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Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Implantation of the Syncardia Total Artificial Heart
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Mechanical pump complication after HeartMate 3 implantation.

Aurelie Merlo1, Panagiotis Tasoudis2, Guilherme C de Oliveira2

  • 1Department of Surgery, University of North Carolina at Chapel Hill, 4005 Burnett-Womack, CB #7050, Chapel Hill, NC, 27599-7050, USA. Aurelie.merlo@unchealth.unc.edu.

Journal of Thrombosis and Thrombolysis
|October 4, 2023
PubMed
Summary

Mechanical pump complications occurred in 7.8% of patients receiving a HeartMate 3 left ventricular assist device (LVAD), often developing late. This highlights the need to address long-term complications for improved LVAD outcomes.

Keywords:
LVADPump thrombosis

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Surgical Technology

Background:

  • Left ventricular assist device (LVAD) implantation has improved survival, but long-term complications require further investigation.
  • Reducing late complications is crucial for optimizing clinical outcomes in LVAD patients.

Purpose of the Study:

  • To determine the incidence of mechanical pump failure requiring surgical intervention after HeartMate 3 LVAD implantation.
  • To define pump failure as outflow graft compression, obstruction, or pump thrombosis necessitating surgery.

Main Methods:

  • A retrospective study of 141 adult patients who received HeartMate 3 LVADs via the "cut-then-sew" technique (September 2015 - September 2021).
  • Primary endpoint: mechanical pump complications (outflow graft obstruction/pump thrombosis) requiring surgery.
  • Secondary endpoints: bleeding, stroke, renal failure, length of stay, and survival; median follow-up: 27.3 months.

Main Results:

  • Eleven patients (7.8%) experienced mechanical pump complications: 6 with outflow graft obstruction, 5 with pump thrombosis.
  • Median time to mechanical complication was 828 days.
  • Of 11 surgically treated patients, 10 (90%) survived to discharge; overall survival at 1, 3, and 5 years was 82.9%, 69.1%, and 55.2%.

Conclusions:

  • The 7.8% mechanical pump complication rate, with a median onset of 828 days, suggests a significant late complication following LVAD implantation.
  • This study underscores the importance of monitoring and managing late-onset mechanical pump issues in LVAD recipients.