title: Outflow Graft Obstruction Treated With Transcatheter Management: A Novel Therapy for a New Diagnosis.
abstract: The duration of support in patients with HeartMate II implantation as a bridge to transplant or as destination therapy is rising. As clinical experience continues to grow, physiologic changes contributing to pump malfunction are becoming apparent. Once malfunction is noted with increased power spikes, rises in lactate dehydrogenase and low-flow alarms, thrombosis of the pump is at risk. We describe outflow graft compression and offer an expeditious and definitive management strategy. Our novel management stenting strategy for outflow graft compression will continue to evolve as experience is gained.
authors.affiliation: Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington.
authors.forename: Castigliano M
authors.initials: CM
authors.lastname: Bhamidipati
authors.affiliation: Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Pal
authors.affiliation: Division of Cardiology, University of Washington Medical Center, Seattle, Washington.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Jones
authors.affiliation: Division of Cardiology, University of Washington Medical Center, Seattle, Washington.
authors.forename: James M
authors.initials: JM
authors.lastname: McCabe
authors.affiliation: Division of Cardiology, University of Washington Medical Center, Seattle, Washington.
authors.forename: Mark
authors.initials: M
authors.lastname: Reisman
authors.affiliation: Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Smith
authors.affiliation: Division of Cardiology, University of Washington Medical Center, Seattle, Washington.
authors.forename: Claudius
authors.initials: C
authors.lastname: Mahr
authors.affiliation: Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington. Electronic address: mokadamn@uw.edu.
authors.forename: Nahush A
authors.initials: NA
authors.lastname: Mokadam
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*