Comparison of Repeat Exchange Rate after Axial-Flow to Centrifugal-Flow Left Ventricular Assist Device Exchange versus Axial-Flow to Axial-Flow Device Exchange

Purpose Patients who suffer from device malfunction after axial-flow left ventricular assist device (af-LVAD) implantation often require device exchange. Although af-LVAD to af-LVAD exchange is reported as a safe procedure, rate of recurrent malfunction remains high. We hypothesized that af-LVAD to centrifugal-flow LVAD (cf-LVAD) exchange is associated with lower rate of recurrent malfunction requiring repeat exchange compared to af-LVAD to af-LVAD exchange. Methods We retrospectively reviewed all patients who underwent af-LVAD implantation between 5/2011 and 3/2019 at out institution. Of these, 31 patients underwent 43 device exchanges either to af-LVAD (AE group, N = 29) or to cf-LVAD (CE group, N = 14). Results Reasons of device exchange in the AE group were pump thrombosis in 19 (66 %), infection in 1 (3 %) and others in 9 (31 %), and those in the CE group were pump thrombosis in 8 (58 %), infection in 3 (21 %) and others in 3 (21 %). There was no difference in baseline characteristics between the groups except higher rate of more than mild aortic insufficiency in the CE group (CE; 50 % vs AE; 0 %, P Conclusion Af-LVAD to cf-LVAD exchange is a safe procedure for af-LVAD patients who require device exchange, and possibly decrease recurrent device malfunction event requiring repeat device exchange.