Journal of Chest Surgery

  • 제57권3호
  • /
  • Pages.315-318
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  • 2024
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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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)
  • 투고 : 2023.08.10
  • 심사 : 2023.11.10
  • 발행 : 2024.05.05
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초록

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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참고문헌

  1. Salerno CT, Hayward C, Hall S, et al. HVAD to HeartMate 3 left ventricular assist device exchange: best practices recommendations. Eur J Cardiothorac Surg 2022;62:ezac169. https://doi.org/10.1093/ejcts/ezac169 
  2. Medtronic. Urgent medical device communication notification letter: Medtronic HVAD System [Internet]. Medtronic; 2021 [cited 2023 Aug 2]. Available from: https://asiapac.medtronic.com/content/dam/medtronic-com/global/HCP/Documents/hvad-urgent-medical-device-notice-june-2021.pdf 
  3. Li S, Beckman JA, Wiederspan L, Guertin L, Pal J, Mahr C. First-in-man use of a modified controller to resolve HVAD failure-to-restart. ASAIO J 2023;69:e409-10. https://doi.org/10.1097/MAT.0000000000001911 
  4. Cogswell R, Cantor RS, Vorovich E, et al. HVAD to Heartmate 3 device exchange: a Society of Thoracic Surgeons Intermacs analysis. Ann Thorac Surg 2022;114:1672-8. https://doi.org/10.1016/j.athoracsur.2021.09.031 
  5. Medtronic. HeartWare HVAD system performance note [Internet]. Medtronic; 2020 [cited 2023 Aug 2]. Available from: https://asiapac.medtronic.com/content/dam/medtronic-com/global/HCP/Documents/performance-note-hvad-controller-fault-alarms-ifu-reinforcement.pdf