Unexpected Restart Failure of Durable Left Ventricular Assist Devices: A Report of Two Cases.

Q4 Medicine Journal of Chest Surgery Pub Date : 2024-05-05 Epub Date: 2024-01-16 DOI:10.5090/jcs.23.104

Hyo Won Seo, Ga Hee Jeong, Sung Min Kim, Minjung Bak, Darae Kim, Jin-Oh Choi, Kiick Sung, Yang Hyun Cho

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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.

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耐用左心室辅助装置意外重启失败：两个病例的报告。

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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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