HeartMate II LVAD Cleaning

During this procedure, guide wires are inserted into the left and right femoral arteries leading to the heart. The patient’s beating heart can continue to perfuse the body however bypass could be necessary. Once they reach the ascending aorta, one guide wire enters the outflow graft of the Left Ventricular Assist Device, while the second guide wire passes through the aortic valve. A balloon catheter is threaded over the first wire and inflated simultaneously while the LVAD is turned off. Then the second wire is inserted into the inflow graft and a balloon catheter is threaded over this wire and the guide wires are removed. The cleaning process begins when the balloons are inflated and saline displaces blood within the pump. The impeller agitates this solution before it is drained out. Next, a thrombolytic solution such as TPA is introduced into the device. This solution, along with impeller agitation, helps dissolve any residue material in the device before it is drained out. The LVAD is flushed repeatedly with a saline solution. As the final step, a net on the catheter in the outflow graft opens up. The balloons are deflated, allowing blood flow to resume. Any remaining material is caught in the net to remove it from circulation. The net will then close to secure any captured materials and the catheters are removed, restoring to the LVAD to its full functionality.