title: Pan-Cardiac Cycle Fixed Mitral Valve Opening in an LVAD Patient Presenting with Hemorrhagic Shock.
abstract: We present the case of a patient with a HeartMate II left ventricular assist device (LVAD) who underwent an elective cholecystectomy and abruptly decompensated on postoperative day 9. We highlight the uncommon echocardiogram finding of mitral valve leaflets fixed widely open throughout the cardiac cycle during an LVAD suction event. Bedside echocardiographic confirmation of a suction event enabled the rapid diagnosis and intervention for hemorrhagic shock before blood tests and radiographic results were available. Acoustic image quality can be limited in LVAD patients, and awareness of this uncommon finding may increase specificity for the echocardiographic diagnosis of LVAD suction events.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Southern California, Los Angeles, California.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Southern California, Los Angeles, California.
authors.forename: Jina
authors.initials: J
authors.lastname: Sohn
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Southern California, Los Angeles, California.
authors.forename: Luanda
authors.initials: L
authors.lastname: Grazette
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Southern California, Los Angeles, California.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Fong
authors.affiliation: Department of Cardiothoracic Surgery, University of Southern California, Los Angeles, California.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Bowdish
mesh_terms: D003422:Critical Care / Q000379:methods; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology*; D012771:Shock, Hemorrhagic / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: left ventricular assist device; mitral valve