Left ventricular assist devices (LVADs) are life-saving, surgically implanted mechanical heart pumps used to treat patients with advanced heart failure (HF). While life-saving, LVAD support is associated with a high incidence of complications, making early recognition and management of LVAD complications a critical need. Blood clot formation within the LVAD, known as LVAD thrombosis, is a catastrophic complication of LVAD therapy that often requires LVAD exchange due to delayed diagnosis and treatment. Using digital stethoscopes, we identified differences in acoustic spectra from two patients presenting with LVAD thrombosis compared with normally functioning LVAD pumps within the same patient. Importantly, these acoustic changes were present even in the absence of typical signs of HF that are often present in LVAD thrombosis patients. Our work suggests that acoustic spectral analysis of digital stethoscope signals could be used for early detection and mitigation of LVAD complications.

References

References
1.
Benjamin
,
E. J.
,
Virani
,
S. S.
,
Callaway
,
C. W.
,
Chamberlain
,
A. M.
,
Chang
,
A. R.
,
Cheng
,
S.
,
Chiuve
,
S. E.
,
Cushman
,
M.
,
Delling
,
F. N.
,
Deo
,
R.
,
de Ferranti
,
S. D.
,
Ferguson
,
J. F.
,
Fornage
,
M.
,
Gillespie
,
C.
,
Isasi
,
C. R.
,
Jimenez
,
M. C.
,
Jordan
,
L. C.
,
Judd
,
S. E.
,
Lackland
,
D.
,
Lichtman
,
J. H.
,
Lisabeth
,
L.
,
Liu
,
S.
,
Longenecker
,
C. T.
,
Lutsey
,
P. L.
,
Mackey
,
J. S.
,
Matchar
,
D. B.
,
Matsushita
,
K.
,
Mussolino
,
M. E.
,
Nasir
,
K.
,
O'Flaherty
,
M.
,
Palaniappan
,
L. P.
,
Pandey
,
A.
,
Pandey
,
D. K.
,
Reeves
,
M. J.
,
Ritchey
,
M. D.
,
Rodriguez
,
C. J.
,
Roth
,
G. A.
,
Rosamond
,
W. D.
,
Sampson
,
U. K. A.
,
Satou
,
G. M.
,
Shah
,
S. H.
,
Spartano
,
N. L.
,
Tirschwell
,
D. L.
,
Tsao
,
C. W.
,
Voeks
,
J. H.
,
Willey
,
J. Z.
,
Wilkins
,
J. T.
,
Wu
,
J. H.
,
Alger
,
H. M.
,
Wong
,
S. S.
,
Muntner
,
P.
,
American Heart Association
,
C.
,
on
,
E.
,
Prevention Statistics
,
C.
, and
Stroke Statistics
,
S.
,
2018
, “
Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association
,”
Circulation
,
137
, pp.
e67
e492
.
2.
Hashim
,
T.
,
Sanam
,
K.
,
Revilla-Martinez
,
M.
,
Morgan
,
C. J.
,
Tallaj
,
J. A.
,
Pamboukian
,
S. V.
,
Loyaga-Rendon
,
R. Y.
,
George
,
J. F.
, and
Acharya
,
D.
,
2015
, “
Clinical Characteristics and Outcomes of Intravenous Inotropic Therapy in Advanced Heart Failure
,”
Circ. Heart Failure
,
8
(
5
), pp.
880
886
.
3.
Kirklin
,
J. K.
,
Naftel
,
D. C.
,
Pagani
,
F. D.
,
Kormos
,
R. L.
,
Stevenson
,
L. W.
,
Blume
,
E. D.
,
Myers
,
S. L.
,
Miller
,
M. A.
,
Baldwin
,
J. T.
, and
Young
,
J. B.
,
2015
, “
Seventh INTERMACS Annual Report: 15,000 Patients and Counting
,”
J. Heart Lung Transplant.
,
34
(
12
), pp.
1495
1504
.
4.
DeVore
,
A. D.
,
Patel
,
P. A.
, and
Patel
,
C. B.
,
2017
, “
Medical Management of Patients With a Left Ventricular Assist Device for the Non-Left Ventricular Assist Device Specialist
,”
JACC Heart Failure
,
5
(
9
), pp.
621
631
.
5.
Akhter
,
S. A.
,
Badami
,
A.
,
Murray
,
M.
,
Kohmoto
,
T.
,
Lozonschi
,
L.
,
Osaki
,
S.
, and
Lushaj
,
E. B.
,
2015
, “
Hospital Readmissions After Continuous-Flow Left Ventricular Assist Device Implantation: Incidence, Causes, and Cost Analysis
,”
Ann. Thorac. Surg.
,
100
(
3
), pp.
884
889
.
6.
Starling
,
R. C.
,
Moazami
,
N.
,
Silvestry
,
S. C.
,
Ewald
,
G.
,
Rogers
,
J. G.
,
Milano
,
C. A.
,
Rame
,
J. E.
,
Acker
,
M. A.
,
Blackstone
,
E. H.
,
Ehrlinger
,
J.
,
Thuita
,
L.
,
Mountis
,
M. M.
,
Soltesz
,
E. G.
,
Lytle
,
B. W.
, and
Smedira
,
N. G.
,
2014
, “
Unexpected Abrupt Increase in Left Ventricular Assist Device Thrombosis
,”
N. Engl. J. Med.
,
370
(
1
), pp.
33
40
.
7.
Norton
,
M. P.
, and
Karczub
,
D. G.
,
2003
,
Fundamentals of Noise and Vibration Analysis for Engineers
,
Cambridge University Press
,
Cambridge, UK
.
8.
HeartMate, 2017, “
HeartMate II® LVAS Operating Manual
,” HeartMate, Thoratec Corporation. Pleasanton, CA.
9.
Uriel
,
N.
,
Morrison
,
K. A.
,
Garan
,
A. R.
,
Kato
,
T. S.
,
Yuzefpolskaya
,
M.
,
Latif
,
F.
,
Restaino
,
S. W.
,
Mancini
,
D. M.
,
Flannery
,
M.
,
Takayama
,
H.
,
John
,
R.
,
Colombo
,
P. C.
,
Naka
,
Y.
, and
Jorde
,
U. P.
,
2012
, “
Development of a Novel Echocardiography Ramp Test for Speed Optimization and Diagnosis of Device Thrombosis in Continuous-Flow Left Ventricular Assist Devices: The Columbia Ramp Study
,”
J. Am. Coll. Cardiol.
,
60
(
18
), pp.
1764
1775
.
10.
Uriel
,
N.
,
Levin
,
A. P.
,
Sayer
,
G. T.
,
Mody
,
K. P.
,
Thomas
,
S. S.
,
Adatya
,
S.
,
Yuzefpolskaya
,
M.
,
Garan
,
A. R.
,
Breskin
,
A.
,
Takayama
,
H.
,
Colombo
,
P. C.
,
Naka
,
Y.
,
Burkhoff
,
D.
, and
Jorde
,
U. P.
,
2015
, “
Left Ventricular Decompression During Speed Optimization Ramps in Patients Supported by Continuous-Flow Left Ventricular Assist Devices: Device-Specific Performance Characteristics and Impact on Diagnostic Algorithms
,”
J. Card. Failure
,
21
(
10
), pp.
785
791
.
11.
Hubbert
,
L.
,
Sundbom
,
P.
,
Loebe
,
M.
,
Peterzen
,
B.
,
Granfeldt
,
H.
, and
Ahn
,
H.
,
2014
, “
Acoustic Analysis of a Mechanical Circulatory Support
,”
Artif. Organs
,
38
(
7
), pp.
593
598
.
12.
Liu
,
Y.
,
Norton
,
J. J.
,
Qazi
,
R.
,
Zou
,
Z.
,
Ammann
,
K. R.
,
Liu
,
H.
,
Yan
,
L.
,
Tran
,
P. L.
,
Jang
,
K. I.
,
Lee
,
J. W.
,
Zhang
,
D.
,
Kilian
,
K. A.
,
Jung
,
S. H.
,
Bretl
,
T.
,
Xiao
,
J.
,
Slepian
,
M. J.
,
Huang
,
Y.
,
Jeong
,
J. W.
, and
Rogers
,
J. A.
,
2016
, “
Epidermal Mechano-Acoustic Sensing Electronics for Cardiovascular Diagnostics and Human-Machine Interfaces
,”
Sci. Adv.
,
2
(
11
), p.
e1601185
.
13.
Feldmann
,
C.
,
Deniz
,
E.
,
Stomps
,
A.
,
Knigge
,
S.
,
Chatterjee
,
A.
,
Wendl
,
R.
,
Hanke
,
J. S.
,
Dogan
,
G.
,
Napp
,
L. C.
,
Glasmacher
,
B.
,
Haverich
,
A.
, and
Schmitto
,
J. D.
,
2018
, “
An Acoustic Method for Systematic Ventricular Assist Device Thrombus Evaluation With a Novel Artificial Thrombus Model
,”
J. Thorac. Dis.
,
10
(
S15
), pp.
S1711
S1719
.
14.
Graney
,
B. P.
, and
Starry
,
K.
,
2012
, “
Rolling Element Bearing Analysis
,”
Mater. Eval.
,
70
(1), pp.
78
85
.https://www.asnt.org/temp/graney_jan2012.pdf
15.
Yost
,
G. L.
,
Royston
,
T. J.
,
Bhat
,
G.
, and
Tatooles
,
A. J.
,
2016
, “
Acoustic Characterization of Axial Flow Left Ventricular Assist Device Operation In Vitro and In Vivo
,”
ASAIO J.
,
62
(
1
), pp.
46
55
.
16.
Kaufmann
,
F.
,
Hormandinger
,
C.
,
Stepanenko
,
A.
,
Kretzschmar
,
A.
,
Soltani
,
S.
,
Krabatsch
,
T.
,
Potapov
,
E.
, and
Hetzer
,
R.
,
2014
, “
Acoustic Spectral Analysis for Determining Pump Thrombosis in Rotary Blood Pumps
,”
ASAIO J.
,
60
(
5
), pp.
502
507
.
You do not currently have access to this content.