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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
HeartMate left ventricular assist system exchange: results and technical considerations
Robert M Adamson1, Walter P Dembitsky, Sam Baradarian
1Department Cardiovascular Surgery, Sharp Memorial Hospital, San Diego, California, USA. robandtl@aol.com
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|September 26, 2009
Summary
Left ventricular assist device (LVAS) exchanges are becoming more common due to longer transplant waits. Device exchange is feasible with low mortality and good survival rates for patients needing LVAS support.
Area of Science:
- Cardiology
- Biomedical Engineering
- Mechanical Circulatory Support
Background:
- Left ventricular assist system (LVAS) support duration has increased.
- The HeartMate LVAS has limited durability, necessitating device replacement.
- Increased use for destination therapy and longer transplant wait times contribute to this trend.
Purpose of the Study:
- To evaluate the outcomes of left ventricular assist device exchanges.
- To assess the safety and efficacy of LVAS replacement procedures.
- To analyze survival rates and reasons for device exchange.
Main Methods:
- Retrospective analysis of 19 LVAS exchanges in 15 patients from 1996 onwards.
- Detailed review of device types, reasons for exchange, and patient outcomes.
- Kaplan-Meier survival analysis was performed.
Main Results:
- Bearing failure (15/19) and infection (4/19) were primary reasons for LVAS exchange.
- No early deaths (30-day) were observed.
- 1-year, 2-year, and 3-year survival rates were 85%, 67%, and 56%, respectively.
Conclusions:
- LVAS exchange is increasingly necessary and can be performed with acceptable operative mortality.
- Patients undergoing LVAS exchange demonstrate good intermediate-term survival.
- This procedure offers a viable option for patients with failing LVADs.
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