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Acute HeartMate3 Malfunction Requiring Exchange Due to Intrapump Obstruction: Inflow Cannula Obstruction Can Cause

Divyam Goel1, Krish Dewan2, Stephen J Greene3

  • 1From the Duke University School of Medicine, Durham, North Carolina.

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

HeartMate III (HM3) pump failure can occur due to obstruction. This case highlights HM3 pump failure caused by biodebris in the inflow cannula and pump interior.

Keywords:
HeartMate3LVADpump obstruction

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Area of Science:

  • Cardiovascular Engineering
  • Medical Device Technology
  • Heart Failure Management

Background:

  • The HeartMate III (HM3) left ventricular assist device (LVAD) is a crucial therapy for advanced heart failure.
  • Pump thrombosis and biodebris obstruction are known, albeit rare, complications impacting HM3 device function.
  • Early identification and management of HM3 pump failure are critical for patient survival.

Purpose of the Study:

  • To report a specific case of HeartMate III (HM3) pump failure.
  • To elucidate the mechanism of failure involving biodebris obstruction.
  • To emphasize the importance of considering biodebris as a cause of HM3 malfunction.

Main Methods:

  • Case report detailing clinical presentation and diagnostic findings.
  • Review of imaging and device interrogation data.
  • Analysis of explanted device components.

Main Results:

  • The HeartMate III (HM3) pump experienced failure 11 months post-implantation.
  • Autopsy revealed significant biodebris accumulation within the inflow cannula and pump interior, causing obstruction.
  • The obstruction was identified as the primary cause of pump malfunction.

Conclusions:

  • Biodebris accumulation can lead to critical HeartMate III (HM3) pump failure.
  • This case underscores the need for vigilance regarding non-thrombotic obstructions in HM3 devices.
  • Further research into the origins and prevention of biodebris in LVADs is warranted.