Journal
CARDIOVASCULAR PATHOLOGY
Volume 50, Issue -, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.carpath.2020.107299
Keywords
Left ventricular assist device; HeartWare HVAD; Inflow cannula obstruction; Thrombosis; Log files
Categories
Funding
- Fondazione Cariplo [2015-1044]
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This case report highlights the importance of early recognition of HVAD inflow cannula obstruction leading to in-pump thrombosis and complete cannula occlusion. Effective strategies and tools for the diagnosis and management of this complication are currently lacking.
In the setting of HeartWare left ventricular assist device (HVAD, Medtronic) implantation, pre-pump blood flow obstruction has been described due to intraventricular thrombus formation occluding the inflow cannula. This phenomenon often evolves in suboptimal pump performance, and requires prompt management to prevent its progression. However, to date, effective strategies and tools for the diagnosis and management of this complication are poorly described. We report a case of HVAD inflow cannula obstruction that drove later in-pump thrombosis and, eventually, complete cannula occlusion, and discuss gap of knowledge and limitations of currently available diagnostic and therapeutic tools in this scenario. Furthermore, we reinforce the value of time-frequency analysis of the HVAD log files to early identify abnormal pump operation associated with inflow cannula obstruction despite unremarkable trends of pump parameters. (C) 2020 Elsevier Inc. All rights reserved.
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