A Redo Percutaneous Emergency Intervention of Left Ventricular Assist Device Graft Occlusion

Rocco Edoardo Stio, Marina Comisso, Luca Paolucci, Silvio Coletta, Vincenzo Cesario, Michele Gioia, Marco Stefano Nazzaro, Guglielmo Saitto, Carlo Contento, Emilio D’Avino, Francesco De Felice, Domenico Gabrielli and Francesco Musumeci
Additional contact information
Rocco Edoardo Stio: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Marina Comisso: Department of Heart and Vessels, Cardiac Surgery and Heart Transplantation Center, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Luca Paolucci: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Silvio Coletta: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Vincenzo Cesario: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Michele Gioia: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Marco Stefano Nazzaro: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Guglielmo Saitto: Department of Heart and Vessels, Cardiac Surgery and Heart Transplantation Center, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Carlo Contento: Department of Cardiovascular Anaesthesia, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Emilio D’Avino: Department of Cardiovascular Anaesthesia, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Francesco De Felice: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Domenico Gabrielli: Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
Francesco Musumeci: Department of Heart and Vessels, Cardiac Surgery and Heart Transplantation Center, San Camillo-Forlanini Hospital, 00152 Rome, Italy

IJERPH, 2022, vol. 19, issue 10, 1-8

Abstract: In patients with advanced heart failure (HF), left ventricular assist devices (LVADs) have demonstrated to be effective in improving the quality of life and reducing further hospitalizations. Although uncommon, LVAD outflow graft obstruction (OGO) is a potentially life-threatening complication and percutaneous treatment has been proposed as a standard intervention strategy in such cases. We report the case of a 69 year old man admitted due to LVAD failure causing unstable HF. Past medical history included percutaneous intervention on the outflow graft with stent implantation one year before. The patient was under chronic treatment with vitamin K antagonists (VKA). Emergent percutaneous angiography was performed, showing recurrent OGO due to thrombosis located at a kinking site, distally to the previously treated segment. Using distal anchoring technique, a balloon-expandable 10 × 79 mm endoprosthesis (GORE ® Viabahn ® VBX) was effectively positioned and post-dilated. Final angiography confirmed the patency of the stent implanted one-year before. Despite the procedure succeeding in restoring LVAD function, the patient died due to septic shock ten days after. Our case suggests that recurrent OGO can be effectively treated with percutaneous redo and that long-term stent patency can be achieved with a standard antithrombotic treatment, despite further thrombotic events in other segments of the graft are still possible (especially at the kinking site). Moreover, other noncardiac conditions as infective complications, can dramatically impact the clinical course and lead to unfavorable outcomes.

Keywords: left ventricular assist device; percutaneous coronary intervention; heart failure (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/10/5976/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/10/5976/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:10:p:5976-:d:815668

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().