Research progress on unplanned readmissions in patients with left ventricular assist devices_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Yaxie ¹ , XIAO Li ^1,2 , CHEN Mengshi ¹ , SU Yushuang ¹ ,  YANG Qin ^1,3

1. School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, P. R. China;
2. Department of Geriatric Cardiology, Sichuan Academy of Medical Sciences/Sichuan Provincial People’s Hospital, Chengdu, 610072, P. R. China;
3. Department of Intensive Care Medicine Center, Sichuan Academy of Medical Sciences/Sichuan Provincial People’s Hospital, Chengdu, 610072, P. R. China;

Corresponding author：

YANG Qin, Email: 20152160@qq.com

Keywords：

Left ventricular assist device; unplanned readmissions; influencing factors; review

DOI：

10.7507/1007-4848.202406026

Video：

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Abstract Full text Figures/Tables Video References Cited by

The implantation of left ventricular assist device (LVAD) has significantly improved the quality of life for patients with end-stage heart failure. However, it is assiosciated with the risk of complications, with unplanned readmissions gaining increasing attention. This article reviews the influencing factors, prediction methods, models, and intervention measures for unplanned readmissions in LVAD patients, aiming to provide scientific guidance for clinical practice, assist healthcare professionals in accurately assessing patients' conditions, and develop rational care plans.

1.	黎万汇, 岳雯静, 王子涵, 等. 左心室辅助装置植入患者生活体验质性研究的Meta整合. 中华护理杂志, 2023, 58(10): 1261-1268.Li WH, Yue WJ, Wang ZH, et al. A systematic meta-synthesis of qualitative research on life experience of patients with left ventricular assist device implantation. Chin J Nurs, 2023, 58(10): 1261-1268.
2.	朱旭菁, 陈霞, 黄翱黎, 等. 左心室辅助装置植入患者心理护理的研究进展. 中华急危重症护理杂志, 2023, 4(9): 860-864.Zhu XJ, Chen X, Huang AL, et al. Research progress in psychological nursing of patients with left ventricular assist device implantation. Chin J Emerg Crit Care Nurs, 2023, 4(9): 860-864.
3.	Agrawal S, Garg L, Shah M, et al. Thirty-day readmissions after left ventricular assist device implantation in the United States: Insights from the nationwide readmissions database. Circ Heart Fail, 2018, 11(3): e004628.
4.	Briasoulis A, Ueyama H, Kuno T, et al. Trends and outcomes of device-related 30-day readmissions after left ventricular assist device implantation. Eur J Intern Med, 2021, 84: 56-62.
5.	Rali AS, Ranka S, Acharya P, et al. Comparison of trends, mortality, and readmissions after insertion of left ventricular assist devices in patients <65 years vs ≥65 years. Am J Cardiol, 2020, 128: 16-27.
6.	Shih H, Mondellini GM, Kurlansky PA, et al. Unplanned hospital readmissions following HeartMate 3 implantation: Readmission rates, causes, and impact on survival. Artif Organs, 2024, 48(9): 1049-1059.
7.	Sezgin M, Rabuş MB, Selçuk E, et al. The analysis of unplanned readmissions after left ventricular assist device implantation as bridge-to-transplant. Turk Gogus Kalp Damar Cerrahisi Derg, 2020, 28(1): 55-62.
8.	Jiang Q, Tian F, Liu Z, et al. Hospital competition and unplanned readmission: Evidence from a systematic review. Risk Manag Healthc Policy, 2021, 14: 473-489.
9.	赖莎, 周忠良, 张小龙, 等. 非计划再住院的界定与控制策略. 卫生经济研究, 2022, 39(7): 41-45.Lai S, Zhou ZL, Zhang XL, et al. Definition and control strategies of unplanned readmissions. J Pre Health Econ Res, 2022, 39(7): 41-45.
10.	Hui J, Mauermann WJ, Stulak JM, et al. Intensive care unit readmission after left ventricular assist device implantation: Causes, associated factors, and association with patient mortality. Anesth Analg, 2019, 128(6): 1168-1174.
11.	Su A, Al'Aref SJ, Beecy AN, et al. Clinical and socioeconomic predictors of heart failure readmissions: A review of contemporary literature. Mayo Clin Proc, 2019, 94(7): 1304-1320.
12.	Majmundar M, Kumar A, Doshi R, et al. Contemporary trends of clinical outcomes in primary left ventricular assist device implantation and postprocedure high-risk categories. J Card Fail, 2022, 28(2): 270-282.
13.	Briasoulis A, Ueyama H, Kuno T, et al. Analysis of trends and outcomes of 90 and 180 day readmissions after left ventricular assist device implantation. ASAIO J, 2022, 68(3): 356-362.
14.	Lemor A, Michaels A, Al-Darzi W, et al. National landscape of hospitalizations in patients with left ventricular assist device. insights from the national readmission database 2010-2015. ASAIO J, 2020, 66(10): 1087-1094.
15.	胡盛寿, 王现强, 周星彤. 心室辅助装置治疗心力衰竭—现状和下一步思考. 中国循环杂志, 2023, 38(8): 791-793.Hu SS, Wang XQ, Zhou XT. Ventricular assist devices for the treatment of heart failure: Current state and future prospects. Chin Circ J, 2023, 38(8): 791-793.
16.	Schlöglhofer T, Michalovics P, Riebandt J, et al. Left ventricular assist device driveline infections in three contemporary devices. Artif Organs, 2021, 45(5): 464-472.
17.	Zhu T, Dufendach KA, Hong Y, et al. Infectious complications following contemporary left ventricular assist device implantation. J Card Surg, 2022, 37(8): 2297-2306.
18.	Kirklin JK, Pagani FD, Kormos RL, et al. Eighth annual INTERMACS report: Special focus on framing the impact of adverse events. J Heart Lung Transplant, 2017, 36(10): 1080-1086.
19.	Yu J, Petersen MR, Meece LE, et al. A new opportunity for patient selection and optimization: Systematic review of cognitive frailty in patients undergoing left ventricular assist device implantation. Geriatr Gerontol Int, 2024, 24(2): 204-210.
20.	Uzun HG, Simsek E, Engin C, et al. Relation between frailty and 1-year outcomes after implantation of a left ventricular assist device. Am J Cardiol, 2022, 173: 88-93.
21.	Imburgio S, Udongwo N, Mararenko A, et al. Impact of frailty on left ventricular assist device clinical outcomes. Am J Cardiol, 2023, 207: 69-74.
22.	Farooq U, Tarar ZI, Malik A, et al. Impact of left ventricular assist devices on 30-day readmission and outcomes in non-variceal upper gastrointestinal bleeding: A nationwide analysis. Prz Gastroenterol, 2024, 19(2): 175-185.
23.	Gangwani MK, Aziz M, Nawras A, et al. Predictors of gastrointestinal bleeding in patients following left ventricular assist device implantation: A systematic review and meta-analysis. Future Cardiol, 2022, 18(12): 957-967.
24.	Phan J, Elgendi K, Javeed M, et al. Thrombotic and hemorrhagic complications following left ventricular assist device placement: An emphasis on gastrointestinal bleeding, stroke, and pump thrombosis. Cureus, 2023, 15(12): e51160.
25.	Shah R, Qayed E. Outcomes and predictors of readmissions with GI bleeding in patients with left ventricular assist devices. South Med J, 2018, 111(11): 666-673.
26.	Welden CV, Truss W, McGwin G, et al. Clinical predictors for repeat hospitalizations in left ventricular assist device (LVAD) patients with gastrointestinal bleeding. Gastroenterology Res, 2018, 11(2): 100-105.
27.	Wang J, Okoh AK, Chen Y, et al. Association of psychosocial risk factors with quality of life and readmissions 1 year after LVAD implantation. J Card Fail, 2024, S1071-S9164.
28.	Snipelisky D, Stulak JM, Schettle SD, et al. Psychosocial characteristics and outcomes in patients with left ventricular assist device implanted as destination therapy. Am Heart J, 2015, 170(5): 887-894.
29.	Rosson S, Monaco F, Miola A, et al. Longitudinal course of depressive, anxiety, and posttraumatic stress disorder symptoms after heart surgery: A meta-analysis of 94 studies. Psychosom Med, 2021, 83(1): 85-93.
30.	Kitagaki K, Ono R, Shimada Y, et al. Depressive symptoms interfere with the improvement in exercise capacity by cardiac rehabilitation after left ventricular assist device implantation. Artif Organs, 2022, 46(3): 471-478.
31.	Lundgren S, Lowes BD, Zolty R, et al. Do psychosocial factors have any impact on outcomes after left ventricular assist device implantation? ASAIO J, 2018, 64(4): e43-e47.
32.	Combs P, Imamura T, Siddiqi U, et al. Effect of tobacco smoking on outcomes after left ventricular assist device implantation. Artif Organs, 2020, 44(7): 693-699.
33.	Walther CP, Winkelmayer WC, Deswal A, et al. Readmissions after acute kidney injury during left ventricular assist device implantation hospitalization. Am J Nephrol, 2020, 51(3): 172-181.
34.	McElderry B, Alvarez P, Hanna M, et al. Outcomes of bariatric surgery in patients with left ventricular assist device. J Heart Lung Transplant, 2022, 41(7): 914-918.
35.	Imburgio S, Dandu S, Pannu V, et al. Sex-based differences in left ventricular assist device clinical outcomes. Catheter Cardiovasc Interv, 2024, 103(2): 376-381.
36.	Sherazi S, Alexis JD, McNitt S, et al. Racial differences in clinical characteristics and readmission burden among patients with a left ventricular-assist device. Artif Organs, 2023, 47(8): 1242-1249.
37.	Shaaban A, Schultz J, Leonard J, et al. Outcomes of patients referred for cardiac rehabilitation after left ventricular assist device implantation. ASAIO J, 2023, 69(3): 304-308.
38.	Schlöglhofer T, Gross C, Moscato F, et al. Exercise performance and quality of life of left ventricular assist device patients after long-term outpatient cardiac rehabilitation. J Cardiopulm Rehabil Prev, 2023, 43(5): 346-353.
39.	Ahmed MM, Li P, Meece LE, et al. A varied approach to left ventricular assist device follow-up improves cost-effectiveness. Curr Med Res Opin, 2021, 37(9): 1501-1505.
40.	Damman K, Caliskan K, Birim O, et al. Left ventricular assist device implantation and clinical outcomes in the Netherlands. Neth Heart J, 2023, 31(5): 189-195.
41.	Imamura T, Jeevanandam V, Kim G, et al. Optimal hemodynamics during left ventricular assist device support are associated with reduced readmission rates. Circ Heart Fail, 2019, 12(2): e005094.
42.	Rubinstein G, Moeller CM, Lotan D, et al. Hemodynamic optimization by invasive ramp test in patients supported with heartmate 3 left ventricular assist device. ASAIO J, 2024, 70(8): 641-650.
43.	Tang PC, Millar J, Noly PE, et al. Preoperative passive venous pressure-driven cardiac function determines left ventricular assist device outcomes. J Thorac Cardiovasc Surg, 2024, 168(1): 133-144.
44.	Macera F, Dewachter C, Stefanidis C, et al. Lung diffusion capacity correlates with pre-implant pulmonary hypertension and predicts outcome after LVAD implantation. ESC Heart Fail, 2023, 10(2): 1043-1053.
45.	Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J, 2022, 60(1): 2101499.
46.	Tsuji M, Amiya E, Bujo C, et al. Carbon monoxide diffusing capacity predicts cardiac readmission in patients undergoing left ventricular assist device implantation in Japan. ASAIO J, 2021, 67(10): 1111-1118.
47.	Moscato F, Gross C, Maw M, et al. The left ventricular assist device as a patient monitoring system. Ann Cardiothorac Surg, 2021, 10(2): 221-232.
48.	Krishnaswamy RJ, Robson D, Gunawan A, et al. Using pulsatility responses to breath-hold maneuvers to predict readmission rates in continuous-flow left ventricular assist device patients. Artif Organs, 2024, 48(1): 70-82.
49.	Vidula H, Kutyifa V, Johnson BA, et al. Readmission patterns during long-term follow-up after left ventricular assist device implantation. Am J Cardiol, 2018, 122(6): 1021-1027.
50.	Imamura T, Kinugawa K, Nitta D, et al. Readmission due to driveline infection can be predicted by new score by using serum albumin and body mass index during long-term left ventricular assist device support. J Artif Organs, 2015, 18(2): 120-127.
51.	王琳, 翁峰霞, 卫建华, 等. 3例左心室辅助装置植入患者术后危重期的护理. 中华护理杂志, 2023, 58(19): 2401-2405.Wang L, Weng FX, Wei JH, et al. Nursing care of 3 patients with critical complications after left ventricular assist device implantation. Chin J Nurs, 2023, 58(19): 2401-2405.
52.	Iseler JI, Wierenga KL, Shaid EC, et al. Implications of transitional care interventions on hospital readmissions in patients with destination therapy left ventricular assist devices. Res Theory Nurs Pract, 2019, 33(1): 81-96.

1. 黎万汇, 岳雯静, 王子涵, 等. 左心室辅助装置植入患者生活体验质性研究的Meta整合. 中华护理杂志, 2023, 58(10): 1261-1268.Li WH, Yue WJ, Wang ZH, et al. A systematic meta-synthesis of qualitative research on life experience of patients with left ventricular assist device implantation. Chin J Nurs, 2023, 58(10): 1261-1268.
2. 朱旭菁, 陈霞, 黄翱黎, 等. 左心室辅助装置植入患者心理护理的研究进展. 中华急危重症护理杂志, 2023, 4(9): 860-864.Zhu XJ, Chen X, Huang AL, et al. Research progress in psychological nursing of patients with left ventricular assist device implantation. Chin J Emerg Crit Care Nurs, 2023, 4(9): 860-864.
3. Agrawal S, Garg L, Shah M, et al. Thirty-day readmissions after left ventricular assist device implantation in the United States: Insights from the nationwide readmissions database. Circ Heart Fail, 2018, 11(3): e004628.
4. Briasoulis A, Ueyama H, Kuno T, et al. Trends and outcomes of device-related 30-day readmissions after left ventricular assist device implantation. Eur J Intern Med, 2021, 84: 56-62.
5. Rali AS, Ranka S, Acharya P, et al. Comparison of trends, mortality, and readmissions after insertion of left ventricular assist devices in patients <65 years vs ≥65 years. Am J Cardiol, 2020, 128: 16-27.
6. Shih H, Mondellini GM, Kurlansky PA, et al. Unplanned hospital readmissions following HeartMate 3 implantation: Readmission rates, causes, and impact on survival. Artif Organs, 2024, 48(9): 1049-1059.
7. Sezgin M, Rabuş MB, Selçuk E, et al. The analysis of unplanned readmissions after left ventricular assist device implantation as bridge-to-transplant. Turk Gogus Kalp Damar Cerrahisi Derg, 2020, 28(1): 55-62.
8. Jiang Q, Tian F, Liu Z, et al. Hospital competition and unplanned readmission: Evidence from a systematic review. Risk Manag Healthc Policy, 2021, 14: 473-489.
9. 赖莎, 周忠良, 张小龙, 等. 非计划再住院的界定与控制策略. 卫生经济研究, 2022, 39(7): 41-45.Lai S, Zhou ZL, Zhang XL, et al. Definition and control strategies of unplanned readmissions. J Pre Health Econ Res, 2022, 39(7): 41-45.
10. Hui J, Mauermann WJ, Stulak JM, et al. Intensive care unit readmission after left ventricular assist device implantation: Causes, associated factors, and association with patient mortality. Anesth Analg, 2019, 128(6): 1168-1174.
11. Su A, Al'Aref SJ, Beecy AN, et al. Clinical and socioeconomic predictors of heart failure readmissions: A review of contemporary literature. Mayo Clin Proc, 2019, 94(7): 1304-1320.
12. Majmundar M, Kumar A, Doshi R, et al. Contemporary trends of clinical outcomes in primary left ventricular assist device implantation and postprocedure high-risk categories. J Card Fail, 2022, 28(2): 270-282.
13. Briasoulis A, Ueyama H, Kuno T, et al. Analysis of trends and outcomes of 90 and 180 day readmissions after left ventricular assist device implantation. ASAIO J, 2022, 68(3): 356-362.
14. Lemor A, Michaels A, Al-Darzi W, et al. National landscape of hospitalizations in patients with left ventricular assist device. insights from the national readmission database 2010-2015. ASAIO J, 2020, 66(10): 1087-1094.
15. 胡盛寿, 王现强, 周星彤. 心室辅助装置治疗心力衰竭—现状和下一步思考. 中国循环杂志, 2023, 38(8): 791-793.Hu SS, Wang XQ, Zhou XT. Ventricular assist devices for the treatment of heart failure: Current state and future prospects. Chin Circ J, 2023, 38(8): 791-793.
16. Schlöglhofer T, Michalovics P, Riebandt J, et al. Left ventricular assist device driveline infections in three contemporary devices. Artif Organs, 2021, 45(5): 464-472.
17. Zhu T, Dufendach KA, Hong Y, et al. Infectious complications following contemporary left ventricular assist device implantation. J Card Surg, 2022, 37(8): 2297-2306.
18. Kirklin JK, Pagani FD, Kormos RL, et al. Eighth annual INTERMACS report: Special focus on framing the impact of adverse events. J Heart Lung Transplant, 2017, 36(10): 1080-1086.
19. Yu J, Petersen MR, Meece LE, et al. A new opportunity for patient selection and optimization: Systematic review of cognitive frailty in patients undergoing left ventricular assist device implantation. Geriatr Gerontol Int, 2024, 24(2): 204-210.
20. Uzun HG, Simsek E, Engin C, et al. Relation between frailty and 1-year outcomes after implantation of a left ventricular assist device. Am J Cardiol, 2022, 173: 88-93.
21. Imburgio S, Udongwo N, Mararenko A, et al. Impact of frailty on left ventricular assist device clinical outcomes. Am J Cardiol, 2023, 207: 69-74.
22. Farooq U, Tarar ZI, Malik A, et al. Impact of left ventricular assist devices on 30-day readmission and outcomes in non-variceal upper gastrointestinal bleeding: A nationwide analysis. Prz Gastroenterol, 2024, 19(2): 175-185.
23. Gangwani MK, Aziz M, Nawras A, et al. Predictors of gastrointestinal bleeding in patients following left ventricular assist device implantation: A systematic review and meta-analysis. Future Cardiol, 2022, 18(12): 957-967.
24. Phan J, Elgendi K, Javeed M, et al. Thrombotic and hemorrhagic complications following left ventricular assist device placement: An emphasis on gastrointestinal bleeding, stroke, and pump thrombosis. Cureus, 2023, 15(12): e51160.
25. Shah R, Qayed E. Outcomes and predictors of readmissions with GI bleeding in patients with left ventricular assist devices. South Med J, 2018, 111(11): 666-673.
26. Welden CV, Truss W, McGwin G, et al. Clinical predictors for repeat hospitalizations in left ventricular assist device (LVAD) patients with gastrointestinal bleeding. Gastroenterology Res, 2018, 11(2): 100-105.
27. Wang J, Okoh AK, Chen Y, et al. Association of psychosocial risk factors with quality of life and readmissions 1 year after LVAD implantation. J Card Fail, 2024, S1071-S9164.
28. Snipelisky D, Stulak JM, Schettle SD, et al. Psychosocial characteristics and outcomes in patients with left ventricular assist device implanted as destination therapy. Am Heart J, 2015, 170(5): 887-894.
29. Rosson S, Monaco F, Miola A, et al. Longitudinal course of depressive, anxiety, and posttraumatic stress disorder symptoms after heart surgery: A meta-analysis of 94 studies. Psychosom Med, 2021, 83(1): 85-93.
30. Kitagaki K, Ono R, Shimada Y, et al. Depressive symptoms interfere with the improvement in exercise capacity by cardiac rehabilitation after left ventricular assist device implantation. Artif Organs, 2022, 46(3): 471-478.
31. Lundgren S, Lowes BD, Zolty R, et al. Do psychosocial factors have any impact on outcomes after left ventricular assist device implantation? ASAIO J, 2018, 64(4): e43-e47.
32. Combs P, Imamura T, Siddiqi U, et al. Effect of tobacco smoking on outcomes after left ventricular assist device implantation. Artif Organs, 2020, 44(7): 693-699.
33. Walther CP, Winkelmayer WC, Deswal A, et al. Readmissions after acute kidney injury during left ventricular assist device implantation hospitalization. Am J Nephrol, 2020, 51(3): 172-181.
34. McElderry B, Alvarez P, Hanna M, et al. Outcomes of bariatric surgery in patients with left ventricular assist device. J Heart Lung Transplant, 2022, 41(7): 914-918.
35. Imburgio S, Dandu S, Pannu V, et al. Sex-based differences in left ventricular assist device clinical outcomes. Catheter Cardiovasc Interv, 2024, 103(2): 376-381.
36. Sherazi S, Alexis JD, McNitt S, et al. Racial differences in clinical characteristics and readmission burden among patients with a left ventricular-assist device. Artif Organs, 2023, 47(8): 1242-1249.
37. Shaaban A, Schultz J, Leonard J, et al. Outcomes of patients referred for cardiac rehabilitation after left ventricular assist device implantation. ASAIO J, 2023, 69(3): 304-308.
38. Schlöglhofer T, Gross C, Moscato F, et al. Exercise performance and quality of life of left ventricular assist device patients after long-term outpatient cardiac rehabilitation. J Cardiopulm Rehabil Prev, 2023, 43(5): 346-353.
39. Ahmed MM, Li P, Meece LE, et al. A varied approach to left ventricular assist device follow-up improves cost-effectiveness. Curr Med Res Opin, 2021, 37(9): 1501-1505.
40. Damman K, Caliskan K, Birim O, et al. Left ventricular assist device implantation and clinical outcomes in the Netherlands. Neth Heart J, 2023, 31(5): 189-195.
41. Imamura T, Jeevanandam V, Kim G, et al. Optimal hemodynamics during left ventricular assist device support are associated with reduced readmission rates. Circ Heart Fail, 2019, 12(2): e005094.
42. Rubinstein G, Moeller CM, Lotan D, et al. Hemodynamic optimization by invasive ramp test in patients supported with heartmate 3 left ventricular assist device. ASAIO J, 2024, 70(8): 641-650.
43. Tang PC, Millar J, Noly PE, et al. Preoperative passive venous pressure-driven cardiac function determines left ventricular assist device outcomes. J Thorac Cardiovasc Surg, 2024, 168(1): 133-144.
44. Macera F, Dewachter C, Stefanidis C, et al. Lung diffusion capacity correlates with pre-implant pulmonary hypertension and predicts outcome after LVAD implantation. ESC Heart Fail, 2023, 10(2): 1043-1053.
45. Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J, 2022, 60(1): 2101499.
46. Tsuji M, Amiya E, Bujo C, et al. Carbon monoxide diffusing capacity predicts cardiac readmission in patients undergoing left ventricular assist device implantation in Japan. ASAIO J, 2021, 67(10): 1111-1118.
47. Moscato F, Gross C, Maw M, et al. The left ventricular assist device as a patient monitoring system. Ann Cardiothorac Surg, 2021, 10(2): 221-232.
48. Krishnaswamy RJ, Robson D, Gunawan A, et al. Using pulsatility responses to breath-hold maneuvers to predict readmission rates in continuous-flow left ventricular assist device patients. Artif Organs, 2024, 48(1): 70-82.
49. Vidula H, Kutyifa V, Johnson BA, et al. Readmission patterns during long-term follow-up after left ventricular assist device implantation. Am J Cardiol, 2018, 122(6): 1021-1027.
50. Imamura T, Kinugawa K, Nitta D, et al. Readmission due to driveline infection can be predicted by new score by using serum albumin and body mass index during long-term left ventricular assist device support. J Artif Organs, 2015, 18(2): 120-127.
51. 王琳, 翁峰霞, 卫建华, 等. 3例左心室辅助装置植入患者术后危重期的护理. 中华护理杂志, 2023, 58(19): 2401-2405.Wang L, Weng FX, Wei JH, et al. Nursing care of 3 patients with critical complications after left ventricular assist device implantation. Chin J Nurs, 2023, 58(19): 2401-2405.
52. Iseler JI, Wierenga KL, Shaid EC, et al. Implications of transitional care interventions on hospital readmissions in patients with destination therapy left ventricular assist devices. Res Theory Nurs Pract, 2019, 33(1): 81-96.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesResearch progress on unplanned readmissions in patients with left ventricular assist devices

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