Table 1 Summary of the included studies
1st author (year), country | N | Age | Sex | Cardiology diagnosis | Indication of LVAD | Previous LVAD | Duration of previous device | Exchange indication | Approach of pump exchange | Complications | Outcome | Duration of follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
4 | 56 | Male | DCM | – | 1 | 266d | Driveline infection | Lateral thoracotomy | Early: Respiratory failure | Alive | 3y | |
56 | Male | ICM | – | 1 | 3722d | Driveline infection | Lateral thoracotomy | Early: Respiratory failure, minor cerebral bleeding | Alive | 3y | ||
76 | Male | ICM | – | 1 | 530d | Driveline infection | Lateral thoracotomy | – | Alive | 3y | ||
61 | Male | DCM | – | 1 | 1475d | Pump thrombosis | Lateral thoracotomy | Early: temporary dialysis for acute renal failure Follow-up: low flow alarms, syncope | Alive | 3y | ||
Khayata [9], USA | 1 | 34 | Female | ICM | – | 1 | – | Pump thrombosis | Posterolateral (5th intercostal) thoracotomy, HM2 left in place, HM3 outflow to descending aorta | – | Alive | 6 m |
Wert [13], Germany | 1 | 77 | Male | End-stage HF | – | 1 | 17 m | Pump prolapse | Anterolateral thoracotomy | – | Alive | – |
Takeda [12], USA | 9 | Median 58 | Male (n = 7), female (n = 2) | ICM (n = 3), DCM (n = 6) | BTT (n = 5), DT (n = 4) | 1 | median 608d | Pump thrombosis (n = 8), driveline injury (n = 1) | Left lateral thoracotomy toward a subcostal incision + a separate upper midline abdominal incision for outflow anastomosis | Early: Re-exploration for bleeding at HM2 pump pocket site (n = 1), pneumonia (n = 1), prolonged intubation (n = 2), inflow malposition at post-exchange day 7 (n = 1), recurrent device thrombosis (n = 1) Follow-up: old pump pocket infection undergoing surgical drainage and debridement (n = 3) | Alive (n = 8) death (n = 1) | Median 486d |
Barac [6], USA | 14 | *Mean 56.8 | *Male (n = 11), female (n = 8) | *ICM (n = 9), 10 Non-ICM (n = 10) | – | *1 (n = 10), 2 (n = 7), 3 (n = 2) | *Median 456d | *Malfunction (n = 3), infection (n = 2), thrombosis (n = 14) | Redosternotomy | *Dialysis (n = 1) | *Death or another replacement (n = 2). 90d-mortality = 100% | *Mean 221d |
Radcliffe [10], USA | 1 | 49 | Male | Non-ICM | – | 1 | – | Pump pocket infection (MSSA) | Left subcostal thoracotomy | Prolong VRE pump pocket infection | Alive (under long-term suppression with daptomycin then linezolid) | > 870d |
Radcliff [11], USA | 1 | 75 | Male | ICM | DT | 1 | 28 m | Driveline infection (Mycobacterium fortuitum) | – | Early: cerebrovascular accident | Death (post-exchange day 7) | – |
Alam [5], USA | 1 | 61 | Male | ICM | DT | 2 | 3y | External compression of outflow graft from thrombotic, gelatinous materials | Redosternotomy + left subcostal approach | Early: sternal wound debridement | Alive | – |
Ranard [14], USA | 1 | 80 | Male | ICM | DT | 1 | 4y | AR and pump thrombosis | TAVR, then left subcostal thoracotomy | – | Alive | 6 m |
Our case, Taiwan | 1 | 63 | Male | DCM | BTT | 1 | 1030d | Driveline damage | Limited left anterior thoracotomy + lower partial sternotomy | CMV pneumonitis, wound debridement and closure with local flap for previous wound of driveline insertion site | Alive | 1y |