(889) Off-Pump Less Invasive HeartMate3 LVAD Implantation is Safe and Feasible Compared to the On-Pump Technique

Purpose: Our group previously reported the safety and feasibility of the off-pump HeartMate 3 left ventricular assist device in a small cohort of high-risk patients.We now present a larger cohort who underwent offpump HeartMate 3 LVAD placement, the majority via a less invasive approach.The study's primary objective was the safety and feasibility of the off-pump technique compared to the standard on-pump approach with an emphasis on the less invasive technique.Methods: We retrospectively reviewed all patients who underwent Heart-Mate 3 LVAD implantation at our institution since June of 2019.One hundred and sixty-one of these patients underwent on-pump implantation while 52 underwent off-pump implantation with 49 of them (94%) undergoing a less invasive approach which includes bilateral thoracotomies and thoracotomy with hemi-sternotomy.Results: Preoperative characteristics were similar between groups.More patients in the off-pump group were categorized as INTERMACS Profile 1 at the time of implant (67% vs 29% in the on-pump group, p<0.0001).There was no significant difference between total length of stay and in-hospital mortality between the two groups.Postoperative outcomes, including all major complications and short-term survival, were comparable between groups.Conclusion: Results from our single-center, retrospective analysis suggest that off-pump, less invasive LVAD implantation can be offered as a safe alternative for LVAD candidates in critical cardiogenic shock.