Related Experiment Video
Updated: Apr 28, 2026
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Percutaneous Intervention in External Outflow Graft Obstruction of Magnetically Levitated Left Ventricular Assist
Anna Huang1,2, Julia Stein1,2, Vanessa I T Zwaans1,2
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany.
Insights
Percutaneous intervention effectively treats external compression of the outflow graft causing obstruction (eOGO) in HeartMate 3 left ventricular assist device patients, improving flow and quality of life. Early CT imaging is recommended for suspected eOGO due to its potential lethality.
Area of Science:
- Cardiovascular Medicine
- Medical Devices
- Interventional Cardiology
Background:
- External compression of the outflow graft causing obstruction (eOGO) is a serious complication for HeartMate 3 (HM3) left ventricular assist device (LVAD) patients.
- eOGO arises from gelatinous substance buildup, potentially leading to lethal obstruction.
- Treatment options include percutaneous intervention, surgery, or transplantation.
Purpose of the Study:
- To evaluate the efficacy of percutaneous intervention as a treatment for eOGO in HM3 LVAD patients.
- To assess long-term outcomes, including laboratory parameters, LVAD function, and quality of life, following percutaneous intervention for eOGO.
Main Methods:
- Retrospective analysis of 31 HM3 LVAD patients diagnosed with eOGO.
- Data collected on time to diagnosis and post-treatment follow-up duration.
- Quality of life assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12).
Main Results:
- Percutaneous intervention was performed in 64.5% of patients, leading to an immediate significant improvement in LVAD flow (0.5 L/min, p=0.04).
- Post-intervention follow-up averaged 686 days.
- Among survey respondents, 62.5% reported fair to excellent health status post-intervention.
Conclusions:
- Percutaneous intervention is a suitable and effective strategy for managing eOGO, restoring LVAD flow and improving patient quality of life.
- High vigilance for eOGO is crucial, especially after one year of support, given its 29.0% mortality rate.
- Early computed tomography (CT) imaging is recommended for suspected eOGO.
Objectives:
External compression of the outflow graft causing obstruction (eOGO) is a potentially lethal complication in patients on long-term mechanical circulatory support with the HeartMate 3 (HM3, Abbott) left ventricular assist device (LVAD). This complication results from the build-up of gelatinous substance between the bend relief and outflow graft and can be resolved by percutaneous intervention, surgery, or transplantation. This single-centre follow-up study evaluated the suitability of percutaneous intervention as a treatment strategy and long-term outcomes of eOGO patients in terms of laboratory, LVAD, and quality-of-life parameters.
Methods:
On October 31, 2024, a search of the implantation centre's electronic database identified HM3 patients diagnosed with eOGO. Individual patient data concerning 31 cases was analyzed. A quality-of-life survey was conducted using the short version of the Kansas City Cardiomyopathy Questionnaire (KCCQ-12).
Results:
The patient cohort had a median support time to eOGO diagnosis of 1219 days [976, 1917] and a post-treatment follow-up of 686 days [447, 1003]. 64.5% of patients (n = 20) underwent percutaneous intervention showing immediate LVAD flow improvement of 0.5 L/min post-intervention (p = 0.04). Of eight post-interventional survey respondents, 62.5% (n = 5) were assigned a fair-excellent health status according to the KCCQ-12.
Conclusions:
Percutaneous intervention is a suitable treatment strategy for eOGO, resolving low flow and providing satisfactory long-term quality of life outcomes. Given the increasing eOGO incidence after 1 year of support and overall mortality of 29.0%, clinicians should remain on high alert for this complication. We suggest computed tomography (CT) imaging be considered early on when eOGO is suspected.
