JACC. Case reports · 2026
Cerebral-Protected Percutaneous Thrombectomy for Near-Occlusive LVAD Outflow Graft Thrombosis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chakrala Teja S, Tanko Toochukwu, Raje Vikram, Charles Lawrence, Janko Matthew, Thompson R Kyle, Ramadan Ronnie, Egolum Ugochukwu O
Аннотация
BACKGROUND: Late low-flow alarms in left ventricular assist devices (LVADs) most commonly result from volume depletion or right-sided failure, but mechanical outflow graft obstruction is an infrequent yet life-threatening cause.
CASE SUMMARY: A 70-year-old man with a HeartMate 3 LVAD presented with persistent low-flow (0 L/min) alarms after defecation but felt entirely well. Laboratory testing showed no overt hemolysis, and transthoracic echocardiography excluded right-sided failure. Computed tomographic angiography revealed >90% thrombotic narrowing of the distal outflow graft. The patient underwent percutaneous cerebral-protected thrombectomy with a Penumbra aspiration catheter followed by serial balloon dilatations (8-18 mm) achieving complete graft patency and immediate restoration of device flow to 4 L/min.
DISCUSSION: Outflow graft thrombosis occurs in approximately 2% to 5% of contemporary LVAD recipients and carries high morbidity if untreated. Few reports describe successful catheter-directed thrombectomy; this case highlights prompt multimodality imaging, a heart-team approach, and the utility of cerebral protection to mitigate embolic risk.
TAKE-HOME MESSAGES: Persistent low-flow alarms mandate systematic evaluation. Early imaging-guided intervention can safely rescue outflow graft thrombosis and avoid emergent pump exchange.
CASE SUMMARY: A 70-year-old man with a HeartMate 3 LVAD presented with persistent low-flow (0 L/min) alarms after defecation but felt entirely well. Laboratory testing showed no overt hemolysis, and transthoracic echocardiography excluded right-sided failure. Computed tomographic angiography revealed >90% thrombotic narrowing of the distal outflow graft. The patient underwent percutaneous cerebral-protected thrombectomy with a Penumbra aspiration catheter followed by serial balloon dilatations (8-18 mm) achieving complete graft patency and immediate restoration of device flow to 4 L/min.
DISCUSSION: Outflow graft thrombosis occurs in approximately 2% to 5% of contemporary LVAD recipients and carries high morbidity if untreated. Few reports describe successful catheter-directed thrombectomy; this case highlights prompt multimodality imaging, a heart-team approach, and the utility of cerebral protection to mitigate embolic risk.
TAKE-HOME MESSAGES: Persistent low-flow alarms mandate systematic evaluation. Early imaging-guided intervention can safely rescue outflow graft thrombosis and avoid emergent pump exchange.