Long-Term Outcomes After Left Ventricular Assist Device Exchange: Survival Rates and Postoperative Complications

INTRODUCTION: Some patients require left ventricular assist device (LVAD) exchange because of pump thrombosis, infection, or pump failure. The aim of this study is to compare the long-term survival and postoperative complications between patients who did not require LVAD exchange and patients who required LVAD exchange. METHODS: We included patients who underwent HeartMate II, HeartWare Ventricular Assist Device and HeartMate 3, LVAD implantation at our institution between December 2008 and November 2019. We compared survival rate and postoperative complications between the cases which did not require LVAD exchange (Group 1) and the cases which required LVAD exchange (Group 2). RESULTS: There were 333 cases which met our criteria. Group 1 included 296 cases; group 2 included 37 cases. Causes of LVAD exchange were pump thrombosis (n = 22), driveline fracture (n = 6) cases, driveline infection (n = 8), and pump failure (n = 1). There was no statistical difference between groups in cumulative incidence of death 5 y after surgery, or in postoperative gastrointestinal bleeding and neurological complications. The rate of postoperative device-related infection was higher in group 2. CONCLUSIONS: To the best of our knowledge, this report includes the longest follow-up period comparing patients who required LVAD exchange after surgery to those who did not require LVAD exchange. LVAD exchange can be performed safely without increasing mortality rates, gastrointestinal bleeding, or neurological complications.