeding is associated with higher frequency of RV failure post LVAD and higher 90-days mortality.
Details
- Title: Subtitle
- (1127) - Prevalence, Risk Factors and Prognostic Implications of Intraoperative Bleeding during CF LVAD Implant
- Creators
- E Ruiz Duque - University of Iowa, Cardiovascular MedicineI. Mortada - University of Iowa, Internal MedicineC. Kourek - National and Kapodistrian University of AthensR. Kshetri - Internal Medicine, University of Iowa Hospital and Clinics, Iowa City, IAA. Singhal - University of Iowa, Cardiothoracic SurgeryA. Panos - University of Iowa, Cardiothoracic SurgeryA. Briasoulis - National and Kapodistrian University of AthensM. Mohammed - Cardiovascular Medicine, University of Iowa Hospital and Clinics, Iowa City, IAS. Mansour - Cardiovascular Medicine, University of Iowa Hospital and Clinics, Iowa City, IAI. Yumul - University of Iowa, Cardiovascular MedicineP Alvarez - Cleveland Clinic
- Resource Type
- Abstract
- Publication Details
- The Journal of heart and lung transplantation, Vol.44(4 Supplement), pp.S529-S529
- DOI
- 10.1016/j.healun.2025.02.1137
- ISSN
- 1053-2498
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 04/2025
- Academic Unit
- Cardiovascular Medicine; General Internal Medicine; Cardiothoracic Surgery; Internal Medicine
- Record Identifier
- 9984815909402771
Metrics
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