Percutaneous management of left ventricular assist device outflow graft obstruction

DOI: 10.4244/EIJ-D-21-00899

Aleksandra Gasecka
Aleksandra Gasecka1, MD, PhD; Mariusz Szymanski1, MD, PhD; Michiel Voskuil1, MD, PhD; Linda W. van Laake1, MD, PhD; Faiz Ramjankhan2, MD; Adriaan O. Kraaijeveld1, MD, PhD
1. Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands; 2. Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands

Figure 1. Multimodality imaging and treatment of LVAD outflow graft obstruction. A 37-year-old man who received a HeartWare ventricular assist device (HVAD) due to a pheochromocytoma with stress-induced, non-reversible cardiomyopathy four years earlier was admitted due to general malaise and low-flow alarms. Computed tomography (CT) angiography demonstrated HVAD outflow graft obstruction (A: white arrow; B: white arrow), which was confirmed with intravascular ultrasound (C: IVUS). Peak-to-peak pressure gradient was 75 mmHg. The stenosis was treated with a balloon-expandable covered stent (D: black arrow; Advanta V12, 12 mm×41 mm), leading to an increase in LVAD flow to 3.5 L/min. The control angiography ...

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