Total left ventricular outflow tract obstruction due to left ventricular assist device-induced sub-aortic thrombosis in 2 patients with aortic valve bioprosthesis.
This report describes 2 patients with an aortic bioprosthesis. Both patients developed total thrombotic occlusion of the sub-aortic left ventricular outflow tract consequent to insertion of a left ventricular assist device (LVAD). Replacing a mechanical valve with a bioprosthesis in patients receiving a left ventricular assist device offers no additional protection against thrombosis of the aortic prosthesis. Pericardial patching below the aortic prosthesis at the time of LVAD implantation may be performed, but will significantly impede or prohibit the native ventricle from ejecting blood and demonstrating any degree of recovery.
Department of Laboratory Medicine and Pathology, University of Minnesota and Fairview-University Medical Center, Minneapolis, Minnesota 55455, USA.
Alan G
AG
Rose
John H
JH
Connelly
Soon J
SJ
Park
O Howard
OH
Frazier
Leslie W
LW
Miller
Sofia
S
Ormaza
D000328:Adult; D001021:Aortic Valve; D001705:Bioprosthesis / Q000009:adverse effects*; D005260:Female; D006331:Heart Diseases / Q000209:etiology* / Q000473:pathology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology; D014694:Ventricular Outflow Obstruction / Q000209:etiology* / Q000473:pathology