Decommissioning of Durable Left Ventricular Assist Devices

Abstract

Cardiac recovery following durable left ventricular assist device (LVAD) implantation is the ideal outcome for heart failure patients. Traditionally, the durable LVAD has required explantation. We describe our single-centre experience with LVAD decommissioning. LVAD decommissioning involved making a sternotomy or sub-xiphoid incision, ligating the outflow graft, and removing the driveline by transecting the driveline inside and outside of the chest. Six patients underwent durable LVAD decommissioning from 2017-2024. One patient had a HeartWare (Medtronic, Galway, Ireland) device, 3 patients had a HeartMate II (Abbott, Abbott Park, IL), and 2 patients had a HeartMate 3 (Abbott). All patients were successfully decommissioned and discharged without mechanical circulatory support.