Correlation of Pre-Explant Lactate Dehydrogenase Concentrations and Findings During Post-Explant Pump Analysis of the HeartMate II Left Ventricular Assist Device

Vikram Sood, Osman Alam, Vakhtang Tchantchaleishvili, Francis D. Pagani, Keith D. Aaronson, Jonathan Haft, David L. Joyce, Lyle D. Joyce, Richard C. Daly, Simon Maltais, John M. Stulak

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Analyses of the HeartMate II left ventricular assist device are routinely performed after explant if returned to the manufacturer. Findings from manufacturer-reported pump analyses have not been correlated with pre-explant serum lactate dehydrogenase (LDH) values. Methods: Between May 2004 and December 2014, 502 patients underwent primary HeartMate II implantation. Seventy pumps were explanted in 58 patients and returned to the manufacturer for pump analysis: 51 (73%) for suspected pump thrombosis, 12 (17%) for device-related infection, and 7 (13%) for percutaneous lead fracture. Median time from implant to explant was 12.4 months (range, 1 to 57 months). Results: Pump thrombus was confirmed in 53 of 70 pumps (76%). Stratified by major clinical indications for explant of suspected pump thrombus or infection and lead fracture, the presence of pump thrombus was identified in 47 of 51 (92%) and 6 of 19 (32%), respectively. The median of 1) all LDH values, 2) maximum LDH values, and 3) interval change in LDH between 6 and 2 months before device explant were 1,061, 1,940, and -27 IU/L with thrombus present and 533, 504, and 13 IU/L in the absence of thrombus. Density estimation of LDH concentrations identified that a LDH value of 1,155 IU/L in the 6 months preceding pump thrombus had a 78% sensitivity and 90% specificity for findings of pump thrombus at the time of pump analysis. Conclusions: Pre-explant LDH concentrations significantly correlated with findings on manufacture-performed pump analysis. These data validate LDH surveillance as an important clinical tool for identification of pump thrombus.

Original languageEnglish (US)
JournalAnnals of Thoracic Surgery
DOIs
StateAccepted/In press - 2016

Fingerprint

Heart-Assist Devices
L-Lactate Dehydrogenase
Thrombosis
Equipment and Supplies
Infection
Sensitivity and Specificity

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Correlation of Pre-Explant Lactate Dehydrogenase Concentrations and Findings During Post-Explant Pump Analysis of the HeartMate II Left Ventricular Assist Device. / Sood, Vikram; Alam, Osman; Tchantchaleishvili, Vakhtang; Pagani, Francis D.; Aaronson, Keith D.; Haft, Jonathan; Joyce, David L.; Joyce, Lyle D.; Daly, Richard C.; Maltais, Simon; Stulak, John M.

In: Annals of Thoracic Surgery, 2016.

Research output: Contribution to journalArticle

Sood, Vikram ; Alam, Osman ; Tchantchaleishvili, Vakhtang ; Pagani, Francis D. ; Aaronson, Keith D. ; Haft, Jonathan ; Joyce, David L. ; Joyce, Lyle D. ; Daly, Richard C. ; Maltais, Simon ; Stulak, John M. / Correlation of Pre-Explant Lactate Dehydrogenase Concentrations and Findings During Post-Explant Pump Analysis of the HeartMate II Left Ventricular Assist Device. In: Annals of Thoracic Surgery. 2016.
@article{9ee4a7604b134d46863ee94836bddcb4,
title = "Correlation of Pre-Explant Lactate Dehydrogenase Concentrations and Findings During Post-Explant Pump Analysis of the HeartMate II Left Ventricular Assist Device",
abstract = "Background: Analyses of the HeartMate II left ventricular assist device are routinely performed after explant if returned to the manufacturer. Findings from manufacturer-reported pump analyses have not been correlated with pre-explant serum lactate dehydrogenase (LDH) values. Methods: Between May 2004 and December 2014, 502 patients underwent primary HeartMate II implantation. Seventy pumps were explanted in 58 patients and returned to the manufacturer for pump analysis: 51 (73{\%}) for suspected pump thrombosis, 12 (17{\%}) for device-related infection, and 7 (13{\%}) for percutaneous lead fracture. Median time from implant to explant was 12.4 months (range, 1 to 57 months). Results: Pump thrombus was confirmed in 53 of 70 pumps (76{\%}). Stratified by major clinical indications for explant of suspected pump thrombus or infection and lead fracture, the presence of pump thrombus was identified in 47 of 51 (92{\%}) and 6 of 19 (32{\%}), respectively. The median of 1) all LDH values, 2) maximum LDH values, and 3) interval change in LDH between 6 and 2 months before device explant were 1,061, 1,940, and -27 IU/L with thrombus present and 533, 504, and 13 IU/L in the absence of thrombus. Density estimation of LDH concentrations identified that a LDH value of 1,155 IU/L in the 6 months preceding pump thrombus had a 78{\%} sensitivity and 90{\%} specificity for findings of pump thrombus at the time of pump analysis. Conclusions: Pre-explant LDH concentrations significantly correlated with findings on manufacture-performed pump analysis. These data validate LDH surveillance as an important clinical tool for identification of pump thrombus.",
author = "Vikram Sood and Osman Alam and Vakhtang Tchantchaleishvili and Pagani, {Francis D.} and Aaronson, {Keith D.} and Jonathan Haft and Joyce, {David L.} and Joyce, {Lyle D.} and Daly, {Richard C.} and Simon Maltais and Stulak, {John M.}",
year = "2016",
doi = "10.1016/j.athoracsur.2016.07.073",
language = "English (US)",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Correlation of Pre-Explant Lactate Dehydrogenase Concentrations and Findings During Post-Explant Pump Analysis of the HeartMate II Left Ventricular Assist Device

AU - Sood, Vikram

AU - Alam, Osman

AU - Tchantchaleishvili, Vakhtang

AU - Pagani, Francis D.

AU - Aaronson, Keith D.

AU - Haft, Jonathan

AU - Joyce, David L.

AU - Joyce, Lyle D.

AU - Daly, Richard C.

AU - Maltais, Simon

AU - Stulak, John M.

PY - 2016

Y1 - 2016

N2 - Background: Analyses of the HeartMate II left ventricular assist device are routinely performed after explant if returned to the manufacturer. Findings from manufacturer-reported pump analyses have not been correlated with pre-explant serum lactate dehydrogenase (LDH) values. Methods: Between May 2004 and December 2014, 502 patients underwent primary HeartMate II implantation. Seventy pumps were explanted in 58 patients and returned to the manufacturer for pump analysis: 51 (73%) for suspected pump thrombosis, 12 (17%) for device-related infection, and 7 (13%) for percutaneous lead fracture. Median time from implant to explant was 12.4 months (range, 1 to 57 months). Results: Pump thrombus was confirmed in 53 of 70 pumps (76%). Stratified by major clinical indications for explant of suspected pump thrombus or infection and lead fracture, the presence of pump thrombus was identified in 47 of 51 (92%) and 6 of 19 (32%), respectively. The median of 1) all LDH values, 2) maximum LDH values, and 3) interval change in LDH between 6 and 2 months before device explant were 1,061, 1,940, and -27 IU/L with thrombus present and 533, 504, and 13 IU/L in the absence of thrombus. Density estimation of LDH concentrations identified that a LDH value of 1,155 IU/L in the 6 months preceding pump thrombus had a 78% sensitivity and 90% specificity for findings of pump thrombus at the time of pump analysis. Conclusions: Pre-explant LDH concentrations significantly correlated with findings on manufacture-performed pump analysis. These data validate LDH surveillance as an important clinical tool for identification of pump thrombus.

AB - Background: Analyses of the HeartMate II left ventricular assist device are routinely performed after explant if returned to the manufacturer. Findings from manufacturer-reported pump analyses have not been correlated with pre-explant serum lactate dehydrogenase (LDH) values. Methods: Between May 2004 and December 2014, 502 patients underwent primary HeartMate II implantation. Seventy pumps were explanted in 58 patients and returned to the manufacturer for pump analysis: 51 (73%) for suspected pump thrombosis, 12 (17%) for device-related infection, and 7 (13%) for percutaneous lead fracture. Median time from implant to explant was 12.4 months (range, 1 to 57 months). Results: Pump thrombus was confirmed in 53 of 70 pumps (76%). Stratified by major clinical indications for explant of suspected pump thrombus or infection and lead fracture, the presence of pump thrombus was identified in 47 of 51 (92%) and 6 of 19 (32%), respectively. The median of 1) all LDH values, 2) maximum LDH values, and 3) interval change in LDH between 6 and 2 months before device explant were 1,061, 1,940, and -27 IU/L with thrombus present and 533, 504, and 13 IU/L in the absence of thrombus. Density estimation of LDH concentrations identified that a LDH value of 1,155 IU/L in the 6 months preceding pump thrombus had a 78% sensitivity and 90% specificity for findings of pump thrombus at the time of pump analysis. Conclusions: Pre-explant LDH concentrations significantly correlated with findings on manufacture-performed pump analysis. These data validate LDH surveillance as an important clinical tool for identification of pump thrombus.

UR - http://www.scopus.com/inward/record.url?scp=85008627448&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008627448&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2016.07.073

DO - 10.1016/j.athoracsur.2016.07.073

M3 - Article

C2 - 27743635

AN - SCOPUS:85008627448

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

ER -