Skip to main content
SpringerLink
Log in

LVAD Woes: Lub-Dub, Lub-Dub, Lub-Dub…or Maybe Not!

  • Chapter
  • First Online:
Case Studies in Emergency Medicine

  • 1458 Accesses

Abstract

Left ventricular assist devices (LVADs) are designed to assist left ventricular output in patients with severe cardiomyopathy. There are two types of LVADs: pulsatile flow and continuous flow. As with any implantable device, there is always a risk of complications. Some common complications include ventricular arrhythmias, infections, stroke, worsening heart failure, and bleeding from anticoagulation. Additionally, although reliable, the devices can malfunction or become thrombosed. LVAD patients can be complex and early involvement of the LVAD team that normally cares for the patient can be helpful.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fitzgibbon J, Kman NE, Gorgas D. Asymptomatic sustained polymorphic ventricular tachycardia in a patient with a left ventricular assist device: case report and what the emergency physician should know. J Emerg Med. 2016;50:E135–41.

    Article  Google Scholar 

  2. Baughman K, Jarcho J. Bridge to life - cardiac mechanical support. N Engl J Med. 2007;357(9):846–9.

    Article  CAS  Google Scholar 

  3. Mehra MR, Goldstein DJ, Uriel N, et al. Two-Year outcomes with a magnetically levitated cardiac pump in heart failure. N Engl J Med. 2018;378:1386–95.

    Article  Google Scholar 

  4. Ammar K, Jacobsen S, Mahoney D, Kors J, Redfield M, Burnett J, et al. Prevalence and prognostic significance of heart failure stages - application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community. Circulation. 2007;115(12):1563–70.

    Article  Google Scholar 

  5. Al Danaf J, Butler J, Yehya A. Updates on device-based therapies for patients with heart failure. Curr Heart Fail Rep. 2018;15(2):53–60.

    Article  Google Scholar 

  6. McIlvennan C, Magid K, Ambardekar A, Thompson J, Matlock D, Allen L. Clinical outcomes after continuous-flow left ventricular assist device: a systematic review. Circ Heart Fail. 2014;7(6):1003–237.

    Article  Google Scholar 

  7. Miller L, Rogers J. Evolution of left ventricular assist device therapy for advanced heart failure: a review. JAMA Cardiol. 2018;3(7):650–8.

    Article  Google Scholar 

  8. Bedi M, Kormos R, Winowich S, McNamara D, Mathier M, Murali S. Ventricular arrhythmias during left ventricular assist device support. Am J Cardiol. 2007;99(8):1151–3.

    Article  Google Scholar 

  9. Andersen M, Videbaek R, Boesgaard S, Sander K, Hartsen P, Gustafsson F. Incidence of ventricular arrhythmias in patients on long-term support with a continuous-flow assist device (HeartMate II). J Heart Lung Transplant. 2009;28(7):733–5.

    Article  Google Scholar 

  10. Greet BD, Pujara D, Burkland D, Pollet M, Sudhakar D, Rojas F, Costello B, Postalian A, Hale Z, Jenny B, Lai C, Igbalode K, Wadhera D, Nair A, Ono M, Morgan J, Simpson L, Civitello A, Cheng J, Mathuria N. Incidence, predictors, and significance of ventricular arrhythmias in patients with continuous-flow left ventricular assist devices: a 15-year institutional experience. JACC Clin Electrophysiol. 2018;4(2):257–64.

    Article  Google Scholar 

  11. Cantillon D, Saliba W, Wazni O, Kanj M, Starling R, Tang W, et al. Low cardiac output associated with ventricular tachyarrhythmias in continuous-flow LVAD recipients with a concomitant ICD (LoCo VT Study). J Heart Lung Transplant. 2014;33(3):318–20.

    Article  Google Scholar 

  12. Kataria R, Jorde UP. GI bleeding during CF-LVAD support: state of the field. Cardiol Rev. 2018;27:8. https://doi.org/10.1097/CRD.0000000000000212.

    Article  Google Scholar 

  13. Bunte MC, Blackstone EH, Thuita L, Fowler J, Joseph L, Ozaki A, Starling RC, Smedira NG, Mountis MM. Major bleeding during HeartMate II support. J Am Coll Cardiol. 2013;62(23):2188–96.

    Article  Google Scholar 

  14. Izzy S, Rubin DB, Ahmed FS, Akbik F, Renault S, Sylvester KW, Vaitkevicius H, Smallwood JA, Givertz MM, Feske SK. Cerebrovascular accidents during mechanical circulatory support: new predictors of ischemic and hemorrhagic strokes and outcome. Stroke. 2018;49(5):1197–203.

    Article  Google Scholar 

  15. Tahsili-Fahadan P, Curfman DR, Davis AA, Yahyavi-Firouz-Abadi N, Rivera-Lara L, Nassif ME, LaRue SJ, Ewald GA, Zazulia AR. Cerebrovascular events after continuous-flow left ventricular assist devices. Neurocrit Care. 2018;29:225. https://doi.org/10.1007/s12028-018-0531-y.

    Article  CAS  PubMed  Google Scholar 

  16. Asleh R, Hasin T, Briasoulis A, Schettle SD, Borlaug BA, Behfar A, Pereira NL, Edwards BS, Clavell AL, Joyce LD, Maltais S, Stulak JM, Kushwaha SS. Hemodynamic assessment of patients with and without heart failure symptoms supported by a continuous-flow left ventricular assist device. Mayo Clin Proc. 2018;93:895. https://doi.org/10.1016/j.mayocp.2018.01.031.

    Article  PubMed  Google Scholar 

  17. O’Horo JC, Abu Saleh OM, Stulak JM, Wilhelm MP, Baddour LM, Rizwan Sohail M. Left ventricular assist device infections: a systematic review. ASAIO J. 2018;64(3):287–94.

    Article  Google Scholar 

  18. DeVore AD, Patel PA, Patel CB. Medical management of patients with a left ventricular assist device for the non-left ventricular assist device specialist. JACC Heart Fail. 2017;5(9):621–31.

    Article  Google Scholar 

  19. Yoshioka D, Sakaniwa R, Toda K, Samura T, Saito S, Kashiyama N, et al. Relationship between bacteremia and hemorrhagic stroke in patients with continuous-flow left ventricular assist device. Circ J. 2018;82(2):448–56.

    Article  CAS  Google Scholar 

  20. Vierecke J, Schweiger M, Feldman D, Potapov E, Kaufmann F, Germinario L, Hetzer R, Falk V, Krabatsch T. Emergency procedures for patients with a continuous flow left ventricular assist device. Emerg Med J. 2017;34(12):831–41.

    Article  Google Scholar 

  21. Mabvuure N, Rodrigues J. External cardiac compression during cardiopulmonary resuscitation of patients with left ventricular assist devices. Interact Cardiovasc Thorac Surg. 2014;19(2):286–9.

    Article  Google Scholar 

  22. Peberdy M, Gluck J, Ornato J, Bermudez C, Griffin R, Kasirajan V, et al. Cardiopulmonary resuscitation in adults and children with mechanical circulatory support a scientific statement from the American Heart Association. Circulation. 2017;135(24):E1115–34.

    Article  Google Scholar 

  23. Ornato JP, Louka A, Grodman SW, Ferguson JD. How to determine whether to perform chest compressions on an unconscious patient with an implanted left ventricular assist device. Resuscitation. 2018;129:e12. https://doi.org/10.1016/j.resuscitation.2018.05.024.

    Article  PubMed  Google Scholar 

  24. Rimsans J, Levesque A, Lyons E, Sylvester K, Givertz MM, Mehra MR, Stewart GC, Connors JM. Four factor prothrombin complex concentrate for warfarin reversal in patients with left ventricular assist devices. J Thromb Thrombolysis. 2018;46:180. https://doi.org/10.1007/s11239-018-1680-8.

    Article  CAS  PubMed  Google Scholar 

  25. Luc JGY, Tchantchaleishvili V, Phan K, Dunlay SM, Maltais S, Stulak JM. Medical therapy compared with surgical device exchange for left ventricular assist device thrombosis: a systematic review and meta-analysis. ASAIO J. 2018;65:307. https://doi.org/10.1097/MAT.0000000000000833.

    Article  Google Scholar 

  26. Loforte A, Grigioni F, Marinelli G. The risk of right ventricular failure with current continuous-flow left ventricular assist devices. Expert Rev Med Devices. 2017;14(12):969–83.

    Article  CAS  Google Scholar 

  27. Sayer G, Sarswat N, Kim GH, Adatya S, Medvedofsky D, Rodgers D, Kruse E, Ota T, Jeevanandam V, Lang R, Uriel N. The hemodynamic effects of aortic insufficiency in patients supported with continuous-flow left ventricular assist devices. J Card Fail. 2017;23(7):545–51.

    Article  Google Scholar 

  28. Dang G, Epperla N, Muppidi V, Sahr N, Pan A, Simpson P, Baumann Kreuziger L. Medical management of pump-related thrombosis in patients with continuous-flow left ventricular assist devices: a systematic review and meta-analysis. ASAIO J. 2017;63(4):373–85.

    Article  Google Scholar 

Download references

Disclosure Statement

The authors of this chapter report no significant disclosures.

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Wexner Medical Center at The Ohio State University, Columbus, OH, USA

    Nick Kman & Leslie Adrian

Authors
  1. Nick Kman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Leslie Adrian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nick Kman .

Editor information

Editors and Affiliations

  1. Wexner Medical Center, Ohio State University, Columbus, OH, USA

    Colin G. Kaide

  2. Wexner Medical Center, Ohio State University, Columbus, OH, USA

    Christopher E. San Miguel

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kman, N., Adrian, L. (2020). LVAD Woes: Lub-Dub, Lub-Dub, Lub-Dub…or Maybe Not! . In: Kaide, C., San Miguel, C. (eds) Case Studies in Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-22445-5_35

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-22445-5_35

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-22444-8

  • Online ISBN: 978-3-030-22445-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation