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Decommission of a Heartmate 3 LVAD in a patient with left ventricular recovery
  • S. Allan Schaffer,
  • Stephen Shannon
S. Allan Schaffer
St Boniface General Hospital

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Stephen Shannon
St Boniface General Hospital
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Background: Left ventricular assist devices have been a significant development in the treatment of patients with advanced heart failure supporting circulation as a bridge to transplant, recovery or long-term destination therapy. When ventricular recovery occurs, there are multiple described ways of proceeding. HM2 decommissions are well described with varying degrees of explant operations, less so in HM3 due to the novelty of the device. In certain situations, invasive surgery can carry high risk and so a minimally invasive decommission, leaving the LVAD essentially intact in situ can be considered. Case report In this report, we describe the case of a 35-year-old male diagnosed with an idiopathic dilated cardiomyopathy requiring an LVAD with subsequent identification of cardiac recovery with the asymptomatic thrombosis of the 2 nd HM3 device. Investigations demonstrated absent flow through the pump whilst the patient-reported NYHA I functional class symptoms. The Driveline was cut with the remaining internal pump components decommissioned and left in situ. At 1 year the patient continues to do well with continued features of cardiac recovery with an LVEF of over 40%. Conclusion LV recovery is well recognized with typical management being LVAD explant surgeries performed. Each case should be analyzed for risks and benefits to the patient and future research showed be directed towards levels of decommissioning surgery and management post-LVAD decommission patient care.
22 Apr 2022Submitted to Journal of Cardiac Surgery
03 Jun 2022Submission Checks Completed
03 Jun 2022Assigned to Editor
05 Jun 2022Reviewer(s) Assigned
01 Aug 2022Review(s) Completed, Editorial Evaluation Pending
11 Aug 2022Editorial Decision: Revise Minor
09 Sep 20221st Revision Received
09 Sep 2022Submission Checks Completed
09 Sep 2022Assigned to Editor
21 Sep 2022Reviewer(s) Assigned
05 Oct 2022Review(s) Completed, Editorial Evaluation Pending
08 Oct 2022Editorial Decision: Accept