Hyo Won Seo, Ga Hee Jeong, Sung Min Kim, Minjung Bak, Darae Kim, Jin-Oh Choi, Kiick Sung, Yang Hyun Cho
{"title":"Unexpected Restart Failure of Durable Left Ventricular Assist Devices: A Report of Two Cases.","authors":"Hyo Won Seo, Ga Hee Jeong, Sung Min Kim, Minjung Bak, Darae Kim, Jin-Oh Choi, Kiick Sung, Yang Hyun Cho","doi":"10.5090/jcs.23.104","DOIUrl":null,"url":null,"abstract":"<p><p>The HeartWare Ventricular Assist Device (HVAD) was widely used for mechanical circulatory support in patients with end-stage heart failure. However, there have been reports of a critical issue with HVAD pumps failing to restart, or experiencing delays in restarting, after being stopped. This case report describes 2 instances of HVAD failure-to-restart during heart transplantation surgery and routine outpatient care. Despite multiple attempts to restart the pump using various controllers and extensions, the HVAD failed to restart, triggering a hazard alarm for pump stoppage. In one case, the patient survived after receiving a heart transplantation, while in the other, the patient died immediately following the controller exchange. These cases highlight the rare but life-threatening complication of HVAD failure-to-restart, underscoring the importance of awareness among clinicians, patients, and caregivers, and adherence to the manufacturer's guidelines and recommendations for HVAD management.</p>","PeriodicalId":34499,"journal":{"name":"Journal of Chest Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089060/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Chest Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5090/jcs.23.104","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
The HeartWare Ventricular Assist Device (HVAD) was widely used for mechanical circulatory support in patients with end-stage heart failure. However, there have been reports of a critical issue with HVAD pumps failing to restart, or experiencing delays in restarting, after being stopped. This case report describes 2 instances of HVAD failure-to-restart during heart transplantation surgery and routine outpatient care. Despite multiple attempts to restart the pump using various controllers and extensions, the HVAD failed to restart, triggering a hazard alarm for pump stoppage. In one case, the patient survived after receiving a heart transplantation, while in the other, the patient died immediately following the controller exchange. These cases highlight the rare but life-threatening complication of HVAD failure-to-restart, underscoring the importance of awareness among clinicians, patients, and caregivers, and adherence to the manufacturer's guidelines and recommendations for HVAD management.
HeartWare心室辅助设备(HVAD)被广泛用于终末期心力衰竭患者的机械循环支持。然而,有报告称,HVAD 泵在停止后出现无法重启或重启延迟的严重问题。本病例报告描述了在心脏移植手术和常规门诊护理期间发生的两例 HVAD 重启失败。尽管使用各种控制器和扩展装置多次尝试重启泵,但 HVAD 还是未能重启,并触发了泵停止的危险警报。在其中一个病例中,患者在接受心脏移植手术后存活了下来,而在另一个病例中,患者在更换控制器后立即死亡。这些病例突显了 HVAD 重启失败这一罕见但危及生命的并发症,强调了临床医生、患者和护理人员提高认识以及遵守制造商的 HVAD 管理指南和建议的重要性。