Percutaneous approach to left ventricular assist device decommissioning

Abstract

Objective To assess the outcomes of a single‐center experience with percutaneous left ventricular assist device (LVAD) decommissioning. Background Patients with LVADs may eventually require their removal, either due to recovery of left ventricular function or recurrent complications. Traditionally, withdrawal of LVAD support has been managed with surgical device explantation, which carries significant procedural risks. Transcatheter LVAD decommissioning, with outflow graft occlusion and driveline transection, has recently been described as an alternative to surgical removal. Methods Here, we report on a retrospective cohort of five consecutive cases treated with transcatheter LVAD decommissioning. Results The procedure was effective in all cases, and no patient experienced procedure‐related complications. At midterm follow‐up, the three patients who had myocardial function recovery were alive and had not experienced heart failure‐related symptoms or complications. Conclusion Percutaneous LVAD decommissioning appears to be a safe and effective approach to LVAD treatment discontinuation.

Emergent left ventricular assist device decommissioning in the setting of impending pump shutdown in heart transplant candidate

“… 1 Unfortunately, no echocardiogram was performed during this attempt. Catheter-based occlusion 2 was not available at our institution. A subxiphoid approach risked cross-contamination from the driveline.…”