Perioperative management and outcomes of hip and knee arthroplasty among heartmate 3 left ventricular assist device recipients

PURPOSE: We aimed to evaluate preoperative cardiovascular assessment, perioperative management, and outcomes in HM3 recipients undergoing hip or knee arthroplasty. METHODS: This retrospective case series included six patients with HM3 LVADs undergoing total hip or knee arthroplasty. Mean age was 67.4 ± 5.7 years; two were female, and two had ischemic cardiomyopathy. Average ejection fraction was 15 ± 4.5%. RESULTS: Procedures included three knee arthroplasties (50%), two total hip arthroplasties (33.3%), and one hip hemiarthroplasty (16.7%). Median time from LVAD implantation to arthroplasty was 19.2 ± 13.6 months. Patients were admitted an average of 2.7 ± 1.8 days preoperatively; mean postoperative length of stay was 13 days. All patients were anticoagulated with warfarin (mean INR 1.4 ± 0.2), with five requiring heparin bridging. LVAD-related infections developed in three patients (50%), and two (33%) required readmission. At final follow-up, two patients (33%) had died, at a mean of 28 ± 8 months post-arthroplasty and 47 ± 36 months after HM3 implantation. CONCLUSION: Hip and knee arthroplasty in HM3 LVAD recipients can be performed with perioperative management strategies that mitigate excess mortality beyond expected LVAD outcomes. These findings highlight the importance of specialized perioperative care in improving the safety and feasibility of arthroplasty in HM3 LVAD patients. Larger studies with longer follow-up are needed to refine patient selection, optimize perioperative care, and clarify the value of arthroplasty in this complex population.

Abstract aus PubMed (NCBI) für den zitierten Eintrag, in der Originalsprache wiedergegeben. Maßgeblich ist die Fassung der Originalpublikation.

Das Abstract wird nicht übersetzt, damit die eigene Wortwahl der Autoren erhalten bleibt.

Six HeartMate 3 LVAD recipients underwent hip or knee arthroplasty while anticoagulated with warfarin, five needing heparin bridging; three developed LVAD-related infections and two died at follow-up, supporting careful perioperative management in this population.

Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist

Weitere begutachtete Studien in der Kategorie „Klinische Studien“.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Auswirkungen der Hirudotherapie auf Leberfunktionen, Lipidprofil und Insulinsensitivität bei Ratten mit metabolischem Syndrom — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Reverse Sural Flap Venous Congestion Successfully Managed With Enoxaparin in a Male Patient With a Traumatic Foot Crush Injury: A Case Report — Velasco-Bustamante J et al. (2026)
• Investigation of the therapeutic effects of medicinal leech treatment on lower extremity ischemia-reperfusion injury — Ünal K et al. (2026)
• Wirksamkeit der Therapie mit medizinischen Blutegeln bei unterschiedlichen klinischen Anwendungen: Eine umfassende Studie aus Aserbaidschan — Farzali S et al. (2025)
• HIRUDOTHERAPY IN RECONSTRUCTIVE SURGERY: CASE-REPORTS AND REVIEW — Heinz P et al. (2020)
• Hirudotherapy in Wound Healing — Nair H et al. (2022)
• Improvement of patient care through hirudotherapy and the management of leeches from their reception to their disposal in France — Vaesken C et al. (2023)

Alle von der ASH analysierten Studien →