[KSCI] Korea Science Citation Index Service

http://dx.doi.org/10.5090/jcs.21.075

Non-Surgical Resolution of Inflow Cannula Obstruction of a Left Ventricular Assist Device: A Case Report

Lee, Yoonseo (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Sung, Kiick (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Wook Sung (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Jeong, Dong Seop (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Shinn, Sung Ho (Department of Thoracic and Cardiovascular Surgery, Cheju Halla General Hospital)
Cho, Yang Hyun (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)

Publication Information

Journal of Chest Surgery / v.54, no.6, 2021 , pp. 543-546 More about this Journal

Abstract

A 55-year-old woman who had received an implantable left ventricular assist device 3 months earlier presented with dyspnea and a low-flow alarm of the device. Computed tomography and log-file analysis of the device system suggested inflow cannula obstruction. Since the patient had cardiogenic shock due to pump failure, venoarterial extracorporeal membrane oxygenation (ECMO) was initiated. With ECMO, surgical exchange of the pump was considered. However, the obstruction spontaneously resolved without surgical intervention. It turned out that an obstructive thrombus was washed out by rebooting the pump. Moreover, the thrombus was embolized in the patient's left subclavian artery. The patient underwent heart transplantation 4 months after the pump obstruction accident and continued to do well.

Keywords

Heart-assist devices; Ventricular assist devices; Embolism and thrombosis; Thrombosis; Case report;

Citations & Related Records

Reference

1	Tchantchaleishvili V, Sagebin F, Ross RE, Hallinan W, Schwarz KQ, Massey HT. Evaluation and treatment of pump thrombosis and hemolysis. Ann Cardiothorac Surg 2014;3:490-5.
2	Bouzas-Cruz N, Gonzalez-Fernandez O, Ferrera-Duran C, et al. Initial conservative management strategy of HeartWare left ventricular assist device thrombosis with intravenous heparin or bivalirudin. Int J Artif Organs 2020;43:444-51. DOI
3	Kormos RL, Cowger J, Pagani FD, et al. The Society of Thoracic Surgeons Intermacs database annual report: evolving indications, outcomes, and scientific partnerships. J Heart Lung Transplant 2019;38:114-26. DOI
4	Patel CB, Cowger JA, Zuckermann A. A contemporary review of mechanical circulatory support. J Heart Lung Transplant 2014;33:667-74. DOI
5	Scandroglio AM, Kaufmann F, Pieri M, et al. Diagnosis and treatment algorithm for blood flow obstructions in patients with left ventricular assist device. J Am Coll Cardiol 2016;67:2758-68. DOI
6	Saeed D, Maxhera B, Albert A, Westenfeld R, Hoffmann T, Lichtenberg A. Conservative approaches for HeartWare ventricular assist device pump thrombosis may improve the outcome compared with immediate surgical approaches. Interact Cardiovasc Thorac Surg 2016;23:90-5. DOI