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Off-Pump Explant of a Left Ventricular Assist Device Using a Recovery Plug in a Pediatric Patient
Tracy R Geoffrion1, Kendall M Lawrence2, Matthew J O'Connor3
1Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Insights
Continuous-flow left ventricular assist devices (LVADs) offer a bridge to recovery for pediatric myocarditis patients. Device explantation is possible after myocardial recovery, demonstrated in a 13-year-old using a novel titanium plug.
Area of Science:
- Pediatric cardiology
- Cardiovascular surgery
- Medical device innovation
Background:
- Continuous-flow left ventricular assist devices (LVADs) are increasingly used in pediatric patients as a bridge to myocardial recovery.
- Myocardial recovery may allow for the successful explantation of these devices.
Observation:
- A 13-year-old patient with myocarditis required LVAD implantation.
- The patient demonstrated sufficient myocardial recovery for potential device explantation.
Findings:
- Device explantation was successfully performed via thoracotomy without cardiopulmonary bypass.
- A newly developed, custom-designed titanium recovery plug for the HeartMate 3 device was utilized.
Implications:
- This case highlights the feasibility of LVAD explantation in pediatric patients following recovery from myocarditis.
- The novel titanium recovery plug may facilitate safer and more efficient LVAD explantation procedures.
Abstract:
Though the numbers remain small, the use of continuous-flow left ventricular assist devices as a bridge to recovery in pediatric patients has been increasing. Select patients may have sufficient myocardial recovery to allow for device removal. Here, we describe a 13-year old requiring left ventricular assist device implantation for myocarditis who was referred for explant of the device after recovery. This was performed via thoracotomy, without cardiopulmonary bypass, using a newly developed titanium recovery plug that is custom designed to fit the HeartMate 3.
