Minimally Invasive LVAD Implantation for Advanced Heart Failure: A Single-Center Retrospective Analysis and the Promise of Minimally Invasive Approaches

Objective This retrospective analysis reveals the clinical experience and technical advantages of minimally invasive left ventricular assist device (LVAD) implantation for patients with advanced heart failure. It highlights our single-center experience and discusses the potential of minimally invasive LVAD implantation, offering promising insights. Methods Our team evaluated patients who met the criteria for LVAD implantation surgery. We performed minimally invasive LVAD implantation for these patients and compared their cardiac function, intraoperative conditions, hemodynamics, and perioperative complications before and after the surgery. We used SPSS 26.0 software to statistically analyze the technical advantages of minimally invasive LVAD implantation. Results Within three months, a total of three patients underwent minimally invasive LVAD implantation surgery, all of whom were male, with a median age of 55.33 years [IQR:36.00–74.00 years]. The median body mass index was 26.90 [IQR:24.70–30.30]. All three patients (100%) were diagnosed with ischemic cardiomyopathy. Among them, 33.33% (1/3) had hypertension, 66.67% (2/3) had coronary artery disease, and 100% (3/3) were classified as NYHA class IV. Additionally, 33.33% (1/3) had aortic disease, 33.33% (1/3) had an INTERMACS score of 1, and 66.67% (2/3) had an INTERMACS score of 3. Preoperatively, 33.33% (1/3) of the patients were on both IABP and ECMO, while 100% (3/3) received positive inotropic agents, and all patients (3/3) had valve regurgitation. The median surgical time was 311.67 minutes [IQR:240.00-380.00 minutes], with a median intraoperative blood loss of 533.33 ml [IQR:500–600 ml] and a median cardiopulmonary bypass time of 169.00 minutes [IQR:121.00-214.00 minutes]. Postoperatively, the median duration of mechanical ventilation was 3.00 days [IQR:1.00–5.00 days], and the median ICU stay was 5.00 days [IQR:3.00–7.00 days]. Perioperative complications included arrhythmias in 33% (1/3), thrombosis in 0% (0/3), re-thoracotomy in 0% (0/3), and gastrointestinal bleeding in 0% (0/3). The 30-day mortality rate was 0% (0/3), while the six-month survival rate was 100% (3/3). Conclusion The implantation of a minimally invasive LVAD for the treatment of advanced heart failure is a safe and effective surgical method that can improve symptoms, reduce complications, lower the risk of perioperative right heart failure, and enhance early survival rates.