{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T11:56:25Z","timestamp":1769860585196,"version":"3.49.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,7,21]],"date-time":"2019-07-21T00:00:00Z","timestamp":1563667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Right ventricular (RV) failure after left ventricular assist device (LVAD) implantation continues to be a morbid complication. In this study, we hypothesized that a less invasive approach to implantation would preserve RV function relative to a conventional sternotomy (CS) approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All patients (2013\u20132017) who underwent LVAD implantation were reviewed. Patients were stratified by surgical approach: less invasive left thoracotomy with hemi-sternotomy (LTHS) and CS. The primary outcome was severe RV failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Eighty-three patients (LTHS: 37, CS: 46) were identified. The median Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score was significantly worse in the LTHS compared to the CS cohort, and there was a trend towards higher RV failure scores and HeartMate II mortality scores. Preoperative RV dysfunction, in pulmonary artery pulsatility index and RV stroke work index were similar between the 2 groups. Though operative time did not significantly differ between the 2 groups, cardiopulmonary bypass time was significantly shorter in the LTHS group (61 vs 95 min, P\u2009&lt;\u20090.001). The incidence of postoperative severe RV failure was significantly reduced in the LTHS group (16% vs 39%, P\u2009=\u20090.030), along with the need for temporary right ventricular assist device (3% vs 26%, P\u2009=\u20090.005). Improvement in RV function, along with a change in pulmonary artery pulsatility index, was significantly greater in the LTHS cohort. There was a trend towards improved Kaplan\u2013Meier 1-year survival in the LTHS cohort (91% vs 56%, P\u2009=\u20090.056).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In this cohort, less invasive LVAD implantation appears to be associated with reduced postoperative RV failure, and equivalent or improved survival compared to conventional LVAD implantation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivz143","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T15:27:42Z","timestamp":1558625262000},"page":"592-598","source":"Crossref","is-referenced-by-count":49,"title":["Less invasive left ventricular assist device implantation may reduce right ventricular failure"],"prefix":"10.1093","volume":"29","author":[{"given":"Chetan","family":"Pasrija","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3970-2854","authenticated-orcid":false,"given":"Mariem A","family":"Sawan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Sorensen","sequence":"additional","affiliation":[{"name":"Division of Clinical Engineering, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9085-3423","authenticated-orcid":false,"given":"Hannah","family":"Voorhees","sequence":"additional","affiliation":[{"name":"Division of Clinical Engineering, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2302-733X","authenticated-orcid":false,"given":"Aakash","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Strauss","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Van-Khue","family":"Ton","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0854-7241","authenticated-orcid":false,"given":"Laura","family":"DiChiacchio","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Kaczorowski","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartley P","family":"Griffith","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si M","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Mayo Medical Center, Jacksonville, FL, 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