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Case Report

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

1
Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy
2
Department of Heart and Vessels, Cardiac Surgery and Heart Transplantation Center, San Camillo-Forlanini Hospital, 00152 Rome, Italy
3
Department of Cardiovascular Anaesthesia, San Camillo-Forlanini Hospital, 00152 Rome, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Paul B. Tchounwou and Carlos G. Santos-Gallego
Int. J. Environ. Res. Public Health 2022, 19(10), 5976; https://doi.org/10.3390/ijerph19105976
Received: 7 April 2022 / Revised: 11 May 2022 / Accepted: 12 May 2022 / Published: 14 May 2022
(This article belongs to the Special Issue Myocardial Infarction: Prevention and Treatment)
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. View Full-Text
Keywords: left ventricular assist device; percutaneous coronary intervention; heart failure left ventricular assist device; percutaneous coronary intervention; heart failure
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MDPI and ACS Style

Stio, R.E.; Comisso, M.; Paolucci, L.; Coletta, S.; Cesario, V.; Gioia, M.; Nazzaro, M.S.; Saitto, G.; Contento, C.; D’Avino, E.; De Felice, F.; Gabrielli, D.; Musumeci, F. A Redo Percutaneous Emergency Intervention of Left Ventricular Assist Device Graft Occlusion. Int. J. Environ. Res. Public Health 2022, 19, 5976. https://doi.org/10.3390/ijerph19105976

AMA Style

Stio RE, Comisso M, Paolucci L, Coletta S, Cesario V, Gioia M, Nazzaro MS, Saitto G, Contento C, D’Avino E, De Felice F, Gabrielli D, Musumeci F. A Redo Percutaneous Emergency Intervention of Left Ventricular Assist Device Graft Occlusion. International Journal of Environmental Research and Public Health. 2022; 19(10):5976. https://doi.org/10.3390/ijerph19105976

Chicago/Turabian Style

Stio, Rocco E., Marina Comisso, Luca Paolucci, Silvio Coletta, Vincenzo Cesario, Michele Gioia, Marco S. Nazzaro, Guglielmo Saitto, Carlo Contento, Emilio D’Avino, Francesco De Felice, Domenico Gabrielli, and Francesco Musumeci. 2022. "A Redo Percutaneous Emergency Intervention of Left Ventricular Assist Device Graft Occlusion" International Journal of Environmental Research and Public Health 19, no. 10: 5976. https://doi.org/10.3390/ijerph19105976

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