title: Left ventricular assist device outflow cannula obstruction by the rare environmental fungus Myceliophthora thermophila.
abstract: Left ventricular assist devices are used to provide mechanical circulatory support during end-stage heart failure either as a destination therapy or as a bridge to heart transplantation. Perioperative transesophageal echocardiography is becoming an invaluable tool to investigate device function during implantation and in case of mechanical malfunction. Most malfunctions are due to inflow graft occlusion, or device malfunction, while outflow graft dysfunction is rare. Here, we present a case of severe outflow conduit obstruction by a rare environmental fungus, Myceliophthora thermophila. After replacement of the infected device and intensive antifungal treatment, heart transplantation was performed 2 yr later.
authors.affiliation: Department of Anesthesiology, University of Colorado Denver and Health Sciences Center, Aurora, Colorado 80045, USA. nathaen.weitzel@uchsc.ed
authors.forename: Nathaen
authors.initials: N
authors.lastname: Weitzel
authors.forename: Ferenc
authors.initials: F
authors.lastname: Puskas
authors.forename: Joseph
authors.initials: J
authors.lastname: Cleveland
authors.forename: Marilyn E
authors.initials: ME
authors.lastname: Levi
authors.forename: Tamas
authors.initials: T
authors.lastname: Seres
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D020878:Device Removal; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D003904:Mitosporic Fungi / Q000302:isolation & purification*; D009181:Mycoses / Q000209:etiology* / Q000382:microbiology; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology / Q000628:therapy
chemical_list: D000935:Antifungal Agents