Minimally Invasive Left Ventricular Assist Device Implantation: A Systematic Review and Meta-Analysis

Purpose Minimally invasive (MI) approaches for left ventricular assist device (LVAD) implantation has the potential to offer similar benefits to of other well-established cardiac surgery procedures. We performed a systematic review and meta-analysis to determine the potential benefits of MI LVAD implantation compared to sternotomy. Methods We searched MEDLINE and EMBASE databases for studies comparing MI continuous-flow LVAD implantation with sternotomy. Data was extracted by two independent investigators. The main outcomes were perioperative mortality and complications. Results 19 observational studies (1619 patients) with mean follow-up of 9 months were included. HeartWare was the most commonly implanted device (80%), followed by HeartMate II (6%). Serum bilirubin was lower (MD: -5.4 uM; 95%CI: ‒8.1 to -2.7; p Conclusion MI LVAD implantation led to an improved perioperative complication profile and enhanced patient recovery, potentially decreasing mid-term mortality. These are consistent with findings from other well-established MI cardiac surgical procedures. A future randomized trial could further clarify these benefits and establish this technique as a standard practice.