title: The presence of air bubbles in the aorta of a patient with a HeartMate II left ventricular assist device: a novel sign of outflow graft obstruction.
abstract: Microbubbles formed by cavitation have been frequently reported in patients with mechanical heart valves, but have not previously been described in patients with continuous-flow left-ventricular assist devices (LVADs). Obstruction of the LVAD circuit by thrombus, outflow graft kinking, or cannula malposition may cause high-pressure gradients and turbulent flow, often resulting in hemolysis. The article is the first in the field to describe the presence of microbubbles in the ascending aorta of a patient with severe LVAD-associated hemolysis. It is proposed that these bubbles were formed by cavitation in the presence of a high-pressure gradient due to LVAD outflow graft obstruction and suggested that this may be a novel imaging sign of LVAD obstruction in patients with continuous-flow LVADs.
authors.affiliation: From the *Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California; and †Division of Cardiovascular Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Margot K
authors.initials: MK
authors.lastname: Davis
authors.forename: Richard
authors.initials: R
authors.lastname: Ha
authors.forename: Dipanjan
authors.initials: D
authors.lastname: Banerjee
mesh_terms: D001011:Aorta; D004618:Embolism, Air / Q000209:etiology*; D006333:Heart Failure / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged