FENG Huang , WANG Yabo , AN Qi
  • Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
AN Qi, Email: anqi@scu.edu.cn
End-stage heart failure; left ventricular assist device; perioperative management; perioperative outcomes; heart function; cardiomyopathy; postoperative complications; clinical efficacy
10.7507/1007-4848.202511045
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Objective  To evaluate the perioperative management strategies and clinical outcomes in a cohort of 22 patients with end-stage heart failure undergoing implantation of left ventricular assist device (LVAD). Methods  A retrospective analysis was conducted on the clinical records of patients with end-stage heart failure treated with LVAD at West China Hospital of Sichuan University between January 2021 and June 2025. Surgical outcomes were assessed using perioperative variables, including operative duration, cardiopulmonary bypass and aortic cross-clamp time, length of ICU stay, incidence of adverse events, as well as cardiac function and hemodynamic status at the time of discharge. Results The study included 22 patients (19 male, 3 female) with a mean age of (47.9±12.6) years (range: 27-67 years). Preoperatively, all patients were classified as New York Heart Association (NYHA) functional class Ⅳ. All implantations were performed successfully; however, there were two perioperative mortalities due to gastrointestinal bleeding. Post-implantation, significant improvements in cardiac function and hemodynamics were observed: left ventricular ejection fraction increased from a baseline of 24.0%±5.0% to 31.0%±7.0% (P=0.002), tricuspid annular plane systolic excursion improved from (10.0±2.5) mm to (15.0±3.0) mm (P<0.001), fractional area change increased from 22.5%±6.0% to 30.0%±6.5% (P<0.001), and cardiac index rose from (1.9±0.4) L/(min·m2) to (2.8±0.5) L/(min·m2) (P<0.001). The average length of stay in the ICU was 7 (5, 10) days. No device malfunctions or bleeding events necessitating surgical re-exploration were recorded. Conclusion  LVAD therapy provides effective cardiac unloading and enhances systemic perfusion in the perioperative setting, achieving a high rate of survival with the device. Clinical complications are generally manageable. Strengthening right heart evaluation and protection, alongside optimizing perioperative management protocols, holds the potential to further enhance patient outcomes.

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