Once Bitten Twice Not So Shy: Outcomes of Left Ventricular Assist Device Pump Exchange

Purpose Left ventricular assist device (LVAD) failure can present as an acute complication requiring prompt diagnosis and treatment with pump exchange (PE). We thought to characterize indication and outcomes of LVAD PE in our institution. Methods A total of 240 continuous flow LVAD were implanted between 2011 and July 2018. We performed a retrospective analysis of 24 LVAD PE performed on 20 patients, including indication for LVAD PE, time on support to first and second pump exchange, pump type, surgical approach, and operative outcomes. Results Of 240 CF LVAD implants performed over 7 years, 24 (10%) represented pump exchange. Patient age was 47 (17-86) years at time of first implant, and all patients were male. A total of 24 LVAD PE were performed on 20 patients. Time on support until first LVAD PE was 548.3 days (41-1345), and to second LVAD PE was 225 days (13-456).Indications included pump thrombosis in 18 (90%) patients, and pump malfunction in 2 (10%) patients.Type of LVAD PE included 15 / 169 Heart Mate II (HMII)(8.8%), and 9 / 69 HeartWare (HW) (13%) (p Conclusion LVAD PE is a safe and effective therapy for patients presenting pump thrombosis or device malfunction. About 20% of patients will require a second LVAD PE within a year.