Authors
Wenfang Zhu, Guiqing Liu, Liangliang Liu, Yuhong Chen, Liang Zhang, Jinpeng Xu
Published in
Perfusion. Pages 2676591261496760. Oct 07, 2026. Epub Oct 07, 2026.
Abstract
IntroductionSome patients considered for durable left ventricular assist device (LVAD) implantation have borderline features or relative contraindication factors that may lead to deferral or reconsideration of implantation. The relationship between perioperative feasibility and post-discharge residual risk in such patients remains incompletely described.MethodsWe retrospectively reviewed borderline LVAD candidates selected from 30 consecutive adults undergoing durable LVAD implantation between October 2024 and September 2025. Patients were included when major preoperative decision concerns influenced implantation planning. Outcomes were successful implantation with survival to first discharge and post-discharge residual risk-related events.ResultsEleven borderline candidates were included. Median age was 56 years (range, 38-73 years). All patients underwent LVAD implantation and survived to first discharge. Median follow-up duration was 13.0 months (range, 2.1-18.0 months). During follow-up, death occurred in 2 patients, ischemic stroke or intracranial hemorrhage in 4, and gastrointestinal bleeding in 1.ConclusionsBorderline candidacy features did not preclude LVAD implantation or discharge after individualized perioperative handling. However, post-discharge residual risk, especially cerebrovascular vulnerability, anticoagulation exposure, and care-management limitations, remained clinically important. LVAD candidacy should be considered as a longitudinal care pathway rather than a perioperative decision alone.
PMID:
42842815
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.
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