title: Management of complications in long-term LVAD support.
abstract: BACKGROUND
  Management of complications in long-term LVAD support like aortic regurgitation, progressive decline of right ventricular function, or pump thrombosis are challenging.
  
  
  RESULTS
  After 2.5 years on a HeartMate II left ventricular assist device (LVAD) a 59-year-old patient was admitted to hospital due to severe hemolysis caused by a partial occlusion and thrombosis caused by a shift of the LVAD inflow cannula towards the lateral wall of the left ventricle (LV). Preoperative assessment revealed additional severe aortic regurgitation and impaired right ventricular (RV) function (severe tricuspid regurgitation, RV ejection fraction 25%, central venous pressure 14 mmHg). After LVAD device exchange and aortic valve replacement (AVR) RV failure occurred and a temporary right ventricular assist device (RVAD) was employed. RVAD explantation was feasible 21 days after surgery. The patient was discharged to a rehabilitation center.
  
  
  CONCLUSIONS
  In this case, LVAD exchange with concomitant AVR and temporary RVAD efforts saved the patient's life and restored a good quality of life.
authors: Division of Cardiology, Department of Pediatric Cardiology and Congenital Heart Disease, University Children's Hospital Zurich, Switzerland. martinschweig88@hotmail.com
authors: Martin
authors: M
authors: Schweiger
authors: Juliane
authors: J
authors: Vierecke
authors: Evgenij
authors: E
authors: Potapov
authors: Thomas
authors: T
authors: Krabatsch
mesh_terms: D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020878:Device Removal; D019918:Heart Valve Prosthesis Implantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006439:Hemodynamics; D006461:Hemolysis; D006801:Humans; D008875:Middle Aged; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left