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Novel Plug Device for HeartMate 3 Explantation: First Multicenter Experience.

Silvia Mariani^1,2, Tong Li¹, Anna Lassia Meyer³

¹From the Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)

|May 11, 2022

Summary

A novel apical ring plug facilitated HeartMate3 left ventricular assist device (LVAD) explantation in seven patients. This safe and effective method resulted in all patients being discharged from intensive care unit.

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Area of Science:

Cardiovascular Surgery
Mechanical Circulatory Support
Heart Failure Management

Background:

Explantation of left ventricular assist devices (LVADs) after myocardial recovery is uncommon but increasingly relevant due to the growing LVAD population.
Novel strategies are needed for LVAD explantation, particularly for devices like the HeartMate3.

Purpose of the Study:

To evaluate the safety and efficacy of a custom-made apical ring plug for HeartMate3 LVAD explantation.
To assess perioperative outcomes, including intensive care unit discharge status, complications, and transfusion requirements.

Main Methods:

Retrospective review of seven patients undergoing HeartMate3 explantation using a custom-made apical ring plug across four medical centers.
Procedures were performed via conventional sternotomy or left lateral thoracotomy, with or without cardiopulmonary bypass.
Outcomes included intensive care unit discharge, perioperative complications (bleeding, embolic, infectious), and transfusion needs.

Main Results:

The custom-made apical ring plug was implanted without technical difficulties in all seven patients.
No re-operations for bleeding, hemorrhagic, embolic, or plug-related infections were reported.
All patients were discharged alive from the intensive care unit, with perioperative transfusions ranging from 0 to 3 units.

Conclusions:

The novel apical ring plug appears to be a safe and effective device for HeartMate3 LVAD explantation in this initial patient series.
Further larger studies are warranted to confirm long-term outcomes, as current use remains off-label.