Left Ventricular Assist Device Malfunctions

Kormos, Robert L.; McCall, M. G.; Althouse, Andrew D.; Lagazzi, Luigi; Schaub, R; Kormos, M.A.; Zaldonis, Jared A.; Sciortino, Christopher M.; Lockard, K.L.; Kuntz, Nicole; Dunn, E.; Teuteberg, Jeffrey J.

doi:10.1161/circulationaha.117.027360

Cited by 65 publications

(21 citation statements)

References 22 publications

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“…A total of 13% of device failures are caused by internal pump failure, whereas over 60% are caused by the failure of batteries, the controller and the peripheral cable [416]. Damage to the driveline that interferes with the operation of the pump is a rare, but life-threatening complication.…”

Section: Pump Thrombosis and Other Late Adverse Eventsmentioning

confidence: 99%

2019 EACTS Expert Consensus on long-term mechanical circulatory support

Potapov

Antonides

Crespo-Leiro

et al. 2019

European Journal of Cardio-Thoracic Surgery

298

446

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Long-term mechanical circulatory support (LT-MCS) is an important treatment modality for patients with severe heart failure. Different devices are available, and many—sometimes contradictory—observations regarding patient selection, surgical techniques, perioperative management and follow-up have been published. With the growing expertise in this field, the European Association for Cardio-Thoracic Surgery (EACTS) recognized a need for a structured multidisciplinary consensus about the approach to patients with LT-MCS. However, the evidence published so far is insufficient to allow for generation of meaningful guidelines complying with EACTS requirements. Instead, the EACTS presents an expert opinion in the LT-MCS field. This expert opinion addresses patient evaluation and preoperative optimization as well as management of cardiac and non-cardiac comorbidities. Further, extensive operative implantation techniques are summarized and evaluated by leading experts, depending on both patient characteristics and device selection. The faculty recognized that postoperative management is multidisciplinary and includes aspects of intensive care unit stay, rehabilitation, ambulatory care, myocardial recovery and end-of-life care and mirrored this fact in this paper. Additionally, the opinions of experts on diagnosis and management of adverse events including bleeding, cerebrovascular accidents and device malfunction are presented. In this expert consensus, the evidence for the complete management from patient selection to end-of-life care is carefully reviewed with the aim of guiding clinicians in optimizing management of patients considered for or supported by an LT-MCS device.

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Section: Pump Thrombosis and Other Late Adverse Eventsmentioning

confidence: 99%

2019 EACTS Expert Consensus on long-term mechanical circulatory support

Potapov

Antonides

Crespo-Leiro

et al. 2019

European Journal of Cardio-Thoracic Surgery

298

446

View full text Add to dashboard Cite

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“…About 50% of patients with a durable MCS experience device malfunctions other than pump thrombosis within 1 year postoperatively [47]. The durability and functionality of LVADs are influenced by numerous factors including implantation technique; anatomical constraints; and complications such as infection and bleeding, anticoagulation, pump settings and device design.…”

Section: Complicationsmentioning

confidence: 99%

Current perspectives on mechanical circulatory support

Schramm

Morshuis

Schoenbrodt

et al. 2019

European Journal of Cardio-Thoracic Surgery

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Summary Mechanical circulatory support gained a significant value in the armamentarium of heart failure therapy because of the increased awareness of the prevalence of heart failure and the tremendous advances in the field of mechanical circulatory support during the last decades. Current device technologies already complement a heart transplant as the gold standard of treatment for patients with end-stage heart failure refractory to conservative medical therapy. This article reviews important aspects of mechanical circulatory support therapy and focuses on currently debated issues.

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“…The HVAD is one of the commercially available continuous flow LVADs with more than 16,000 implantations worldwide [3,4]. Although medical complications of HVADs are researched extensively, [5][6][7][8] less attention is given to the usability of its battery and controller system including malfunctions [9][10][11]. The human factors of LVAD wearable components remain a crucial challenge [12,13].…”

Section: Introductionmentioning

confidence: 99%

Eye Tracking Supported Human Factors Testing Improving Patient Training

et al. 2021

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The handling of left ventricular assist devices (LVADs) can be challenging for patients and requires appropriate training. The devices’ usability impacts patients’ safety and quality of life. In this study, an eye tracking supported human factors testing was performed to reveal problems during use and test the trainings’ effectiveness. In total 32 HeartWare HVAD patients (including 6 pre-VAD patients) and 3 technical experts as control group performed a battery change (BC) and a controller change (CC) as an everyday and emergency scenario on a training device. By tracking the patients’ gaze point, task duration and pump-off time were evaluated. Patients with LVAD support ≥1 year showed significantly shorter BC task duration than patients with LVAD support <1 year (p = 0.008). In contrast their CC task duration (p = 0.002) and pump-off times (median = 12.35 s) were higher than for LVAD support patients <1 year (median = 5.3 s) with p = 0.001. The shorter BC task duration for patients with LVAD support ≥1 year indicate that with time patients establish routines and gain confidence using their device. The opposite effect was found for CC task duration and pump-off times. This implies the need for intermittent re-training of less frequent tasks to increase patients’ safety.

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Left Ventricular Assist Device Malfunctions

Abstract: Device malfunction is much broader than pump failure alone and occurs for different components at different rates based on the type of LVAD.

Cited by 65 publications

References 22 publications

2019 EACTS Expert Consensus on long-term mechanical circulatory support

2019 EACTS Expert Consensus on long-term mechanical circulatory support

Current perspectives on mechanical circulatory support

Eye Tracking Supported Human Factors Testing Improving Patient Training

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