title: Minimally Invasive LVAD Deactivation in a 65-Year-Old Man with Recurrent Pump Thrombosis and Left Ventricular Recovery.
abstract: Pump thrombosis is a dire sequela after left ventricular assist device (LVAD) implantation. Treatment comprises antiplatelet agents, anticoagulants, thrombolytic agents, and pump exchange. Although pump exchange is the definitive therapy, it is also the most invasive, often exposing patients to the risks of repeat sternotomy and cardiopulmonary bypass. In some cases, patients experience left ventricular recovery after LVAD implantation. The optimal strategy surrounding the management of LVADs in patients who have experienced ventricular recovery is unknown; techniques range from total system explantation to partial pump resection. Here, we describe a novel means of LVAD deactivation in a 65-year-old man with recurrent pump thrombosis, via percutaneous outflow graft closure in the cardiac catheterization laboratory. We also review the existing literature on surgical and percutaneous LVAD deactivation techniques.
authors.forename: Akshay
authors.initials: A
authors.lastname: Pendyal
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Chien
authors.forename: James O
authors.initials: JO
authors.lastname: Mudd
authors.forename: Jill M
authors.initials: JM
authors.lastname: Gelow
mesh_terms: D000368:Aged; D018618:Echocardiography, Doppler, Color; D054143:Heart Failure, Systolic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D020127:Recovery of Function; D012008:Recurrence; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left
keywords: Device removal/instrumentation/methods; heart failure/rehabilitation; heart-assist devices/adverse effects; recovery of function/physiology; thrombosis/etiology; treatment outcome; ventricular function/physiology