A fatal mechanical disorder of the TCI heartmate left ventricularassist system

Abstract

ever, better to have all metal areas where the disc hits the struts polished, as in all other patients (patients 4-12).The area adjacent to the suture ring is the important place to have a microporous surface to bind down the covering from the suture ring. After 11 to 13 years of follow-up of 12 patients with the Björk-Shiley Monostrut mechanical mitral valve with a microporous surface and without anticoagulation, 9 children have been born and no thromboembolic complications have been encountered.Summary. This microporous surface will be covered in 3 months by a thin, smooth, glistening endothelium, free from excrescence formation and fibrin precipitation, extending over the groove and adjacent part of the suture ring. Thus the thicker fibrous covering over the suture ring will be connected with the microporous covering. This will prevent a thrombotic protrusion into the valve orifice with risk for emboli. As the Monostrut valve has been accepted by the Food and Drug Administration after 16 years of successful clinical use, the results achieved from this pilot study indicate the necessity of a multicenter study, the outcome of which could solve valve surgery problems, especially for young girls.

Morbidity and Outcome After Mechanical Ventricular Support Using Thoratec, Novacor, and HeartMate for Bridging to Heart Transplantation

“…In the present study, mechanical failures occurred in a small number of cases, 3 (4%) in the Thoratec group and 4 (9%) in the HeartMate group. The mechanical failures observed in the Thoratec group were equal to those reported by Pennington et al In the HeartMate group, bleeding from a junction in the outflow conduit or inflow cannula was observed as a main symptom of mechanical failure, although 2 patients developed a rupture of the diaphragm (20).…”

Successful replacement of malfunctioning TCI HeartMate LVAD with DeBakey LVAD as a bridge to heart transplantation

“…The rupture of the inflow valve in the TCI Heartmate has been already reported in several cases [4,5].…”

Complications of circulatory assist

“…These complications were device related, with fatal outcome in one case. 11 Gastrointestinal complications were observed in 27 of our patients (12%), about half of them (n = 14, 6%) requiring surgery. Seven patients underwent hemicolectomy, while cholecystectomy, splenectomy, and appendectomy had to be performed in two patients each, and one patient was operated upon for gastrointestinal bleeding.…”

“…Unfortunately, circulatory assist technology is still subject to technical problems, which cannot be neglected, some of which are severe. 2,10,11 In our colletive, we had events of minor importance, such as cracks within the driveline resulting from extended support and thus excessive stress on the material (n = 6 with Novacor, n = 3 with Heart-Mate, 8% vs 7%), controller exchanges due to software faults (n = 2 with Novacor, n = 14 with HeartMate, 0.03% vs 0.33%) and driver defects in Thoratec patients (n = 3 in patients with the dual driver console, n = 10 in patients with the TLC-II, 2.6% vs 48%). These problems did not affect patient outcome in our cohort.…”