Thrombosis After LVAD Implantation Is on the Rise

At three high-volume institutions, the rate of thrombosis in the first 3 months after implantation of the HeartMate II device nearly quadrupled within a span of 2 years.

The HeartMate II left ventricular assist device (LVAD), as a bridge to transplantation or as “destination” therapy, has dramatically changed how advanced heart failure is managed. In clinical trials and postmarketing studies, the rate of thrombosis — a feared LVAD complication — has ranged from 2% to 4%. A higher thrombosis rate documented during quality review at a single center prompted investigators from three high-volume institutions to assess pump thromboses in a cohort of 837 patients (mean age, 55; 79% men) who had 895 HeartMate II devices implanted from 2004 to mid 2013.

Seventy-two LVAD thromboses were confirmed in 66 patients, and an additional 36 were suspected. The overall monthly risk for confirmed thrombosis peaked at 1.4% with…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)