Department of Cardiovascular Surgery, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
J Artif Organs. 2020 Dec;23(4):371-373. doi: 10.1007/s10047-020-01181-0. Epub 2020 May 30.
The driveline's durability is crucial for optimal long-term support with a left-ventricular assist device (LVAD). The incidence of percutaneous driveline fracture after HeartMate II LVAD implantation is low. For the first time, we describe a patient with an already repaired driveline and a massive constriction and twisting of the driveline in the area of the repair site. This dramatic finding necessitates a renewed exchange of the external part of the driveline by the manufacturer. Due to the increasing number of patients with elongated LVAD support, the stability of the driveline and possible repairs including the replacement of the driveline are becoming more and more important. Our case report describes a possible serious late complication after replacement of the driveline, shows possible risks for this development, and describes the necessity of a prophylactic X-ray examination of repaired drivelines to detect such complications as early as possible.
对于左心室辅助装置 (LVAD) 的长期最佳支持，动力轴的耐用性至关重要。HeartMate II LVAD 植入后经皮动力轴骨折的发生率较低。我们首次描述了一位患者，其动力轴已修复，且在修复部位区域出现动力轴严重的狭窄和扭曲。这一戏剧性的发现需要制造商重新更换动力轴的外部部分。由于接受延长 LVAD 支持的患者数量不断增加，动力轴的稳定性以及可能的修复（包括更换动力轴）变得越来越重要。我们的病例报告描述了更换动力轴后的一种可能的严重迟发性并发症，说明了这种发展的可能风险，并描述了对已修复动力轴进行预防性 X 射线检查的必要性，以便尽早发现这种并发症。
