Related Experiment Video
Updated: Apr 1, 2026
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Identification and Management of Pump Thrombus in the HeartWare Left Ventricular Assist Device System: A Novel
Ulrich P Jorde1, Keith D Aaronson2, Samer S Najjar3
1Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York.
Insights
HeartWare ventricular assist device (HVAD) log files can predict successful thrombolysis for device thrombosis. Analyzing pump power consumption patterns may guide treatment decisions and improve patient outcomes.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Device thrombosis is a critical complication in mechanical circulatory support.
- Increased power consumption in HeartWare ventricular assist devices (HVADs) often precedes thrombosis.
- HVAD log files offer accessible data for early diagnosis and treatment prediction.
Purpose of the Study:
- To identify patterns in HVAD log files correlating with successful medical treatment of device thrombosis.
- To assess the predictive value of pump power consumption for thrombolysis success.
- To evaluate the potential of log file analysis in guiding pump exchange decisions.
Main Methods:
- Analysis of HVAD log files from ADVANCE trial patients (n=15) with 16 thrombus events treated with tissue plasminogen activator (tPA).
- Assessment of absolute and rate of increase in power consumption for correlation with treatment success.
- Validation of identified log file patterns in an external cohort (n=43) with 53 thrombus events.
Main Results:
- The overall success rate of tPA therapy was 57%.
- Successful thrombolysis was associated with significantly lower percent of expected power (130.9% vs. 196.1%) and rate of increase in power (0.61 vs. 2.87).
- Medical therapy achieved success in 77.7% (derivation) and 81.3% (validation) of cases using specific power consumption thresholds.
Conclusions:
- HVAD log file parameters, particularly power consumption metrics, can predict the success of tPA treatment for device thrombosis.
- Prospective validation of these findings could significantly impact thrombus management strategies.
- Log file analysis offers a non-invasive tool for optimizing treatment decisions in HVAD patients.
Objectives:
The study sought to characterize patterns in the HeartWare (HeartWare Inc., Framingham, Massachusetts) ventricular assist device (HVAD) log files associated with successful medical treatment of device thrombosis.
Background:
Device thrombosis is a serious adverse event for mechanical circulatory support devices and is often preceded by increased power consumption. Log files of the pump power are easily accessible on the bedside monitor of HVAD patients and may allow early diagnosis of device thrombosis. Furthermore, analysis of the log files may be able to predict the success rate of thrombolysis or the need for pump exchange.
Methods:
The log files of 15 ADVANCE trial patients (algorithm derivation cohort) with 16 pump thrombus events treated with tissue plasminogen activator (tPA) were assessed for changes in the absolute and rate of increase in power consumption. Successful thrombolysis was defined as a clinical resolution of pump thrombus including normalization of power consumption and improvement in biochemical markers of hemolysis. Significant differences in log file patterns between successful and unsuccessful thrombolysis treatments were verified in 43 patients with 53 pump thrombus events implanted outside of clinical trials (validation cohort).
Results:
The overall success rate of tPA therapy was 57%. Successful treatments had significantly lower measures of percent of expected power (130.9% vs. 196.1%, p = 0.016) and rate of increase in power (0.61 vs. 2.87, p < 0.0001). Medical therapy was successful in 77.7% of the algorithm development cohort and 81.3% of the validation cohort when the rate of power increase and percent of expected power values were <1.25% and 200%, respectively.
Conclusions:
Log file parameters can potentially predict the likelihood of successful tPA treatments and if validated prospectively, could substantially alter the approach to thrombus management.
More Related Videos
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
