Purpose Surgeon volume affects outcomes of complex operations. However, it is not clear if individual surgeon volume in a large volume program affects left ventricular assist device (LVAD) outcomes. Methods… Click to show full abstract
Purpose Surgeon volume affects outcomes of complex operations. However, it is not clear if individual surgeon volume in a large volume program affects left ventricular assist device (LVAD) outcomes. Methods We reviewed primary LVAD implants at our center between 2013 and 2020. Cases were dichotomized into a high-volume group (surgeons averaging more than 10 LVAD cases per year), and a low-volume group (10 or less cases per year). Propensity score matching was performed. Survival and incidence of major adverse events were compared; predictors of survival were identified with multivariable analysis. Results There were 315 patients who met inclusion criteria- 45 implants in the low-volume group, 270 in the high-volume group. In the propensity matched cohort, there was no difference in survival to hospital discharge between the low (91.9%) and high (91.7%) volume groups (p=1). Survival at 1-year was also similar between the groups (85.4% vs 88.6%, p=0.732). There was no difference in the incidence of major adverse events between the groups. Predictors of mortality in the first year included: age (Hazards Ratio [HR] 1.061, p Conclusion There was no difference in survival or adverse events between high and low volume surgeons suggesting that, in an experienced center, low-volume VAD surgeons can achieve similar outcomes to their high-volume colleagues.
               
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