AI Article Synopsis
- Wedge thrombus formation around LVAD inflow cannulas can lead to systemic thromboemboli, and a new titanium mesh-wrapped cannula (GU30) was introduced to potentially address this issue.
- A study compared clinical outcomes, such as survival and incidence of thromboembolism, between the standard GU10 cannula and the new GU30 design in patients with LVAD implanted.
- Findings revealed no major differences in survival or severe neurological events, but the GU30 cannula led to earlier severe emboli post-implantation; however, it did promote neointimal growth that prevented wedge thrombus formation in long-term support cases.
Article Abstract
Wedge thrombus formation around the inflow cannula of a continuous left ventricular assist device (LVAD) is a source of systemic thromboemboli. We previously reported the potential advantages of a new inflow cannula wrapped with titanium mesh (GU30) over the standard smooth surface oblique cut cannula (GU10). The objective of the present study was to clinically validate this new cannula. A retrospective cohort analysis of patients with implanted LVAD (EVAHEART) comparing the GU10 to the GU30 was conducted. Clinical outcomes, including survival, the incidence of thromboembolism, and bleeding events, were compared. Gross and histopathological analyses of explanted GU30 cannula were conducted following transplant or patient death. No significant differences in the survival rate, severe emboli, or cerebral bleeding were observed during the LVAD implantation. However, severe emboli occurred earlier after LVAD implantation when using the GU30 cannula compared with the GU10. In cases of long LVAD support, the neointima fully covered the inflow of the GU30 cannulae without wedge thrombus formation. The titanium mesh-wrapped inflow cannulae did not reduce the overall incidence of neurological events significantly. However, the titanium mesh-wrapped inflow cannula induced autologous neointimal growth over the cannula and prevented wedge thrombus formation in late-phase LVAD implantation.
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| http://dx.doi.org/10.1097/MAT.0000000000001865 | DOI Listing |
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