(Figure 1): backup here.
Pump exchange remains the standard in the treatment of LVAD thrombosis; however, not all patients are candidates for LVAD exchange.
On June 3, 2021, Medtronic stopped selling and distributing the HeartWare Ventricular Assist Device (HVAD) system. Leaving HeartMate 3 as the only available centrifugal pump on the market, however, HM3 does not fit into the HVAD sewing ring: the click-in mechanism for pump fixation of HM3 does not work with the HVAD ring 3. So, the change from HVAD to HM3 is feasible and was previously reported; however, many technical challenges increase the burden of the procedure.
Thrombolysis carried a high risk in our patient because of the fresh wound. The retrograde washout maneuver seemed to be a rational alternative for this patient. Still, this procedure carries a significant risk of peripheral thromboembolism, which the wedge thrombus can cause 4. The safety of this approach without using a neuroprotective device still needs to be studied in a more extensive series.