Neointima-Inducing Inflow Cannula for over 5 Years after Left Ventricular Assist Device Implantation

Purpose We previously reported experimental advantages of new titanium mesh wrapped inflow cannula for left ventricular assist device (LVAD) to avoid wedge thrombus formation. There was no thrombus formation in any of the explanted LVAD system and around the outside of the inflow cannula after 2 months from LVAD implantation in calves. We had applied this newly developed inflow cannula into the clinical arena with EVAHEART LVAD since 2013. We had clinically evaluated experience of this inflow cannula and showed the clear induction of autologous neointima avoiding wedge thrombus formation for over 5 years from LVAD implantation. Methods Retrospective data were analyzed from 19 patients who underwent EVAHEART LVAD implantation using newly inflow cannula as a bridge to transplant since September 2013 at Tokyo Women's Medical University. Results All patients achieved hospital discharge on LVAD support. 9 patients underwent heart transplantation and 3 of 9 patients were supported over 5 years (5.12-5.45 years) from LVAD implantation. Thromboembolic complications in these patients included 1 cerebral bleeding event, 1 cerebral infarction and 2 transit ischemic attack. In macroscopically findings were no thrombus formation around the inflow cannula. The titanium mesh was completely enveloped with white neointima tissue that appeared to have grown from the ventricular endocardium (Figure). Conclusion The titanium mesh inflow cannula induces autologous neointima avoiding wedge thrombus formation in clinical experience for over 5 years after LVAD implantation.