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Technical Brief

Acoustic Signatures of Left Ventricular Assist Device Thrombosis

[+] Author and Article Information
Priyesh Patel

Medical Center and WakeMed Heart Center,
Duke University,
3000 New Bern Avenue, Suite 1200,
Raleigh, NC 27610
e-mail: priyesh.patel@dm.duke.edu

Boyla Mainsah

Department of Electrical and Computer Engineering,
Duke University,
130 Hudson Hall,
Durham, NC 27708
e-mail: boyla.mainsah@duke.edu

Carmelo A. Milano

Medical Center,
Duke University,
Box 3043,
Durham, NC 27710
e-mail: carmelo.milano@duke.edu

Douglas P. Nowacek

Marine Laboratory,
Duke University,
135 Duke Marine Lab Road,
Beaufort, NC 28516
e-mail: doug.nowacek@duke.edu

Leslie Collins

Department of Electrical and Computer Engineering,
Duke University,
130 Hudson Hall,
Durham, NC 27708
e-mail: leslie.collins@duke.edu

Ravi Karra

Medical Center,
Duke University,
Box 3126,
Durham, NC 27710
e-mail: ravi.karra@duke.edu

1Corresponding authors.

Manuscript received June 12, 2018; final manuscript received September 14, 2018; published online January 18, 2019. Assoc. Editor: Thomas J. Royston.

ASME J of Medical Diagnostics 2(2), 024501 (Jan 18, 2019) (4 pages) Paper No: JESMDT-18-1027; doi: 10.1115/1.4041529 History: Received June 12, 2018; Revised September 14, 2018

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.

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Figures

Grahic Jump Location
Fig. 1

Components of axial flow left ventricular assist device

Grahic Jump Location
Fig. 2

(a) Thrombus within patient 2 LVAD. ((b) and (c)) Acoustic spectra for patients 1 and 2 taken before and after subcostal LVAD exchange. Predominant components of the acoustic spectrum include its rotational frequency, f=(r/60)rpm, and its harmonics, where r is the pump speed in rpm. Note the additional frequency peaks that are present in the pre-exchange pumps that are absent in postexchange pumps (arrows).

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