title: Left ventricular assist device implantation in heart failure patients with a left ventricular thrombus.
abstract: BACKGROUND
  In this report, we share our experience with left ventricular assist device (LVAD) implantation in cases with a left ventricular (LV) thrombus.
  
  
  METHODS
  Over the 3 years, more than 100 end-stage heart failure cases have been treated with LVAD implantation in our center, including 6 patients with a LV thrombus. Three were detected using preoperative transthoracic echocardiography. Fifty percent of the patients had dilated cardiomyopathy and the remaining cases had an ischemic etiology. Double inotropic support with dopamine and dobutamine was used in all, with 3 drugs with the addition of adrenaline in 2 patients. In 4 cases we implanted the HeartWare Ventricular Assist System (HeartWare, Inc., Miramar, Fla, United States) and in the remaining 2 patients, the Berlin Heart EXCOR ventricular assist device (Berlin Heart AG, Berlin, Germany) for biventricular support. In 1 patient the apical ventriculotomy was extended to remove an intertrabecular thrombosis and ventricular septal surface covered with a dacron patch to minimize the thrombogenic potential.
  
  
  RESULTS
  Two patients died due to sepsis and multiorgan failure. None of the patients experienced a neurological event, pump thrombosis, or pump malfunction. Two subjects underwent re-explorations due to hemorrhage. Two candidates underwent successfull transplantation without any evidence of thrombosis in the explanted heart or device.
  
  
  CONCLUSIONS
  We believe that patients with a LV thrombus and preserved right ventricular function are good candidates for implantation of a LVAD after removing the intracavitary thrombus.
authors.affiliation: Department of Cardiovascular Surgery, Ege University Medical Faculty Hospital, Izmir, Turkey. cagatayengin@yahoo.com
authors.forename: C
authors.initials: C
authors.lastname: Engin
authors.forename: T
authors.initials: T
authors.lastname: Yagdi
authors.forename: O
authors.initials: O
authors.lastname: Balcioglu
authors.forename: S
authors.initials: S
authors.lastname: Erkul
authors.forename: B
authors.initials: B
authors.lastname: Baysal
authors.forename: E
authors.initials: E
authors.lastname: Oguz
authors.forename: F
authors.initials: F
authors.lastname: Ayik
authors.forename: P
authors.initials: P
authors.lastname: Ozturk
authors.forename: M
authors.initials: M
authors.lastname: Ozbaran
mesh_terms: D004280:Dobutamine / Q000008:administration & dosage; D004298:Dopamine / Q000008:administration & dosage; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D018487:Ventricular Dysfunction, Left / Q000601:surgery*
chemical_list: D004280:Dobutamine; D004298:Dopamine