J Chest Surg.  2024 May;57(3):315-318. 10.5090/jcs.23.104.

Unexpected Restart Failure of Durable Left Ventricular Assist Devices: A Report of Two Cases

• Seo HW
• Jeong GH
• Kim SM
• Bak M
• Kim D
• Choi JO
• Sung K
• Cho YH

• KMID: 2555801
• DOI: http://doi.org/10.5090/jcs.23.104

Abstract

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.

Keyword

Heart failure; Cardiomyopathies; Heart-assist devices; Heart transplantation; Extracorporeal membrane oxygenation; Case reports