Percutaneous Decommissioning 11 Years After Initial CF-LVAD Placement.

Area of Science:

• Cardiology
• Medical Devices
• Minimally Invasive Procedures

Background:

• Severe nonischemic cardiomyopathy requires advanced mechanical circulatory support.
• Left ventricular assist device (LVAD) therapy offers long-term support but can face complications.
• Driveline fractures are a known complication of long-term LVAD use.

Observation:

• An 80-year-old male patient with a history of LVAD implantation experienced recurrent device alarms.
• The alarms were attributed to an internal driveline fracture, a mechanical complication.
• The patient exhibited partial myocardial recovery and a strong preference against further surgical interventions.

Findings:

• Percutaneous LVAD decommissioning was successfully performed.
• The procedure involved occlusion of the outflow graft to safely disable the device.
• Subsequent driveline removal was completed without major complications.

Implications:

• Percutaneous decommissioning offers a less invasive alternative to surgical explantation for select LVAD patients.
• This approach may be suitable for patients with partial myocardial recovery who wish to avoid major surgery.
• It highlights the potential for device management strategies beyond traditional explantation or continued support.