Novel Plug Device for HeartMate 3 Explantation: First Multicenter Experience

Silvia Mariani, Tong Li, Anna Lassia Meyer, Tracy Geoffrion, Matthias Fittkau, Alexandra Schöde, Jasmin S Hanke, Antonio Loforte, Axel Haverich, Jan D Schmitto*, Günes Dogan

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Patients undergoing explantation of left ventricular assist devices (LVADs) after improvement of myocardial function remain a minority. Nevertheless, considering the growing population of LVAD patients, increasing demand for new explantation strategies is expected. Herein, we present a retrospective review of seven patients undergoing HeartMate3 explantation with the use of a custom-made apical ring plug in four medical centers. The primary outcome was status at intensive care unit discharge. Secondary outcomes included perioperative complications and transfusions. Six out of seven patients were males. The median age at explantation and time on LVAD support was 35 years (range:13-73) and 10 months (range:9-24), respectively. No technical difficulties were experienced during plug implantation via a conventional sternotomy or through a left lateral thoracotomy, either with or without cardiopulmonary bypass. Perioperative transfusions ranged from 0 to 3 units/patient. No re-operations for bleeding, hemorrhagic, embolic, or plug-related infective events were observed. Heparin was started 6 hours after surgery as a bridge to oral anticoagulation (international normalized ratio: 2-2.5). All patients were discharged alive from intensive care unit. This novel plug device for HeartMate3 explantation was successfully and safely implanted in this first patient series. Notwithstanding, its use should still be considered off-label and larger studies are required to investigate its long-term results.

Original languageEnglish
Pages (from-to)E262-E267
Number of pages6
JournalAsaio Journal
Volume68
Issue number12
Early online date7 May 2022
DOIs
Publication statusPublished - Dec 2022

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