Percutaneous approach to left ventricular assist device decommissioning

Objective: To assess the outcomes of a single-center experience with percutaneous left ventricular assist device (LVAD) decommissioning.

Background: Patients with LVADs may eventually require their removal, either due to recovery of left ventricular function or recurrent complications. Traditionally, withdrawal of LVAD support has been managed with surgical device explantation, which carries significant procedural risks. Transcatheter LVAD decommissioning, with outflow graft occlusion and driveline transection, has recently been described as an alternative to surgical removal.

Methods: Here, we report on a retrospective cohort of five consecutive cases treated with transcatheter LVAD decommissioning.

Results: The procedure was effective in all cases, and no patient experienced procedure-related complications. At midterm follow-up, the three patients who had myocardial function recovery were alive and had not experienced heart failure-related symptoms or complications.

Conclusion: Percutaneous LVAD decommissioning appears to be a safe and effective approach to LVAD treatment discontinuation.