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Master Thesis

ExtraCorporeal life support vs IMPELLA® en bridge à l’assistance mono-ventriculaire gauche de longue durée : étude comparative rétrospective et multicentrique

Abstract : Context: extracorporeal life support (ECLS) and the IMPELLA® are two temporary circulatory assists (TCA) devices used in refractoy cardiogenic shock in bridge to left ventricular assist device (LVAD) implantation. With a more physiological assist running and an axillary implantation the IMPELLA® put the patients in conditions similar to thoses under LVAD with the possibilitie of an active rehabilitation. Our hypothesis is that patients assisted with an IMPELLA® in bridge to LVAD would have a better postoperative evolution to a better pre-operative rehabilitation. Methods: in this muticentric retrospective study we included consicutively patients undergoing LVAD inplantation after TCA beetween january 2012 and december 2018 in five university hospital centers. IMPELLA group included patients assisted only by an IMPELLA device at least 144 hours prior to LVAD implantation as the ECLS group included patient treated by ECLS associated or not to an IMPELLA®. The primary endoint was the proportion of patient with a John Hopkins Highest Level of Mobility score of 8, out of critical care unit and no longer perfused at thirty days after LVAD implantation. Secondary endpoints were rehabilitation under TCA and mortality after LVAD implantation among others. Results: seventy patients were implanted with a LVAD after TCA and included in the final analysis (41 in IMPELLA group and 29 in ECLS group). The proportion of patient having reached the primary endpoint was higher in the IMPELLA group (51% vs 21%, p=0,01). Early rehabilitation was more common in the IMPELLA group (seating 50% vs 0% p =0,001 and walking 24% vs 0% p=0,01). Conclusion: resorting to a TCA strategy with an IMPELLA device in bridge to LVAD might be associated with a better postoperative prognosis by permitting a better rehabilitation before implantation.
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https://dumas.ccsd.cnrs.fr/dumas-03034379
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Submitted on : Tuesday, December 1, 2020 - 4:59:42 PM
Last modification on : Thursday, January 21, 2021 - 3:10:31 AM
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  • HAL Id : dumas-03034379, version 1

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Olivier Simon. ExtraCorporeal life support vs IMPELLA® en bridge à l’assistance mono-ventriculaire gauche de longue durée : étude comparative rétrospective et multicentrique. Sciences du Vivant [q-bio]. 2019. ⟨dumas-03034379⟩

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