Surgical Procedures
All the patients received a HeartMate 3 continuous-flow
LVAD. Patients underwent LVAD implantation through a median sternotomy
with systemic cardiopulmonary bypass (CPB), during which the inflow
cannula was inserted into the apex of the left ventricle, and the
outflow graft was anastomosed to the ascending aorta. Three patients
with at least mild aortic insufficiency received aortic valve
replacement with a tissue valve. In four patients with mild or moderate
tricuspid regurgitation a concomitant tricuspid valve repair was
conducted by implanting 28 mm Contour 3D™Medtronic annuloplasty rings
were implanted. There was no statistical difference between the two
groups in terms of CPB time that resulted 75,6 ± 23,7 minutes for RVF +
group and 85,0 ± 44,5 minutes for RVF – group (p=0,371). Early right
ventricular failure occurred in three patients requiring temporary right
ventricular support instituted through femoral-pulmonary cannulation.
All three patients were successfully weaned from RV support after a mean
time of 8,5 ± 2,7 days.