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Case Reports
. 2023 Mar;39(2):165-169.
doi: 10.1007/s12055-022-01435-x. Epub 2022 Nov 22.

Left ventricular assist device inflow obstruction

Vinod Kumar Manikala  1   2 , Quynh Nguyen  3 , Qiang Fu  1   2 , Angela Neufeld  2   4 , Roderick MacArthur  1   2 , Jennifer Conway  2   5 , Holger Buchholz  1   2
Affiliations
Case Reports

Left ventricular assist device inflow obstruction

Vinod Kumar Manikala et al. Indian J Thorac Cardiovasc Surg. 2023 Mar.

Abstract

Inflow cannula obstruction is a rare complication of left ventricular assist device implantation. In this report, we present a case of inflow obstruction that was successfully treated with left ventricle myectomy and mitral valvectomy. Transesophageal echocardiogram was essential in diagnosing this condition.

Keywords: Inflow cannula obstruction; LVAD; Low flow alarm; TEE.

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Conflict of interest statement

Conflict of interestAll authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Representative intraoperative transesophageal images. A Preoperative LVAD implantation, mid-esophageal long axis view of LV cavity showing dilated LV without muscle hypertrophy. B Preoperative LVAD implantation, mid-esophageal two-chamber view showing dilated LV cavity without muscle hypertrophy. C Postoperative LVAD implantation, pre-CPB mid-esophageal long axis view showing hypertrophied muscle within LV cavity protruding into the inflow cannula causing obstruction. D Postoperative LVAD implantation, pre-CPB mid-esophageal two-chamber view with color Doppler showing increased inflow cannula velocity with turbulent blood flow. E Postoperative myectomy with LVAD pump exchange, post-CPB mid-esophageal long axis view of LV cavity showing patent inflow cannula. F Postoperative myectomy with LVAD pump exchange, post-CPB mid-esophageal long axis view with color Doppler showing normal flow velocity across the inflow cannula without turbulent blood flow. CPB, cardiopulmonary bypass; LV, left ventricle; LVAD, left ventricular assist device
Fig. 2
Fig. 2
Chest X-ray images (A) after the initial LVAD implant and (B) after the LVAD pump exchange. LVAD, left ventricular assist device
Fig. 3
Fig. 3
Computed tomography images of the LVAD system at the first presentation of low flow alarms post-initial LVAD implant. (A) Coronal image of the inflow cannula; (B) sagittal image of the pump and inflow cannula; (C) coronal image of the pump and outflow graft; (D) sagittal image of the outflow graft. LVAD, left ventricular assist device
See this image and copyright information in PMC

References

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