(264) - Development of a Repair for Traumatic Damage to the HeartWare HVAD® Pump Driveline

Abstract

Ventricular assist devices (VAD) have improved the quality of life of heart failure patients though significant challenges remain with the percutaneous driveline. Trauma to the driveline may increase risk for a pump stop leading to possible adverse events. Splice repair of the driveline in cases of traumatic damage can avoid the risk for emergent pump exchange. The HeartWare HVAD® Pump is powered by two motors for increased efficiency and has the redundancy for VAD support on one motor. In cases where damage has caused single motor operation, an enhanced splice repair that uses a Y-cable has been developed to minimize pump off time during the procedure. A retrospective analysis of all splice repairs was performed of HVAD pumps implanted from March 2006 through October 2013. Data was obtained from HeartWare Quality Assurance complaint and HVAD controller log file databases. Log file data was used to calculate VAD off time during the repair. Driveline splice repairs were performed in 18 patients with all sources of damage external to the body. The repair was successful in 17 patients (94%) with one repair resulting in a pump exchange. 13 patients were supported in single motor operation with no pump off time before the repair while 5 patients had pump stoppage due to damage on both motors before the repair. Of the 13 patients with uninterrupted VAD support, 6 were repaired using the enhanced procedure and 7 were repaired without the Y-Cable. Pump off time during the repair was significantly reduced (P = 0.005) using the enhanced procedure with an average of 58 ± 59 seconds compared to 423 ± 270 seconds for no Y-Cable (Figure 1). The low incidence of the splice repair supports long-term reliability of the HeartWare HVAD Pump driveline. The enhanced splice procedure allows for repair of traumatically damaged drivelines operating on one motor with minimal pump off time (58sec) decreasing risk for device exchange.