Journal
TEXAS HEART INSTITUTE JOURNAL
Volume 44, Issue 1, Pages 70-72Publisher
TEXAS HEART INST
DOI: 10.14503/THIJ-16-5787
Keywords
Device removal/instrumentation/methods; heart failure/rehabilitation; heart-assist devices/adverse effects; recovery of function/physiology; thrombosis/etiology; treatment outcome; ventricular function/physiology
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Pump thrombosis is a dire sequela after left ventricular assist device (LVAD) implantation. Treatment comprises antiplatelet agents, anticoagulants, thrombolytic agents, and pump exchange. Although pump exchange is the definitive therapy, it is also the most invasive, often exposing patients to the risks of repeat sternotomy and cardiopulmonary bypass. In some cases, patients experience left ventricular recovery after LVAD implantation. The optimal strategy surrounding the management of LVADs in patients who have experienced ventricular recovery is unknown; techniques range from total system explantation to partial pump resection. Here, we describe a novel means of LVAD deactivation in a 65-year-old man with recurrent pump thrombosis, via percutaneous outflow graft closure in the cardiac catheterization laboratory. We also review the existing literature on surgical and percutaneous LVAD deactivation techniques.
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