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Management of complications in long-term LVAD support


Schweiger, Martin; Vierecke, Juliane; Potapov, Evgenij; Krabatsch, Thomas (2013). Management of complications in long-term LVAD support. The International Journal of Artificial Organs, 36(6):444-446.

Abstract

INTRODUCTION: Management of complications in long-term LVAD support like aortic regurgitation, progressive decline of right ventricular function, or pump thrombosis are challenging.

METHODS AND RESULTS: After 2.5 years on a HeartMate II left ventricular assist device (LVAD) a 59-year-old patient was admitted to hospital due to severe hemolysis caused by a partial occlusion and thrombosis caused by a shift of the LVAD inflow cannula towards the lateral wall of the left ventricle (LV). Preoperative assessment revealed additional severe aortic regurgitation and impaired right ventricular (RV) function (severe tricuspid regurgitation, RV ejection fraction 25%, central venous pressure 14 mmHg). After LVAD device exchange and aortic valve replacement (AVR) RV failure occurred and a temporary right ventricular assist device (RVAD) was employed. RVAD explantation was feasible 21 days after surgery. The patient was discharged to a rehabilitation center.

DISCUSSION: In this case, LVAD exchange with concomitant AVR and temporary RVAD efforts saved the patient's life and restored a good quality of life.

Abstract

INTRODUCTION: Management of complications in long-term LVAD support like aortic regurgitation, progressive decline of right ventricular function, or pump thrombosis are challenging.

METHODS AND RESULTS: After 2.5 years on a HeartMate II left ventricular assist device (LVAD) a 59-year-old patient was admitted to hospital due to severe hemolysis caused by a partial occlusion and thrombosis caused by a shift of the LVAD inflow cannula towards the lateral wall of the left ventricle (LV). Preoperative assessment revealed additional severe aortic regurgitation and impaired right ventricular (RV) function (severe tricuspid regurgitation, RV ejection fraction 25%, central venous pressure 14 mmHg). After LVAD device exchange and aortic valve replacement (AVR) RV failure occurred and a temporary right ventricular assist device (RVAD) was employed. RVAD explantation was feasible 21 days after surgery. The patient was discharged to a rehabilitation center.

DISCUSSION: In this case, LVAD exchange with concomitant AVR and temporary RVAD efforts saved the patient's life and restored a good quality of life.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:14 Feb 2014 07:42
Last Modified:05 Apr 2016 17:34
Publisher:Wichtig Editore
ISSN:0391-3988
Publisher DOI:https://doi.org/10.5301/ijao.5000212
PubMed ID:23653295

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