From the Guidelines
If the battery dies on a Left Ventricular Assist Device (LVAD), the pump will stop until at least one power source is restored.
LVAD Power Source Management
- The LVAD is powered through 2 power sources (batteries or alternating-current power source) at all times via the controller to a percutaneous lead that exits the abdominal wall 1.
- If both power supplies are disconnected at the same time, the pump will stop until at least one power source is restored 1.
- If battery power is low, either the batteries should be replaced or the configuration should be changed to wall power (alternating-current power source) 1.
Clinical Implications
- It is crucial to check all connections and confirm the power source if there is concern for power failure 1.
- If the power source is confirmed but there is no pump function, further assessment is required 1.
- In case of a persistent device alarm, the controller should be exchanged for the backup controller 1.
From the Research
Left Ventricular Assist Device (LVAD) Battery Failure
- If the battery dies on an LVAD, it can lead to sudden power loss, as reported in a case study 2.
- The study describes a situation where a clip was dropped with the battery inserted, causing intermittent contact with the battery terminals and resulting in power loss.
- However, with proper inspection, testing, and patient training, such incidents can be prevented.
LVAD Design and Functionality
- LVADs are designed to provide long-term support, with batteries that can last 5 to 8 hours and can be changed on a rotating basis indefinitely 3.
- The devices consist of a pump, driveline, and peripherals, all of which can be subject to failure 4.
- Battery failure is a potential adverse event, accounting for 19% of device malfunctions in one study 4.
Management of LVAD Patients
- Non-expert clinicians need to understand the basics of LVAD physiology, design, and operation to provide effective care 5.
- Important potential device-related adverse events include stroke, gastrointestinal bleeding, hematologic disorders, device infection, LVAD dysfunction, arrhythmias, and heart failure.
- A multidisciplinary team approach is recommended for managing LVAD patients, especially in critical care settings 6.
Potential Complications
- Bleeding, driveline infections, thrombosis, device malfunction, right ventricular failure, and arrhythmias are common complications in LVAD patients 6.
- Device thrombosis can occur even with adequate anticoagulation and antiplatelet therapy, and management requires a comprehensive approach.
- Infections must be aggressively treated to avoid seeding the device, and a multidisciplinary team is essential for optimal patient care.