Supplemental Table 1: Review of patients undergoing percutaneous left ventricular assist device exclusion

(1)

Supplemental Table 1: Review of patients undergoing percutaneous left ventricular assist device exclusion

Author, Year Age;

Sex;

Etiology

Type of LVAD;

Duration of support;

Indication Vascular occlusion

device Proximal outflow

graft occlusion

device size

Distal outflow

graft occlusion

device size

Post- procedure Anticoagul

ation

Procedure success Procedural Complicati

ons

Patient outcome

Chowdhury et al; 2018

Patient 1

2015 49 year;

Female;

NICMP (chemothera py induced)

HM II; 4

months Recurrent pump thrombosis and history of prior pump exchange; not a candidate for pump exchange or

transplantation

Amplatzer Septal Occluder (St. Jude Medical, St. Paul, MN)

20mm 18mm Aspirin

325 mg Warfarin, INR:2-3

Third 18mm occluder was deployed inside the inflow cannula.

Following which the VAD was successfully excluded

None Progressive cardiogenic shock and multi-organ failure system failure resulting in death.

Patient 2

2017 60 year;

Male;

NICMP (idiopathic)

HVAD; 1 year and 6 months

Myocardial recovery Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, MN)

14mm 14mm Warfarin.

INR: 2-3 Yes None Alive at 1.5 years on medical

therapy; delisted from transplant list

Patient 3

2017 40 year;

Male NICMP (idiopathic)

HVAD; 6

months Pump thrombosis and multi- organ system failure; not a candidate for pump exchange or transplantation

12mm 12mm Aspirin

325 mg.

Warfarin.

INR: 2-3

Yes None Progressive cardiogenic shock and

multi-organ failure system failure resulting in death at 10- days post LVAD exclusion.

Patient 4

2017 37 year;

Male ICMP

HM II; 11

months Myocardial recovery Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, MN)

20mm (inflow graft)

18mm (inflow graft)

Aspirin 325 mg.

Warfarin.

INR: 2-3

Yes None Doing well 24 months after

procedure

EL Sayed Ahmed et al; 2016 (4)

14 year;

Female;

NICMP (chemothera py induced)

HM II; 2

years Myocardial recovery Amplatzer Vascular Plug II (AGA Medical, Plymouth, MN)

16mm 18mm Warfarin.

INR: 1.5-2 Yes None Did well for 6 months and then

developed heart failure

Zeigler et al; 2014 (5)

70 year;

Female;

NICMP (idiopathic)

HM II; 2

years Myocardial recovery Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, MN)

22mm Warfarin.

INR: 1.8- 2.5

Yes None Doing well 3.5 yrs after procedure

Soon et al;

2017 (6)

47 year;

Male;

NICMP (viral)

HVAD; 18

months Myocardial recovery Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, MN)

14mm 14mm Aspirin

100mg Yes None Doing well 15 months after

procedure

Petit et al;

2015 (7)

17 year;

Male;

NICMP (idiopathic)

HVAD; 22 months

Myocardial recovery Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, MN)

14mm 14mm Warfarin Yes None Doing well 24 months after

procedure

Grinstein et al;

2016 (8)

47 year;

Male;

ICMP

HVAD; 9

months Pump thrombosis.

Patient not a candidate for surgical LVAD explantation

14mm None Yes None Discharged as comfort care.

Doing well 8 months after procedure

(2)

Pendyal et al;

2017 (9)

65 year;

Male;

NICMP (idiopathic)

HM II; 37

months Pump thrombosis; history of prior pump exchange; not a candidate for pump exchange or transplantation

Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, MN)

20mm Warfarin Yes None Procedure was successful.

Doing well 5 months after procedure; underwent cardiac transplant

Sainte et al;

2014 (10)

35 year;

Female;

NICMP (idiopathic)

CircuLite Synergy;

5 months

Myocardial recovery Amplatzer Vascular Plug II- deployed in the proximal tip of the inflow cannula

Not

available Not

available Yes None Procedure was successful.

Doing well 2 years after procedure

(3)

PRBC: Packed red blood cell FFP: Fresh frozen plasma

ICU LOS: Intensive care unit length of stay

Supplemental Table 2: Surgical LVAD exclusion

Year Age;

Sex;

Etiology

Type of LVAD;

Duration of support;

Explant

Indication Procedure details Intra and post-

operative course/

complications

Post- procedure Anticoagulation

Patient outcome

Patient 1

2015 52 year;

Male;

NICMP (Hypertension)

HM II; 18

months Myocardial recovery Left subcostal incision with partial left thoracotomy.

HMII explanted,

Inflow site was reconstructed with an apical plug.

Received 1 unit of PRBC intra-operatively.

Extubated within 24 hours.

ICU LOS: 1 day

Aspirin 81 mg

Warfarin, INR:2-3 Was doing well for 3 years post- procedure and then developed congestive heart failure symptoms

Patient 2

2016 38 year;

Female;

NICMP (idiopathic)

HVAD;

3 years Pump related infection, suspected myocardial recovery

1) Left anterolateral thoracotomy. HVAD explanted; Apical defect closed with sutures.

Portion of Outflow graft was left in.

2) Taken back to OR on post op day 12 for removal of outflow graft. Needed anterior thoracotomy to remove the remaining portion of outflow graft successfully.

1) Had intra-operative bleeding requiring 6 units PRBC & 6 units FFP.

Extubated on post op day 3

ICU LOS: 7 days

2) Bleeding: none Extubated within 24 hours

ICU LOS: 1 day

ASA 81 mg Alive at 3 years follow up.

However, has had multiple admissions for chest wall and mediastinal abscess and bacteremia.

Patient 3

2014 48 year;

Female NICMP (idiopathic)

HM II;

1.5 years Pump related infection, suspected myocardial recovery

Sternotomy;

HM II explanted Apical defect closed with sutures.

Intra-operatively required 2 units of PRBC and 2 units of FFP

Cardiac arrest within 24 hours of procedure

ASA 81mg Progressive cardiogenic shock resulting in death

(4)