The spectrum of complications following left ventricular assist device placement

Nance Yuan, George J. Arnaoutakis, Timothy J. George, Jeremiah G. Allen, Derek G. Ju, Justin M. Schaffer, Stuart D. Russell, Ashish S. Shah, John V. Conte

Research output: Contribution to journalArticle

Abstract

Introduction: Left ventricular assist device (LVAD) support is associated with many complications, but relatively few studies have examined the full spectrum of complications beyond infectious and bleeding events. Methods: We conducted a retrospective review of patients receiving either a pulsatile-flow Heartmate XVE (HM1; Thoratec Corp., Pleasanton, CA, USA) or continuous-flow Heartmate II (HM2; Thoratec Corp.) LVAD at our institution (June 2000 to March 2012). Frequency and date of onset of nonbleeding, noninfectious complications were examined. Results: One hundred eighty-two LVADs were implanted, 49 HM1, and 133 HM2. Support duration was longer for HM2s (median 358 vs. 112 days; p = 0.0003). Overall, the most frequent complications were respiratory failure, ventricular arrhythmia, atrial arrhythmia, right heart failure, and renal failure. Respiratory failure, arrhythmias, severe psychiatric events, and renal failure all occurred with median date of onset ≤ seven days postprocedure. Right heart failure, hepatic failure, thromboembolism, and transient ischemic attacks had a median date of onset 8 to 30 days postprocedure. Stroke, hemolysis, and device failure occurred mostly more than a month postoperatively. Right heart failure, hepatic failure, and device failure were more frequent in HM1 patients than in HM2 patients. Several events, including stroke, had much later onset in HM2 patients. Conclusion: In this 10-year review of complications following LVAD implantation, the most common adverse events tended to occur early after implantation. As pulsatile-flow HM1s showed greater frequency and earlier onset of some adverse events, our data suggest better overall outcomes with the continuous-flow HM2s.

Original languageEnglish (US)
Pages (from-to)630-638
Number of pages9
JournalJournal of Cardiac Surgery
Volume27
Issue number5
DOIs
StatePublished - Sep 2012

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Heart-Assist Devices
Equipment Failure
Cardiac Arrhythmias
Pulsatile Flow
Heart Failure
Liver Failure
Respiratory Insufficiency
Renal Insufficiency
Stroke
Thromboembolism
Transient Ischemic Attack
Hemolysis
Psychiatry
Hemorrhage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Yuan, N., Arnaoutakis, G. J., George, T. J., Allen, J. G., Ju, D. G., Schaffer, J. M., ... Conte, J. V. (2012). The spectrum of complications following left ventricular assist device placement. Journal of Cardiac Surgery, 27(5), 630-638. https://doi.org/10.1111/j.1540-8191.2012.01504.x

The spectrum of complications following left ventricular assist device placement. / Yuan, Nance; Arnaoutakis, George J.; George, Timothy J.; Allen, Jeremiah G.; Ju, Derek G.; Schaffer, Justin M.; Russell, Stuart D.; Shah, Ashish S.; Conte, John V.

In: Journal of Cardiac Surgery, Vol. 27, No. 5, 09.2012, p. 630-638.

Research output: Contribution to journalArticle

Yuan, N, Arnaoutakis, GJ, George, TJ, Allen, JG, Ju, DG, Schaffer, JM, Russell, SD, Shah, AS & Conte, JV 2012, 'The spectrum of complications following left ventricular assist device placement', Journal of Cardiac Surgery, vol. 27, no. 5, pp. 630-638. https://doi.org/10.1111/j.1540-8191.2012.01504.x
Yuan, Nance ; Arnaoutakis, George J. ; George, Timothy J. ; Allen, Jeremiah G. ; Ju, Derek G. ; Schaffer, Justin M. ; Russell, Stuart D. ; Shah, Ashish S. ; Conte, John V. / The spectrum of complications following left ventricular assist device placement. In: Journal of Cardiac Surgery. 2012 ; Vol. 27, No. 5. pp. 630-638.
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