Key result
LVAD exchange shows similar 5-year mortality and complications as primary implants despite higher infection rates.
Why the study?
Some patients require LVAD exchange because of pump thrombosis, infection, or pump failure, motivating a comparison of long-term survival and postoperative complications between patients with and without LVAD exchange.
Does left ventricular assist device (LVAD) exchange affect long-term survival and postoperative complications compared to no LVAD exchange in patients undergoing LVAD implantation?
Cohort (n=333)
No
Does left ventricular assist device (LVAD) exchange affect long-term survival and postoperative complications compared to no LVAD exchange in patients undergoing LVAD implantation?
LVAD exchange can be performed safely without increasing 5-year mortality, gastrointestinal bleeding, or neurological complications, although it is associated with a higher rate of postoperative device-related infection.
Answers are grounded in this paper and cite their sources.
LVAD exchange associated with comparable survival; extends evidence on managing complications but remains hypothesis-generating.
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.
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Kagawa et al. (2026) conducted a cohort in Left ventricular assist device (LVAD) implantation (n=333). Left ventricular assist device (LVAD) exchange vs. No LVAD exchange required was evaluated on Cumulative incidence of death 5 years after surgery and postoperative complications. LVAD exchange (n=37 vs n=296) showed no statistical difference in 5-year cumulative mortality, GI bleeding, or neurological complications, though device-related infection rates were higher.
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