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Case Reports
. 2010 Jul;140(1):e7-8.
doi: 10.1016/j.jtcvs.2009.09.046. Epub 2009 Nov 27.

Early thrombus in a HeartMate II left ventricular assist device: a potential cause of hemolysis and diagnostic dilemma

Castigliano M Bhamidipati  1 , Gorav Ailawadi, James Bergin, John A Kern
Affiliations
Case Reports

Early thrombus in a HeartMate II left ventricular assist device: a potential cause of hemolysis and diagnostic dilemma

Castigliano M Bhamidipati et al. J Thorac Cardiovasc Surg. 2010 Jul.
No abstract available

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Conflict of interest statement

No financial disclosures or conflicts of interest

Figures

Figure 1
Figure 1. Anticoagulation and Hemolysis timeline from HMII and AVR implantation through HMII pump replacement
Vitamin K administration (dark arrow) on POD #1 due to suspected hemorrhage/excessive post-op bleeding, and POD #26 due to evolving hematomas around pump pocket site. Vitamin K on POD #71 administered to reverse therapeutic anticoagulation in preparation for HMII replacement. Warfarin and Aspirin (ASA) administration are identified by grayscale arrows with the INR trend (dark curve) consistent with warfarin administration. LDH activity (data points) remained significantly elevated (dashed regression trend) with the concomitant Hp level <8mg/dl throughout, taken together were suggestive of hemolytic anemia. Regression trend suggests LDH activity increased with lowered systemic anticoagulation.
Figure 2
Figure 2. Thrombus at the distal end of the inflow-conduit as seen through the pump body of the HMII
Note the red arrow in the lateral profile of the HMII LVAD (inset). The inlet bearing cup is identified as the location of the distal inflow-conduit thrombus. Multiple LVAD studies showed normal function despite the presence of thrombus suggesting current modalities may be inadequate to evaluate HMII LVAD pump body lesions. (Image use approved by Thoratec, Inc.)
See this image and copyright information in PMC

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