Get Home, Stay Home: 90-Day Readmission Rate after Complete Sternal-Sparing HeartMate3 Implantation

Purpose The purpose of this study was to evaluate discharge patterns, days spent out of hospital and 90-day readmission rates after utilizing the complete sternal-sparing technique for HeartMate3 implantation. Methods Retrospective analysis of prospectively collected data was performed on 36 consecutive patients implanted with left ventricular assist devices between February and July 2018 at a single institution. Patients were excluded if they were enrolled in a study requiring full sternotomy (1 patient), were a pump exchange (5 patients), or were implanted with the HeartWare device (2 patients). Results A total of 28 patients were included in the study, all of which underwent complete sternal-sparing HeartMate 3 implantation. Two patients died during the initial hospitalization. Average age was 56.0±11.7 years, 77% were male and 50% were INTERMACS Profile 1. Intensive care unit and hospital length of stay were 4.5 days (IQR=2-7 days) and 15 days (IQR=12-31days), respectively. Seventeen patients (65%) were discharged home, and nine patients (35%) were discharged to acute rehab. After hospital discharge, patients spent 97% of their time out of the hospital. Three patients (12%) were readmitted to the hospital, one of whom was readmitted twice. Reasons for readmissions included gastrointestinal bleed, bacteremia, anemia and syncope. Ninety-day survival was 26/28 (93%). Conclusion In our single center experience, two thirds of patients were discharged home after HeartMate 3 implantation using less invasive surgical techniques. Along with short hospital stays, we observed a low 90-day readmission rate. Multicenter studies are required to further validate the benefits of less invasive HeartMate 3 implantation. The purpose of this study was to evaluate discharge patterns, days spent out of hospital and 90-day readmission rates after utilizing the complete sternal-sparing technique for HeartMate3 implantation. Retrospective analysis of prospectively collected data was performed on 36 consecutive patients implanted with left ventricular assist devices between February and July 2018 at a single institution. Patients were excluded if they were enrolled in a study requiring full sternotomy (1 patient), were a pump exchange (5 patients), or were implanted with the HeartWare device (2 patients). A total of 28 patients were included in the study, all of which underwent complete sternal-sparing HeartMate 3 implantation. Two patients died during the initial hospitalization. Average age was 56.0±11.7 years, 77% were male and 50% were INTERMACS Profile 1. Intensive care unit and hospital length of stay were 4.5 days (IQR=2-7 days) and 15 days (IQR=12-31days), respectively. Seventeen patients (65%) were discharged home, and nine patients (35%) were discharged to acute rehab. After hospital discharge, patients spent 97% of their time out of the hospital. Three patients (12%) were readmitted to the hospital, one of whom was readmitted twice. Reasons for readmissions included gastrointestinal bleed, bacteremia, anemia and syncope. Ninety-day survival was 26/28 (93%). In our single center experience, two thirds of patients were discharged home after HeartMate 3 implantation using less invasive surgical techniques. Along with short hospital stays, we observed a low 90-day readmission rate. Multicenter studies are required to further validate the benefits of less invasive HeartMate 3 implantation.