On the path to permanent artificial heart technology: Greater energy independence is paramount

Komlo, Caroline; Throckmorton, Amy L.; Tchantchaleishvili, Vakhtang

doi:10.1111/aor.13907

Cited by 1 publication

(2 citation statements)

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“…Current mechanical circulatory support systems require the driveline as an essential electrical conduit between the external power source and mechanical pump. It is worth noting that percutaneous energy transfer systems that eliminate the need for a driveline are in development and will likely render the driveline obsolete 21 …”

Section: Discussionmentioning

confidence: 99%

“…It is worth noting that percutaneous energy transfer systems that eliminate the need for a driveline are in development and will likely render the driveline obsolete. 21 There were several limitations to this analysis that merit attention. First, the retrospective nature of our analysis introduces the possibility for bias, as is the case for any systematic review.…”

Section: Discussionmentioning

confidence: 99%

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Driveline damage and repair in continuous‐flow left ventricular assist devices: A systematic review

et al. 2021

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With mounting time on continuous-flow left ventricular assist device (CF-LVAD) support, patients occasionally sustain damage to the device driveline. Outcomes associated with external and internal driveline damage and repair are currently not well documented. We sought to evaluate the outcomes of driveline damage and its repair. Electronic search was performed to identify all relevant studies published over the past 20 years. Fifteen studies were selected for analysis comprising of 55 patients with CF-LVAD dysfunction due to driveline damage. Demographic and perioperative variables along with outcomes including survival rates were extracted and pooled for the systematic review. Most patients (53/55) were supported on HeartMate II LVAD (Abbott Laboratories, Abbott Park, IL). Internal damage was more commonly reported than external damage [69.1% (38/55) vs. 30.9% (17/55), P = .01]. Median time to driveline damage was 1.9 years [IQR 1.0, 2.5]. Most patients presented with a CF-LVAD alarm [94.5% (52/55)] and patients with internal driveline damage had a significantly higher rate of alarm activation compared to that observed for those with external damage [38/38 (100%) vs. 14/17 (82.4%), P = .04]. Patients with internal driveline dysfunction were more likely to experience component wear compared to those with external driveline dysfunction [10/38 (26.3%) vs. 0/17 (0%), P = .05]; 14.5% of patients (8/55) underwent external repair of the driveline, 5.5% (3/55) were treated with rescue tape, and 5.5% (3/55) were placed on an ungrounded cable, indicating a short-to-shield event had occurred. A total of 49.1% of patients (27/55) underwent CF-LVAD exchange, 5.5% (3/55) were weaned off the CF-LVAD to explant, and 5.5% (3/55) underwent emergent heart transplantation. The median length of hospital stay was 12 days [IQR 7, 12] and 30-day mortality rate was 14.5% (8/55). Driveline damage was more commonly reported at an internal location and despite being a well-recognized complication, mortality still appears high. K E Y W O R D S continuous-flow left ventricular assist device driveline, device malfunction, driveline damage, driveline infection, driveline repair, heart transplant 820 | D'ANTONIO eT Al. Patient-level data were extracted from article texts, tables, and figures (ND, EM, and KP). Discrepancies between reviewer opinions were resolved by discussion and consensus. How to cite this article: D'Antonio ND, Maynes EJ, Tatum RT, et al. Driveline damage and repair in continuous-flow left ventricular assist devices: A systematic review.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%