Emergent percutaneous therapy for left ventricular assist device retrograde flow

Area of Science:

• Cardiology
• Biomedical Engineering

Background:

• The number of heart transplants is limited by donor availability, leading to an increasing reliance on left ventricular assist devices (LVADs).
• Patients are living longer with LVADs for bridge-to-transplant or destination therapy, increasing the incidence of device-related complications.

Observation:

• Physicians frequently encounter patients with concurrent bleeding and thrombotic complications.
• Managing anticoagulation in LVAD patients is challenging; reducing it for bleeding increases thrombosis risk, while pump thrombosis has limited non-surgical treatment options.

Findings:

• Surgical pump exchange is the definitive treatment for pump thrombosis but carries high risks.
• Temporary LVAD deactivation can lead to rapid patient decline due to retrograde flow.

Implications:

• There is a critical need for prompt, effective percutaneous therapies to manage bleeding and thrombosis in LVAD patients.
• Developing new strategies is essential for improving outcomes and patient stability in this growing population.