Effects of Gamma Radiation on a Ventricular Assist Device and Its Percutaneous Lead Components

Abstract

A patient supported by a left ventricular assist device (LVAD) presented with an abdominal tumor requiring consolidative radiation therapy. To assess the effects of radiation therapy on the operation of the ventricular assist device (VAD) system and assure that the treatment would be safe for the patient with regard to the operation of the VAD system, sample equipment was irradiated and then tested for functionality. Changes in the mechanical properties of components of the percutaneous lead were measured. After testing, it was concluded that radiation therapy would not impede the operation of the pump or produce deleterious alterations of mechanical properties of the various system components. The patient underwent radiation therapy with a total dose of 2,000 cGy without evident complications. There were no observed effects on the LVAD operation nor any indication of alarms or malfunctions. Subsequently, the patient recovered adequate cardiac function for explant of the LVAD and the recovered components were also analyzed confirming the absence of alterations in material properties that would endanger patient safety.

Safe delivery of lung stereotactic body radiation therapy in a patient with a left ventricular assist device and implantable cardioverter defibrillator

“…Similarly, no change in HVAD function (n = 5) was found in response to proton beam therapy up to 70 GyE . No case reports of photon radiation in the specific setting of a third‐generation LVAD exist, although 4 case reports of safe treatment with radiation in earlier generation LVADs are available …”

“…6 No case reports of photon radiation in the specific setting of a third-generation LVAD exist, although 4 case reports of safe treatment with radiation in earlier generation LVADs are available. [7][8][9][10]…”

“…Yet, no large clinical studies have been done to establish the safety or dose constraints of radiation in these cardiac devices. The evidence regarding radiation in an LVAD‐dependent patient is limited to case reports and in vitro studies . Here, we report the first case of thoracic stereotactic body radiation therapy (SBRT) to the left lower lobe of the lung for a suspected solitary lung carcinoma in a patient with a third generation LVAD (Heartware ® ) and ICD.…”

“…The evidence regarding radiation in an LVAD-dependent patient is limited to case reports and in vitro studies. [5][6][7][8][9][10] Here, we report the first case of thoracic stereotactic body radiation therapy (SBRT) to the left lower lobe of the lung for a suspected solitary lung carcinoma in a patient with a third generation LVAD (Heartware ® ) and ICD. This report illustrates that this treatment approach can be safely and successfully used to manage this complex patient population.…”

HeartWare miniaturized intrapericardial ventricular assist device: advantages and adverse events in comparison to contemporary devices

“…Even though no adverse response of the Thoratec pneumatic LVAD with TLC-II ® Portable Driver (Thoratec) [35] and HeartMate II [36] systems to cancer radiation treatment have been reported in individual case reports, so far no evidence exists on device performance after cumulative radiation dose higher than 2000 cGy.…”