Prevalence and timing of bend relief disconnection in patients supported by the late version HeartMate II left ventricular assist device

Evaluation of Bend Relief Disconnection in Patients Supported by a HeartMate II Left Ventricular Assist Device

“…A subsequent single-center cohort of 59 patients who had surveillance imaging revealed a prevalence of bend relief disconnection of 34% (11% with complete disconnection and 23% with partial disconnection). 6 Other centers have also reported complete disconnections in the range of 6% to 15%. 6 Patients with bend relief disconnection may be asymptomatic.…”

“…6 Other centers have also reported complete disconnections in the range of 6% to 15%. 6 Patients with bend relief disconnection may be asymptomatic. In other patients, the outflow graft may kink or deform, leading to low effective pump flow, hemolysis, fluctuations in LVAD pump speed or power, worsening heart failure, or even bleeding if the outflow graft is punctured by the sharp metal edge of the bend relief.…”

“…Because the consequence of bend relief disconnection may be prevented with early detection in asymptomatic patients, routine surveillance of all patients with this version of HM II has been recommended. 6 The bend relief connection is normal when the bend relief snap ring and graft are well aligned ( Figure 1A and 1B). A partial disconnection ( Figure 1C) is diagnosed when the snap ring appears disconnected or poorly aligned with the graft, but without exposure of the underlying outflow graft material.…”

“…5 The initial reported worldwide incidence of disconnected outflow graft bend reliefs was 0.75% (29 of 3852 patients), with 1 death from multisystem organ failure. 5,6 Surgical interventions related to disconnected outflow graft bend reliefs was reported to be 0.13% (5 of 3852). 5,6 Although 29 patients had disconnected outflow graft bend reliefs, the 3823 patients in this report did not undergo systematic screening.…”

“…5,6 Surgical interventions related to disconnected outflow graft bend reliefs was reported to be 0.13% (5 of 3852). 5,6 Although 29 patients had disconnected outflow graft bend reliefs, the 3823 patients in this report did not undergo systematic screening. A subsequent single-center cohort of 59 patients who had surveillance imaging revealed a prevalence of bend relief disconnection of 34% (11% with complete disconnection and 23% with partial disconnection).…”