Factors Related to Pump Thrombosis With the Heartmate II Left Ventricular Assist Device

2015 ◽  
Vol 30 (10) ◽  
pp. 775-780 ◽  
Author(s):  
Charles T. Klodell ◽  
H. Todd Massey ◽  
Robert M. Adamson ◽  
David A. Dean ◽  
Douglas A. Horstmanshof ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Pump Thrombosis ◽  
Left Ventricular Assist

Recurrent pump thrombosis is common after axial continuous-flow left ventricular assist device exchange

2019 ◽  
Vol 43 (2) ◽  
pp. 109-118 ◽  
Author(s):  
Marian Urban ◽  
John Um ◽  
Michael Moulton ◽  
Douglas Stoller ◽  
Ronald Zolty ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Pump Thrombosis ◽  
Left Ventricular Assist ◽  
Device Associated Infection ◽  
Device Exchange

In selected patients with left ventricular assist device–associated infection or malfunction, pump exchange may become necessary after conservative treatment options fail and heart transplantation is not readily available. We examined the survival and complication rate in patients (⩾19 years of age) who underwent HeartMate II to HeartMate II exchange at our institution from 1 January 2010 to 28 February 2018. Clinical outcomes were analyzed and compared for patients who underwent exchange for pump thrombosis (14 patients), breach of driveline integrity (5 patients), and device-associated infection (2 patients). There were no differences in 30-day mortality (p = 0.58), need for temporary renal replacement therapy (p = 0.58), right ventricular mechanical support (p = 0.11), and postoperative stroke (p = 0.80) among groups. Survival at 1 year was 90% ± 7% for the whole cohort and 85% ± 10% for those who underwent exchange for pump thrombosis. In patients exchanged for device thrombosis, freedom from re-thrombosis and survival free from pump re-thrombosis at 1 year were 49% ± 16% and 42% ± 15%, respectively. No association of demographic and clinical variables with the risk of recurrent pump thrombosis after the first exchange was identified. Survival after left ventricular assist device exchange compares well with published results after primary left ventricular assist device implantation. However, recurrence of thrombosis was common among patients who required a left ventricular assist device exchange due to pump thrombosis. In this sub-group, consideration should be given to alternative strategies to improve the outcomes.

scholarly journals Left ventricular assist device exchange for the treatment of HeartMate II pump thrombosis

2018 ◽  
Vol 10 (S15) ◽  
pp. S1728-S1736 ◽  
Author(s):  
Jasmin S. Hanke ◽  
Günes Dogan ◽  
Leonard Wert ◽  
Marcel Ricklefs ◽  
Jan Heimeshoff ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Pump Thrombosis ◽  
Left Ventricular Assist ◽  
Device Exchange

Abstract 19810: A Significant Decrease in Early Confirmed Left Ventricular Assist Device Pump Thrombosis: Recent Observations from a Large Multi-Institutional Experience

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
John M Stulak ◽  
John A Schirger ◽  
Lyle D Joyce ◽  
Keith D Aaronson ◽  
Francis D Pagani ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Similar Proportion ◽  
Assist Device ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Pump Thrombosis ◽  
Left Ventricular Assist

Introduction: Recent reports have documented an abrupt increase in 3-month confirmed HeartMate II left ventricular assist device (LVAD) thrombosis beginning in 2011 without a plateau observed to date. Because very little data exist from multi-institutional efforts, we report our experience. Methods: From January 2004 to December 2013, 516 pt underwent HeartMate II LVAD implant at three institutions (University of Michigan (n=254), Mayo Clinic Rochester (n=205), and Vanderbilt Heart and Vascular Institute (n=57)). Median age at implant was 60 yr (range, 18-82) and 428 (83%) were male. Confirmed pump thrombosis at 3 months was defined as thrombus found in the blood-contacting surfaces of the pump at the time of urgent transplant, device exchange or autopsy. Pt without at least 3 months of follow-up were excluded. Results: Confirmed pump thrombosis occurred in 9 pt within 3 months post implant. The incidence was greatest in the year 2012 (5.3%). Following this peak, the incidence of 3-month confirmed pump thrombosis decreased significantly to 2.9% (Figure). Significant differences in preoperative characteristics between patients with pump thrombosis and without thrombosis included female sex (36% vs. 16%, p=0.01), bridge to transplant (77% vs. 54%, p=0.03), atrial fibrillation (55% vs. 32%, p=0.04), and preop platelet count (231,000 vs. 172,000, p<0.001). Follow-up was available in all for a total of 857 patient years of support. At a median follow-up of 1.2 years (max., 9.8 years), a similar proportion of patients were alive (73% vs. 74%, p=0.9). Conclusions: We report a recent decrease in early, confirmed HeartMate II LVAD thrombosis to historically observed levels, which is disparate to recent reports. While we identified several differences in clinical characteristics between patient groups, the issue of pump thrombosis is complex and multifactorial. Most importantly, our findings demonstrate the need for more granular analyses from collaborative efforts.

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