Successful percutaneous treatment of late outflow graft failure of the left ventricular assist device: a long‐term follow‐up

Zajdel, Wojciech; Tomala, Marek; Bryndza, Magdalena; Krupiński, Maciej; Kapelak, Bogusław; Legutko, Jacek; Wierzbicki, Karol

doi:10.1002/ehf2.13566

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…Thirteen studies 6,9–20 and one unpublished case (performed at Thomas Jefferson University Hospital) were used for analysis, yielding a total of 28 patients with HM3 outflow graft stenosis that underwent stenting. Patient‐level data were extracted for statistical analysis.…”

Section: Resultsmentioning

confidence: 99%

Outcomes of outflow graft stenting in HeartMate 3 left ventricular assist devices: A systematic review and individual patient data meta‐analysis

Patil,

Ahmad,

Shah

et al. 2024

Artificial Organs

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PurposeLVAD outflow graft stenosis continues to remain prevalent with a high complication rate. We sought to pool the existing evidence on indications, utilization patterns, and outcomes of transcatheter interventions for outflow graft stenosis in the HeartMate 3 LVAD.MethodsAn electronic search was performed to identify all studies in the English literature reporting on HeartMate 3 LVAD outflow graft stenting. Patient‐level data were extracted for analysis.ResultsThirteen published reports and one unpublished case comprising a total of 28 patients were included. Median patient age was 68.5 years [Interquartile range: 58, 71] and 25.9% (7/27) were female. Dyspnea [60.7% (17/28)] was the most common presenting symptom. Low flow alarms were present in 60% (15/25) of patients. Findings included external compression [35.7% (10/28)], graft twist [21.4% (6/28)], graft twist and external compression [14.3% (4.28)], intraluminal thrombus [10.7% (3/28)], graft twist and intraluminal thrombus [3.6% (1/28)], and pseudoaneurysm of outflow graft [3.6% (1/28)]. Median time from LVAD implantation to stenting was 2.1 years [1.4, 3]. Immediate flow normalization after stenting was observed in 85.7% (24/28). The 30‐day mortality was 12% (3/25). Overall mortality was 12% (3/25) at a median follow‐up of 3.9 months [1, 17].ConclusionOutflow graft stenting in the HeartMate 3 LVAD appears to be a reasonable treatment option for outflow graft stenosis, with low overall rates of complications and mortality. Further refinement of indications and approaches may improve outcomes.

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Section: Resultsmentioning

confidence: 99%

Outcomes of outflow graft stenting in HeartMate 3 left ventricular assist devices: A systematic review and individual patient data meta‐analysis

Patil,

Ahmad,

Shah

et al. 2024

Artificial Organs

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“…Heart assisting devices have been developing from the late 1960s and still have many issues to deal with 8 : infectious potential, anticoagulation/antiplatelet therapy, immunosuppressive protocol, renal and neurological impact, the best implantation technique and the best device appropriate for the patient 3,6,[9][10][11] . These technological achievements were first thought as bridge-therapy for transplant, but now they are end-therapy for some end-stage HF patients or support for candidates of myocardial recovery [12][13][14][15][16][17] .…”

Section: Discussionmentioning

confidence: 99%

"The Current Management of End-Stage Heart Failure: Two Case Reports"

MOLDOVAN¹,

FRONEA²,

NICA³

et al. 2022

Arch Balk Med Union

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L'approche actuelle de l'insuffisance cardiaque en phase terminale: deux rapports de casIntroduction. L'insuffisance cardiaque est un syndrome clinique causé par des anomalies cardiaques structurelles et/ou fonctionnelles, entraînant un débit cardiaque réduit et/ou des pressions intracardiaques élevées au repos ou pendant le stress. Il s'agit d'une maladie évolutive avec un risque élevé de décès dans les 6 à 12 premiers mois suivant le diagnostic d'insuffisance cardiaque en phase terminale. Présentation des cas. Nous présentons l'implantation réussie d'un dispositif d'assistance ventriculaire gauche HEART MATE III chez un homme de 54 ans atteint de cardiomyopathie ischémique et d'insuffisance cardiaque en phase terminale, et une transplantation cardiaque chez un homme de 31 ans atteint

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“…These do not have the radial strength of balloon expandable stents but are available in longer lengths. 4,5 All stents were postdilated using an 18 mm Vida balloon (BD). Graft angiography was then repeated using a 5 Fr Multi-track catheter in all patients except the one with chronic kidney disease.…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, the remainder of the grafts were fortified with self‐expanding venous stents. These do not have the radial strength of balloon expandable stents but are available in longer lengths 4,5 . All stents were postdilated using an 18 mm Vida balloon (BD).…”

Section: Methodsmentioning

confidence: 99%

Cerebral protection during percutaneous intervention for left ventricular assist device outflow graft obstruction

Joury

Patel

Wever‐Pinzon

et al. 2022

Cathet Cardio Intervent

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Background Left ventricular assist devices (LVAD) outflow graft obstruction is an uncommon complication but carries significant morbidity and mortality. Here we provide a case series of patients with LVAD intrinsic outflow graft obstruction who are deemed to be a high surgical risk for pump exchange and, therefore, underwent percutaneous intervention with the concomitant use of neuroprotective device—Sentinel cerebral protection system (CPS) (Boston Scientific) to prevent embolic stroke. Methods We retrospectively analyzed patients who underwent LVAD placement in our institution and developed LVAD outflow graft obstruction. The diagnosis of LVAD outflow graft obstruction was confirmed by utilizing various cardiac imaging modalities such as echocardiography and/or computed tomography angiography. All patients were treated with percutaneous intervention and a catheter‐based CPS. Results From a total of 501 LVAD implants in our institute, 6 (1.2%) patients with LVAD outflow graft obstruction who underwent percutaneous treatment were included; 4 patients with HeartMate‐III LVAD, 1 patient with HeartMate‐II LVAD, and 1 patient with HeartWare (HVAD). The median age of patients was 56.5 years at the time of LVAD implantation. The median time from the LVAD implantation to the episode of LVAD outflow obstruction was 1343 days. Utilization of Sentinel CPS resulted in the capture and removal of thrombus/debris in all patients. Conclusions Percutaneous intervention of LVAD outflow graft obstruction is less invasive than surgical pump exchange and an acceptable alternative in properly selected patients. In our experience, utilization of a catheter‐based CPS can help in reducing the incidence of periprocedural embolic events.

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Successful percutaneous treatment of late outflow graft failure of the left ventricular assist device: a long‐term follow‐up

Cited by 6 publications

References 9 publications

Outcomes of outflow graft stenting in HeartMate 3 left ventricular assist devices: A systematic review and individual patient data meta‐analysis

Outcomes of outflow graft stenting in HeartMate 3 left ventricular assist devices: A systematic review and individual patient data meta‐analysis

"The Current Management of End-Stage Heart Failure: Two Case Reports"

Cerebral protection during percutaneous intervention for left ventricular assist device outflow graft obstruction

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