Emergency cable repair with electrical splicing connectors of a suicidal HeartMate 3 patient: a case report

Background: Injuries or cuts of driveline may lead to pump stop and detrimental consequences in patients living with left ventricular assist device. Case summary: We report a suicide attempt of a HeartMate 3 patient who cut both modular and pump cable and immediate pump stop occurred. She was transferred to our centre in cardiogenic shock with an INR over 8. After carefully considering the risk of thromboembolism, we decided to attempt restarting the pump by restoring cable integrity. We successfully reconnected each individually coloured wires within the pump cable using commercially available electrical wire lever splicers, exchanged the modular cable and the controller, and successfully restarted the pump. Despite the prolonged pump stop, no neurological sequelae occurred. Discussion: In case of a driveline cut or damage-after carefully considering the risk of thromboembolism and alternative solutions like short-term mechanical support and pump exchange-attempts might be made to restart the pump by restoring cable integrity. Accessories like spare modular cable, back-up controller, and, preferably, splicing connectors should be kept at each implanting centre.