Failure and off-pump replacement of Incor LVAD system

Area of Science:

• Cardiovascular Surgery
• Medical Device Engineering
• Infectious Disease Management

Background:

• Left ventricular assist devices (LVADs) are crucial for end-stage heart failure management.
• Driveline infections pose a significant risk to patients with implanted LVADs.
• The Incor (Berlin Heart AG) is a specific type of LVAD used in clinical practice.

Observation:

• A patient with an Incor LVAD developed a driveline infection requiring hospitalization and antibiotic therapy.
• During monitoring, pump failure was directly correlated with the positioning of the device's external cable.
• Echocardiographic imaging revealed the cable's position critically influenced pump function.

Findings:

• The LVAD pump failure was determined to be entirely dependent on the cable's position, suggesting mechanical obstruction or kinking.
• Urgent surgical intervention was required to address the pump malfunction.
• The pump was successfully replaced without the need for cardiopulmonary bypass.

Implications:

• This case highlights the potential for mechanical complications in LVADs, specifically related to external cable management.
• Prompt diagnosis and intervention are crucial for managing LVAD-related emergencies.
• The successful pump replacement without cardiopulmonary bypass demonstrates a feasible approach for urgent LVAD revision.