First series of left ventricular assist device exchanges to HeartMate 3

Hanke, Jasmin S.; Rojas, Sebastián V.; Doğan, Güneş; Feldmann, C.; Beckmann, Erik; Deniz, E.; Wiegmann, Bettina; Michaelis, Jana-Elena; Napp, L. Christian; Berliner, Dominik; Shrestha, Malakh; Bauersachs, Johann; Haverich, Axel; Schmitto, Jan D.

doi:10.1093/ejcts/ezx010

Cited by 45 publications

(53 citation statements)

References 13 publications

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“…Dealing with chronic DLI can be complicated. If antibiotic therapy fails, an exchange of the LVAD remains the inevitable alternative (15)(16)(17). Altogether using a double tunneling technique for driveline implantation seems to be an important factor to lower infection rates in LVAD patients.…”

Section: Discussionmentioning

confidence: 99%

Reduction of driveline infections through doubled driveline tunneling of left ventricular assist devices—5-year follow-up

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Reduction of driveline infections through doubled driveline tunneling of left ventricular assist devices—5-year follow-up

et al. 2018

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“…The overall early postoperative mortality for patients undergoing exchange appears to be low (25,26). The overall early postoperative mortality for patients undergoing exchange appears to be low (25,26).…”

Section: Discussionmentioning

confidence: 99%

“…LVAD device exchange is an invasive surgical procedure that does not come without risks. The overall early postoperative mortality for patients undergoing exchange appears to be low (25,26). There have been reports of postoperative bleeding and recurrence of underlying etiology that necessitated the exchange (such as infection and thrombosis), although the true rates of postoperative adverse events have not been elucidated in the literature (25,27).…”

Section: Discussionmentioning

confidence: 99%

Device exchange versus nonexchange modalities in left ventricular assist device‐specific infections: A systematic review and meta‐analysis

et al. 2018

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No standardized treatment algorithm exists for the management of continuous‐flow left ventricular assist device (CF‐LVAD)‐specific infections. The aim of this systematic review and meta‐analysis was to compare the outcomes of CF‐LVAD‐specific infections as managed by device exchange to other treatment modalities not involving device exchange. Electronic search was performed to identify all studies in the English literature relating to the management of CF‐LVAD‐specific infections. All identified articles were systematically assessed for selection criteria. Thirteen studies with 158 cases of CF‐LVAD‐specific infection were pooled for analysis. Overall, 18/158 (11.4%) patients underwent CF‐LVAD exchange, and 140/158 (88.6%) patients were treated with non‐exchange modalities. The proportion of patients with isolated driveline infections or pump or pocket infections did not differ significantly between the groups. During a mean follow‐up of 290 days, there were no significant differences in the overall mortality [exchange 17.6% (4.3–50.6) vs. non‐exchange 23.3% (15.8–32.9), P = 0.67] and infection recurrence rates [exchange 26.7% (8.7–58.0) vs. non‐exchange 38.6% (15.4–68.5), P = 0.56]. In the setting of CF‐LVAD‐specific infections, device exchange does not appear to confer an advantage in the overall mortality and infection recurrence as compared to non‐exchange modalities.

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“…Even though the need for LVAD exchange is a hazardous complication in VAD therapy, it can be used to upgrade a patient to a new generation assist device e.g., HeartMate 3 (27)(28)(29)(30). The exchange procedure offers an opportunity to upgrade patients to a new generation pump which offers e.g., advanced reduction of adverse events or longer battery capacities (27).…”

Section: Discussionmentioning

confidence: 99%

Left ventricular assist device exchange for the treatment of HeartMate II pump thrombosis

et al. 2018

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Between February 2004 and December 2015, 87 exchanges of LVADs were performed at a single center. In 41 cases pump thrombosis was the reason for LVAD exchange. A total of 28 patient years (10,276 days) were analyzed. Average ICU stay was 15.8±20.4 days and average in-hospital stay 38.1±37.3 days after LVAD exchange. After thirty days the survival rate was 80.5%, 75.6% after 6 months and 70.7% one year after LVAD exchange. Out of the study cohort, three patients have successfully undergone heart transplantation. Twelve patients suffered a stroke postoperatively (29%). Twelve patients needed postoperative dialysis (29%). No technical complications of the VAD were recorded in the study group. Two patients underwent successful LVAD explantation due to myocardial recovery. One year after LVAD exchange, 14 patients underwent re-exchange due to pump thrombosis (34%). Eight patients suffered from a LVAD related infection out of which two patients were treated by pump exchange. A total of 12 patients died during the complete one year follow up of this study (29%). Four patients died in the second, two in the third and one in the fourth year after LVAD exchange. The remaining 17 patients are still ongoing on the device. It is generally feasible to treat pump thrombosis via LVAD exchange. Yet, the exchange procedure is not without risk and the risk of re-thrombosis (34%), stroke (29%), postoperative dialysis (29%) and perioperative complications remains high.

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First series of left ventricular assist device exchanges to HeartMate 3

Abstract: LVAD exchanges from HM II as well from HVAD to HM 3 are proven to be technically feasible. Due to the advantages and technical improvements of the new-generation pumps, this procedure is an excellent opportunity to give patients access to a superior generation of assist device.

Cited by 45 publications

References 13 publications

Reduction of driveline infections through doubled driveline tunneling of left ventricular assist devices—5-year follow-up

Reduction of driveline infections through doubled driveline tunneling of left ventricular assist devices—5-year follow-up

Device exchange versus nonexchange modalities in left ventricular assist device‐specific infections: A systematic review and meta‐analysis

Left ventricular assist device exchange for the treatment of HeartMate II pump thrombosis

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