Left Ventricular Assist Device (LVAD)-Related Major Adverse Events Account for a Low Number of Emergency Room Admissions in HeartMate 3™ Patients—A 10-Year Retrospective Study

TL;DR

This study finds that most emergency room visits by patients with a HeartMate 3™ LVAD are not related to the device itself.

Contribution

A 10-year retrospective analysis of ER admissions in HeartMate 3™ LVAD patients reveals low rates of LVAD-related major adverse events.

Findings

Out of 100 ER admissions, 92 were unrelated to the LVAD.

Only 2% of admissions were major adverse events directly related to the LVAD.

Most LVAD-related issues were minor and treated on the ward, not in the ICU.

Abstract

Background: The yearly number of left ventricular assist device (LVAD) implantations is approximately twice the number of heart transplantations (HTX) in Germany. As the number of patients with an LVAD installed grows, so does the likelihood of their presentation to the emergency room (ER). Due to uneasiness in identifying their primary complaint, ER personnel are often likely to overlook important clues in the treatment of patients with an LVAD. Methods: To assess the urgency of patients’ conditions and their relationship with LVADs, we retrospectively examined the ER admissions of patients with HeartMate 3TM (HM 3) LVADs installed between 2014 and 2024 at our university medical center. We counted referrals to the peripheral ward (minor) and to the intensive care unit (ICU, major). Relation to LVAD relation was also recorded. The survival was analyzed with respect to the severity of the cause of admission (minor/major) and the relationship to the LVAD therapy. Results: We observed 100 presentations to the emergency department. Of these, 77 were minor and 23 were major. The majority (92) was not related to the LVAD. Of the eight admissions related to the LVAD, two were major adverse events, accounting only for 2% of the total cases. Conclusions: An ER presentation of a patient with an HM 3 is very likely to have a medical cause not related to the LVAD. LVAD-related causes were mostly minor and could be treated on the ward.

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