Thorac Cardiovasc Surg 2017; 65(05): 410-414
DOI: 10.1055/s-0036-1593867
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

HeartMate II Left Ventricular Assist Device Pump Exchange: A Single-Institution Experience

Asad F. Shaikh
1  College of Medicine, Texas A&M University Health Science Center, Dallas, Texas, United States
,
Susan M. Joseph
2  Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, Texas, United States
,
Brian Lima
3  Department of Cardiac and Thoracic Surgery, Baylor University Medical Center, Dallas, Texas, United States
,
Shelley A. Hall
2  Center for Advanced Heart and Lung Disease, Baylor University Medical Center, Dallas, Texas, United States
,
Rajasekhar Malyala
3  Department of Cardiac and Thoracic Surgery, Baylor University Medical Center, Dallas, Texas, United States
,
Aldo E. Rafael
3  Department of Cardiac and Thoracic Surgery, Baylor University Medical Center, Dallas, Texas, United States
,
Gonzalo V. Gonzalez-Stawinski
3  Department of Cardiac and Thoracic Surgery, Baylor University Medical Center, Dallas, Texas, United States
,
Themistokles Chamogeorgakis
3  Department of Cardiac and Thoracic Surgery, Baylor University Medical Center, Dallas, Texas, United States
› Author Affiliations
Further Information

Publication History

30 June 2016

30 September 2016

Publication Date:
30 November 2016 (online)

Abstract

Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange.

Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution. The indications, demographics, and outcome were extracted and analyzed.

Results Of 250 total patients with implanted HMII LVADs, 16 (6%) required pump exchange during the study period. The initial indications for LVAD placement in these patients were bridge to transplantation (n = 6 [37.5%]) or destination therapy (n = 10 [62.5%]). Fifteen patients (93.8%) required pump exchange due to pump thrombosis and 1 (6.2%) due to refractory driveline infection. Nine patients (56.2%) underwent repeat median sternotomy while a left subcostal approach was used in the remaining seven patients. Fifteen patients (93.7%) survived until hospital discharge. During the follow-up period (median, 155 days), 11 patients remained alive and 4 of these underwent successful cardiac transplantation.

Conclusion HMII LVAD pump exchange can be safely performed for driveline infection or pump thrombosis when heart transplantation is not an option.