Percutaneous Decommissioning of Left Ventricular Assist Device: Is This a Safe Procedure?

Background: The number of left ventricular assist device (LVAD) implantation in patients suffering from terminal heart failure is rising continuously. However, a small number of those patients can be bridged to recovery. To the best of our knowledge, the mid-term results have not yet been examined in detail. Here, we describe our experience with percutaneous decommissioning of left ventricular assist devices (PD-LVAD).

Method: We reviewed our database for all patients who were successfully weaned from LVAD support after myocardial recovery at our center. Demographic and outcome data were collected and retrospectively analyzed.

The PD-LVAD was performed using an Amplatzer Vascular Plug® device (Medtronic Inc, Framingham, Massachusetts, United States). The driveline was resected as staged procedure after occluder implantation.

Results: Between January 2018 and September 2020, a total of 168 consecutive patients underwent LVAD implantation. A total of 26 patients were successfully weaned off LVAD therapy, of whom, 12 patients underwent PD-LVAD (Five HeartMate III: Abbott Inc, Chicago, United States, and six HeartWare: HVAD, Medtronic Inc, Framingham, MA, United States). A total of 14 patients underwent surgical explantation and were excluded. Characteristics and outcome parameters are summarized in Table 1.

Conclusion: Plug device occlusion of the LVAD outflow graft and resection of the driveline is a safe and reproducible procedure in patients successfully weaned from LVAD.

Publication History

Article published online:
03 February 2022