Integrated Imaging to Investigate Low-Flow Alarms of Left Ventricular Assist Devices

Aimo, Alberto; Bianchi, Giacomo; Vergaro, Giuseppe

doi:10.1016/j.jaccas.2020.07.006

Cited by 1 publication

(1 citation statement)

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“…OGO is a rare cause of LVAD malfunction and is typically seen secondary to kinks in the graft with or without associated thrombus. 6 Pump thrombosis is more common than graft thrombosis and factors that play a role in thrombus formation include patient characteristics (hemocompatibility), suboptimal anticoagulation, or mechanical issues Outflow kinks and polytetrafluoroethylene covering alongside the graft have also been linked to the development of outflow thrombosis. 4,7 On initial graft angiography, in this case, an OGO was indeed visualized with a filling defect, and localized thrombolysis failed to improve flow parameters.…”

Section: Discussionmentioning

confidence: 99%

Acute Left Ventricular Assist Device Failure From Outflow Graft Dissection Flap Successfully Treated With Stent Placement

et al. 2022

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Outflow graft obstruction (OGO) is a potentially fatal complication of left ventricular assist device (LVAD) implantation. Common causes include graft kinking, luminal stenosis, and graft thrombosis. We describe a case of a 51-year-old female who presented with acute LVAD failure and cardiogenic shock. Initial imaging revealed OGO without luminal stenosis following which she was she was empirically treated for graft thrombosis with anticoagulation and catheter-based thrombolytic therapy with no success. Further imaging in the catheterization laboratory revealed a potential neointimal flap dissection acting as a one-way valve. A stent was successfully placed across the outflow graft with immediate resolution of cardiogenic shock. The case emphasizes the importance of including neointimal flap as a differential for OGO in acute LVAD failure, especially in cases where thrombolytic therapy fails to correct hemodynamic compromise.

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Section: Discussionmentioning

confidence: 99%