Telecardiographic measurements for device migration: A useful tool for follow-up

Pump thrombosis in left ventricular assist device (LVAD) patients is an important cause of mortality and morbidity. Inflow cannula migration is a predisposing factor for pump thrombosis. Telecardiographic measurements can be used to follow up apical cannula deviation. In this study, we aimed to evaluate the migration of the inflow cannulas in patients with LVADs using angle measurements on telecardiograms.

Twenty-three patients who were implanted left ventricular assist devices in our clinic between February 2013 and April 2016 were included in our study. During the first year of follow-up, changes in angle measurements on postoperative 1^st, 3^rd, 6^th, and 12^th month telecardiograms were compared against the incidence of device thrombus and serum Lactate Dehydrogenase (LDH) levels.

Patients who were diagnosed with device thrombosis had more change in inflow cannula angles than patients without device thrombus (p<0.05 at 6^th and 12^th months). Patients with higher LDH values had more parallel angular changes at all intervals, and the change in angle was statistically significant at 3^rd, 6^th and 12^th months (p<0.05).

This study shows that it is possible to track the migration of inflow cannulas in patients with left ventricular heart failure using telecardiograms. The correlation between angle change and LDH levels and embolic events may suggest that telecardiographic follow up of angles may be a useful tool for ventricular assist devices teams for early detection of thrombus.