Percutaneous Intervention in External Outflow Graft Obstruction of Magnetically Levitated Left Ventricular Assist Device: Long‐Term Follow‐Up and Quality of Life

ABSTRACT Objectives External compression of the outflow graft causing obstruction (eOGO) is a potentially lethal complication in patients on long‐term mechanical circulatory support with the HeartMate 3 (HM3, Abbott) left ventricular assist device (LVAD). This complication results from the build‐up of gelatinous substance between the bend relief and outflow graft and can be resolved by percutaneous intervention, surgery, or transplantation. This single‐centre follow‐up study evaluated the suitability of percutaneous intervention as a treatment strategy and long‐term outcomes of eOGO patients in terms of laboratory, LVAD, and quality‐of‐life parameters. Methods On October 31, 2024, a search of the implantation centre's electronic database identified HM3 patients diagnosed with eOGO. Individual patient data concerning 31 cases was analyzed. A quality‐of‐life survey was conducted using the short version of the Kansas City Cardiomyopathy Questionnaire (KCCQ‐12). Results The patient cohort had a median support time to eOGO diagnosis of 1219 days 976, 1917 and a post‐treatment follow‐up of 686 days 447, 1003. 64.5% of patients ( n = 20) underwent percutaneous intervention showing immediate LVAD flow improvement of 0.5 L/min post‐intervention ( p = 0.04). Of eight post‐interventional survey respondents, 62.5% ( n = 5) were assigned a fair‐excellent health status according to the KCCQ‐12. Conclusions Percutaneous intervention is a suitable treatment strategy for eOGO, resolving low flow and providing satisfactory long‐term quality of life outcomes. Given the increasing eOGO incidence after 1 year of support and overall mortality of 29.0%, clinicians should remain on high alert for this complication. We suggest computed tomography (CT) imaging be considered early on when eOGO is suspected.