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

  • Hyo Won Seo (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ga Hee Jeong (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung Min Kim (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Minjung Bak (Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Darae Kim (Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jin-Oh Choi (Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kiick Sung (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yang Hyun Cho (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2023.08.10
  • Accepted : 2023.11.10
  • Published : 2024.05.05

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.

Keywords

References

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