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 sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Explore how this research connects to clinical practice

More peer-reviewed studies in Clinical Trials.

• 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)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →