Inflow cannula obstruction of the HeartWare left ventricular assist device: what do we really know?

Pappalardo, Federico; Bertoldi, Letizia; Sanvito, Francesca; Marini, Claudia; Consolo, Filippo

doi:10.1016/j.carpath.2020.107299

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…Using new promising methods as loss of circadian rhythm in combination with accelerometer derived signal changes may help in early diagnosis and in the timing of early intervention. 10,17,18…”

Section: Discussionmentioning

confidence: 99%

Improved Detection Of Thromboembolic Complications In Left Ventricular Assist Device By Novel Accelerometer-Based Analysis

et al. 2022

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We have previously demonstrated that accelerometer-based vibration analysis detects thromboembolism and pump thrombosis in HeartWare Left Ventricular Assist Device (HVAD) using the third harmonic frequency (pump_speedx3). Thromboembolism also affected the amplitude of the nonharmonic frequencies. The aim of this study was to determine whether nonharmonic-amplitude (NHA) analysis can improve the diagnosis of thromboembolic complications. An accelerometer was attached to HVAD in three in vitro and seven in vivo experiments. Control interventions, including load and pump speed alternations (n = 107), were followed by thromboembolic events (n = 60). A sliding fast-Fourier-transform was analyzed, and changes in NHAs were quantified in the acute phase and in a steady state. Receiver operating characteristic curves were constructed with cutoff values of NHA to detect thromboembolic events. Positive predictive values were calculated on the basis of a specificity of 1. In the acute phase, NHA change was 6.5 times higher under thromboembolism than under control interventions (p < 0.001). Most thromboembolic events lead to concomitant changes in both NHA and third-harmonic amplitude. Combining the two methods improved the PPV by 8.3%. At steady state, signal changes predominantly demonstrated either NHA or third-harmonic changes. Combined signal analysis improved the PPV by 36%. This method enhanced the detection of thromboembolism and pump thrombosis in the HVAD.

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Section: Discussionmentioning

confidence: 99%

Improved Detection Of Thromboembolic Complications In Left Ventricular Assist Device By Novel Accelerometer-Based Analysis

et al. 2022

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“…The one‐time determination of geometric factors like cannula orientation using a single X‐ray image is also a simplistic approach, as these factors may change over time. Also, we were unable to investigate the course of thrombus development over time, for example, by histological examination 38 …”

Section: Limitationsmentioning

confidence: 99%

“…Also, we were unable to investigate the course of thrombus development over time, for example, by histological examination. 38 Characterization of washout conditions using ventricle size (LVEDD), contractility (LVEF), and other parameters at only one point in time, preferably as close to the examination as possible, also neglects the cumulative influence during the entire period of exposure. These values most likely changed over time.…”

Section: Limitationsmentioning

confidence: 99%

Thrombus formation at the inflow cannula of continuous‐flow left ventricular assist devices—A systematic analysis

et al. 2022

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As a result of the first implantation of a continuous-flow left ventricular assist device (CF-LVAD) more than 20 years ago, 1,2 pump thrombosis 3 and thromboembolic incidents resulting in disabling strokes [4][5][6] continue to be the most severe adverse events. 7 Thrombus formation at the inflow cannula (IC) is still one of the most pressing concerns in long-term mechanical circulatory support systems (MCSS).After the introduction of the sintered version of the HVAD system (Medtronic, MN, USA) in 2012, 8 the first examined specimens demonstrated improved ingrowth at

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“…Indications are based on acutely deranged hemodynamics or abrupt reductions in the pump power consumption (P LVAD ) [8], whereas radiologic and echocardiographic diagnostics are impeded by the LVADs metallic structure. This disregards gradual inflow obstruction cases, which encompasses protruding ventricular thrombi [10], emboli [11], thrombi adhering to the cannula [12], and granulation tissue stenosis [2] (Fig. 1C).…”

Section: Introductionmentioning

confidence: 99%

Detection of inflow obstruction in left ventricular assist devices by accelerometer: An in vitro study

Lilja

Schalit

Espinoza

et al. 2022

Medical Engineering & Physics

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Inflow cannula obstruction of the HeartWare left ventricular assist device: what do we really know?

Cited by 8 publications

References 8 publications

Improved Detection Of Thromboembolic Complications In Left Ventricular Assist Device By Novel Accelerometer-Based Analysis

Improved Detection Of Thromboembolic Complications In Left Ventricular Assist Device By Novel Accelerometer-Based Analysis

Thrombus formation at the inflow cannula of continuous‐flow left ventricular assist devices—A systematic analysis

Detection of inflow obstruction in left ventricular assist devices by accelerometer: An in vitro study

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