Left ventricular assist device (LVAD) represents a valid alternative to heart transplant in patients who suffer from end stage heart failure but adverse events, involving both the internal and the external parts, can occur in ongoing patients and if not promptly diagnosed can be potentially fatal. Main intention is to report our approach to device malfunction.
Over the past ten years in 90 patients a LVAD was implanted at our institution. Patient's LVAD parameters were monitored monthly. A VAD team including nurse, perfusionist, cardiac surgeon, provide 7/24 on call service to afford any emergency. The patients were trained to promptly identify the different alarm and to immediately communicate to the VAD team. According to the alarm severity a support was provided as early as possible and hospitalization was prescribed as mandatory in some case.
In 23 patients a device's part failure occurred. 12 required immediate hospitalization and intervention as consequence of different complications like showed in table 1. N. events Type of complication Intervention 4 Pump Thrombosis 3 Thrombolisis 1 Pump Exchange 5 Controller's Failure Controller Exchange 3 Driveline Fracture Hospidalization 3 HTX urgent 5 Batteries Clips broken Clip Exchange 6 Driveline's Outer Sheath Fracture Repair 1 System control power cables fracture Controller Exchange 1 Connector Nut rupture Controller Exchange.
Early recognition and diagnosis of LVAD complications is mandatory. We support the utility of multidisciplinary VAD Team to guarantee an early identification and solution of VAD related problems.