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Implantation of left ventricular assist device complicated by undiagnosed thrombophilia

Ondrej Szarszoi1, Jiri Maly, Daniel Turek

  • 1Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, 140 21 Prague 4, Czech Republic. onsz@medicon.cz

Texas Heart Institute Journal
|October 31, 2012
PubMed

Insights

Left ventricular assist device implantation can reveal hidden thrombophilia, a blood clotting disorder. Pre-implantation screening is crucial for identifying patients with clotting risks before cardiac support.

Area of Science:

  • Cardiology
  • Hematology
  • Medical Devices

Background:

  • Dilated cardiomyopathy necessitates advanced cardiac support.
  • Left ventricular assist devices (LVADs) are used for end-stage heart failure.
  • Thromboembolic events are a known complication in cardiac patients.

Observation:

  • A patient with dilated cardiomyopathy received an axial-flow LVAD.
  • Post-implantation echocardiography identified a large left ventricular thrombus.
  • The LVAD's inflow cannula remained unobstructed with adequate flow.

Findings:

  • Laboratory tests revealed protein S deficiency, factor V Leiden mutation, and MTHFR C667T mutation.
  • These findings indicate underlying thrombophilia.
  • No significant suction events occurred during circulatory support.

Implications:

  • LVAD implantation can unmask undiagnosed thrombophilia.
  • Pre-operative screening for thrombophilia is recommended.
  • Early identification of thrombophilia can guide patient management and improve outcomes.

Keywords:
Anticoagulants/therapeutic useblood coagulation disorders/complicationsfactor V Leidenfactor V/geneticsleft ventricular assist deviceperioperative carepostoperative complicationsthrombophilia/geneticsthrombus/etiology/prevention & control

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