Percutaneous Decommissioning of Left Ventricular Assist Device

Heart Lung Circ. 2018 Jul;27(7):853-855. doi: 10.1016/j.hlc.2017.07.011. Epub 2017 Aug 19.


Background: The left ventricular assist device (LVAD) has revolutionised our treatment of advanced stage heart failure, giving debilitated patients a new lease on life. A small proportion of these LVAD patients can be bridged-to-recovery. The identification of these patients and decision to wean, however, can be challenging.

Methods: The need to fully explant the device upon recovery has evolved to a minimalist approach aiming to avoid injury to the 'recovered' heart. A review of the evolution of explant strategies was performed to guide our decision to wean the LVAD in our early experience.

Results: Between 2009 and 2014, two patients in our series of 69 LVAD implants (2.9%) were successfully weaned off their LVADs. The second patient had a minimal access implantation of his HeartWare Ventricular Assist Device (HVAD, Medtronic Inc, Framingham, MA, USA). His clinical variables and minimalist weaning strategy are described.

Conclusions: A case of LVAD decommissioning by thrombosis of the outflow graft, using percutaneous Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, MN, USA) without surgery is reported.

Keywords: AVPII; Decommissioning; Explantation; LVAD; Percutaneous.

Publication types

  • Case Reports

MeSH terms

  • Device Removal / methods*
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Failure
  • Recovery of Function*