A Rare and Late Complication After Left Ventricular Assist Device Explantation

George Gradinariu; André R. Simon; Jullien Gaer

doi:10.12945/j.aorta.2017.16.032

AORTA, Table of Contents

CC BY 4.0 · Aorta (Stamford) 2017; 05(02): 53-56
DOI: 10.12945/j.aorta.2017.16.032

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Rare and Late Complication After Left Ventricular Assist Device Explantation

George Gradinariu

¹Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, United Kingdom

,

André R. Simon

²Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, United Kingdom

,

Jullien Gaer

¹Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, Harefield, Middlesex, United Kingdom

› Author Affiliations

Abstract

Late complications can arise after explantation of a left ventricular assist device. We report the case of a patient who presented at the age of 19 years with peri-partum cardiomyopathy and was initially managed with a biventricular support device, which was subsequently upgraded to an ambulatory left ventricular assist device. This was successfully explanted after myocardial recovery via a minimally invasive approach 7 months later. The patient re-presented 5 years following explantation with hemoptysis. At redo sternotomy, a 10-cm remnant of the outflow graft was found to be eroding the surface of the right lung. The conduit was excised and the stump oversewn. Eleven months later, she presented again with hemoptysis, and a pseudo-aneurysm was identified on the computed tomography scan. She underwent urgent open repair with peripheral cannulation and deep hypothermic total circulatory arrest. The Dacron stump was found to be partially dehisced, leaving a 2–3 cm defect in the ascending aorta. The defect was repaired with a bovine pericardial patch. The patient made a good recovery and was successfully discharged.

Key Words

Ventricular assist device explantation - Outflow graft pseudo-aneurysm - Hemoptysis - Redo surgery

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References

References
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