Author + information
- Jay Bhama,
- Chad Eckert,
- Kathleen Lockard,
- Akira Shiose,
- Christian Bermudez,
- Jeffrey Teuteberg,
- Ravi Ramani,
- Marc Simon,
- Vinay Badhwar and
- Robert Kormos
Pump thrombosis requiring device exchange is a dreaded complication after implantation of a left ventricular assist device (LVAD). Sub-optimal inflow cannula (IC) positioning at the time of implant or changes in IC position due to weight gain or ventricular remodeling may lead to non-laminar flow. However, it is unknown whether IC position contributes to the development of pump thrombosis.
A retrospective review of Heartmate II LVAD implants from 2004-2012 was performed. The angle of the IC (AIC) was measured on routine chest x-rays (Fig. 1). Student's t-test was used to determine statistical differences between groups.
A total of 76 patients underwent LVAD placement. The mean AIC for all patients at the time of implant was 59ø±12ø(38ø-98ø). Six patients required device exchange for pump thrombosis (DE Group). The AIC at the time of exchange in the DE Group was significantly larger than the AIC at the time of implant for the remaining 70 patients (71ø±6øvs. 59ø±1ø, p=0.02). When comparing the AIC for the two groups at the time of implant no difference was identified (67ø±7øvs. 59ø±1ø, p=0.27). There was a significant change in the AIC of the 6 patients in the DE Group between implant and exchange (67ø± 17øvs. 71ø± 5ø, p=0.03).
Sub-optimal LVAD IC position at the time of implant and changes in position over time may contribute to pump thrombosis requiring device exchange. Regular monitoring of the AIC, by this simple procedure, may help identify patients at risk for this problem.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Heart Failure: Mechanical Circulatory Support
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1260M-267
- 2013 American College of Cardiology Foundation