Abstract
<h3>Purpose</h3> We have a patient who had expired for sudden pump failure of EVAHEART 1 supported for 1,773days. Pump retrieval study revealed a pump rotor-case diameter expansion is a definitive cause of sudden pump discontinue. This pump rotor-case diameter expansion is associated with the duration of support and the higher risk of sudden pump discontinue is the support longer than 3 years. <h3>Methods</h3> Five BTT patients support with EVAHEART 1 longer than 3 years were in a higher risk for sudden pump discontinue in our institute. Careful consultation with patients and decision making regarding the choice of prophylactic pump exchange surgery or long term hospital admissions were undertaken considering the longer Japanese waiting period(>5years) and QOL of patients. Moreover, all the efforts to detect specific higher risk pump using device parameter and sonographic analysis were undertaken. <h3>Results</h3> All five patients have been survived avoiding sudden device discontinue. Two patients had prophylactic pump exchange procedures and 3 had reached to transplant following long term hospitalization (mean 9.8 months). During the hospital stay, there were not any device related events. All explanted 5 pumps were examined and showed pump rotor-case diameter expansion in 3 and 2 without any expansion. The exact analysis of pump data or sonographic approach did not detect any abnormalities. <h3>Conclusion</h3> Following a sudden device discontinue, the pump retrieval analysis have been translated into clinical patient care and successfully managed either with prophylactic pump exchanges or long term hospitalization and further clinical device discontinues were avoided. It was still impossible to detect the abnormality inside the device even with various modern technology.
Published Version
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