Abstract:

Introduction: We intended to deliver the left ventricular support device (LVAD) with high pulmonary vascular resistance (PVR) to implanted patients and their followers. Instruments and Methods: Between May 2013 and March 2022, LVAD implantation was performed to 62 patients as a destination therapy because the pulmonary vascular resistance was 4 WU or higher. In the follow-up, 17 of the patients (14 men, 82.4%) were subjected to pulmonary artery catheterization and reverse examination. Tracking time, mortality, post-operative drainage, entubation and intensive care stay time, pre-operative and post-operative pulmonary artery catheterization parameters were analyzed. The average age was 38 ± 11. Primary etiology was dilate cardiomyopathy in 13 (76.5%) patients and ischemic cardiomyopathy in 4 (23.5%) patients. After surgery, no extracorporal membrane oxygenator was needed. The median entubation period was 1 (distribution 1-7 days). The average catheterization time of the pulmonary artery after the LVAD implantation is 638±305 days. The PVR before and after operation was 5.2WU±1.5WU and 1.9WU±1.4WU respectively (p<0.001). Five of the patients (29.4 percent) were broken for transplantation, seven (41.2 percent) died and five (29.4 percent) continued to live with LVAD. The average survival period was 53 ± 5 months. The cumulative survival rates were 93.8 percent, 76.7 percent and 42.6 percent in the 2nd, 3rd and 5th years respectively. The result: in patients with high PVR cardiac transplant contraindications, PVR after LVAD is reduced and these patients can be included in the list for cardiac transplantation.

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