title: Thrombotic occlusion of an aortic-root xenograft during left ventricular assistance.
abstract: A 45-year-old man underwent repair of a congenital bicuspid aortic valve and complex aortic-root aneurysm with an aortic-root xenograft. A CentriMag® left ventricular assist device was implanted for cardiac support and was subsequently replaced with a HeartMate II® left ventricular assist device. A day later, the patient was returned to the operating room for control of bleeding, and thrombotic occlusion of the prosthetic aortic valve was detected. The patient underwent thrombus removal, oversewing of the prosthetic valve, and bypass of the left anterior descending coronary artery. This case emphasizes the hazard of bypassing a failed left ventricle with a cardiac assist device after aortic valve replacement, even with a bioprosthesis.
authors.affiliation: The Center for Cardiac Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors.forename: Zumrut T
authors.initials: ZT
authors.lastname: Demirozu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ho
authors.forename: Roberta C
authors.initials: RC
authors.lastname: Bogaev
authors.forename: Scott A
authors.initials: SA
authors.lastname: Lemaire
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Coselli
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000002:abnormalities / Q000601:surgery*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D001026:Coronary Artery Bypass; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D013927:Thrombosis / Q000209:etiology* / Q000601:surgery; D014183:Transplantation, Heterologous; D016896:Treatment Outcome