PhD defence C.F. (Casper) Zijderhand

Below is a brief summary of the dissertation:

This thesis investigates various aspects of end-stage heart failure treatment, focusing on surgical techniques for LVAD (Left Ventricular Assist Device) support and heart transplantation. While surgical treatment options for patients with end-stage heart failure are well-documented, optimizing these techniques using real-time data remains underexplored. Different approaches can lead to varying outcomes, making it crucial to identify clinically relevant information that can help surgeons to improve techniques.
This research examines the LVAD implantation technique, specifically the positioning of the inflow cannula and outflow graft, to determine the optimal position and provide insights for optimization. Two studies explore the impact of patient-specific factors on surgical outcomes, including those with pectus excavatum and anatomical variations in the aortic arch branches. Additionally, the thesis presents a large systematic review with a contemporary meta-analysis demonstrating that the bicaval technique is preferable for heart transplantation.
Other aspects covered in the thesis include a comparison of mechanical device malfunctions between the HeartMate II and the newer HeartMate 3, with the latter showing fewer issues. The thesis also shows that LVAD patients during active infection(s) have an elevated risk of cerebrovascular accidents, using robust data from a large European database.
The thesis concludes with a discussion of the clinical implications of these findings and provides suggestions for further research, emphasizing the importance of optimizing surgical techniques to improve patient outcomes in heart failure treatment.