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J Thorac Cardiovasc Surg 2004;128:619-621
© 2004 The American Association for Thoracic Surgery

Brief communication

HeartMate XVE malfunction caused by fluid aspiration into the vent port

Sinan A. Simsir, MDa, Shu S. Lin, MD, PhDa, Myra F. Ellis, RN, MSNa, Stuart D. Russell, MDb, Carmelo A. Milano, MDa,*

a Department of Surgery, Duke University Medical Center, Durham, NC, USA
b Department of Medicine, Duke University Medical Center, Durham, NC, USA

Received for publication December 22, 2003; accepted for publication January 28, 2004.

* Address for reprints: Carmelo A. Milano, MD, Department of Surgery, Box 3043, Duke South, Durham, NC 27710, USA
milan002@mc.duke.edu

The first 20% of the full text of this article appears below.

The implantation of a left ventricular assist device (LVAD) provides a clinically meaningful survival benefit and better quality of life compared with medical therapy in patients with advanced heart failure.1 Malfunction of the LVAD, however, might significantly reduce the survival benefit it incurs. Seven of 41 deaths in patients with LVADs in the REMATCH trial (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) were attributed to device malfunction.1 We present the case of a patient who had an unusual device complication. Fluid was aspirated into the vent port, resulting in the malfunction of the device and a clinical emergency. A treatment algorithm for this challenging problem is described.

Clinical summary

A 55-year-old man (6'5'', 183 lb) with idiopathic dilated cardiomyopathy had a HeartMate XVE (Thoratec Corp, Pleasanton, Calif) LVAD system implanted. He was convalescing on a step-down ward 3 weeks postoperatively, with stable LVAD flows of between 5 and 6 L/min. The patient was incontinent of urine at 5 AM on the day of the event. Urine was aspirated into the LVAD vent port. The low flow and power limit advisory alarms of the LVAD activated. The low . . . [Full Text of this Article]






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