HVAD Cannula Positioning is Associated with Higher GI Bleed Rates

Abstract

Purpose HVAD cannula positioning is associated with hemodynamics and heart failure readmissions. However, its impact on hemocompatibility-related adverse events (HRAEs) in general, and GI bleeding in particular, remains uncertain. This study assessed the impact of HVAD cannula positioning on HRAEs. Methods HVAD patients were followed for one year following the index hospitalization discharge, when the cannula coronal angle was quantified from chest X-ray (Figure 1A). One-year freedom from any HRAEs and event rates of each HRAE were compared between those with and without cannula coronal angle >65 degrees. Results Among 46 HVAD patients (median age 61 years, 76% male), 9 patients (20%) had cannula coronal angle >65 degrees. The rate of GI bleeding was significantly higher in the angle >65 group (1.03 vs. 0.19 events/year, p\u202f=\u202f0.014). Rates of stroke and pump thrombosis were comparable irrespective of the cannula angle (p >0.05 for all; Figure 1B). One-year freedom from any HRAEs was numerically lower in the angle >65 group compared with the angle ≤65 group (22% vs. 63%, p\u202f=\u202f0.062; Figure 1C). Conclusion HVAD cannula coronal angle is associated with increased GI bleed. Prospective studies evaluating surgical techniques to ensure optimal device positioning and its effects on HRAEs are warranted.