Related Experiment Video
Updated: May 11, 2026
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
Left ventricular assist device implantation in heart failure patients with a left ventricular thrombus
C Engin1, T Yagdi, O Balcioglu
1Department of Cardiovascular Surgery, Ege University Medical Faculty Hospital, Izmir, Turkey. cagatayengin@yahoo.com
Insights
Left ventricular assist device (LVAD) implantation in patients with left ventricular (LV) thrombus is feasible. Successful LVAD implantation for LV thrombus requires careful patient selection and thrombus removal.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Devices
Background:
- Left ventricular assist device (LVAD) implantation is a treatment for end-stage heart failure.
- Left ventricular (LV) thrombus presence poses challenges for LVAD implantation.
- This report details experience with LVAD implantation in patients with LV thrombus.
Purpose of the Study:
- To evaluate the outcomes of LVAD implantation in patients with pre-existing left ventricular thrombus.
- To assess the safety and efficacy of LVAD implantation in this specific patient cohort.
Main Methods:
- Retrospective analysis of 6 patients with LV thrombus undergoing LVAD implantation over 3 years.
- Preoperative diagnosis via transthoracic echocardiography.
- Use of HeartWare and Berlin Heart EXCOR devices; surgical thrombus removal in one case.
Main Results:
- No neurological events, pump thrombosis, or pump malfunction occurred.
- Two patients died from sepsis and multiorgan failure.
- Two patients required re-exploration for hemorrhage; two successfully underwent heart transplantation.
Conclusions:
- LVAD implantation is a viable option for carefully selected patients with LV thrombus and preserved right ventricular function.
- Thrombus removal prior to or during implantation is crucial for favorable outcomes.
Background:
In this report, we share our experience with left ventricular assist device (LVAD) implantation in cases with a left ventricular (LV) thrombus.
Method:
Over the 3 years, more than 100 end-stage heart failure cases have been treated with LVAD implantation in our center, including 6 patients with a LV thrombus. Three were detected using preoperative transthoracic echocardiography. Fifty percent of the patients had dilated cardiomyopathy and the remaining cases had an ischemic etiology. Double inotropic support with dopamine and dobutamine was used in all, with 3 drugs with the addition of adrenaline in 2 patients. In 4 cases we implanted the HeartWare Ventricular Assist System (HeartWare, Inc., Miramar, Fla, United States) and in the remaining 2 patients, the Berlin Heart EXCOR ventricular assist device (Berlin Heart AG, Berlin, Germany) for biventricular support. In 1 patient the apical ventriculotomy was extended to remove an intertrabecular thrombosis and ventricular septal surface covered with a dacron patch to minimize the thrombogenic potential.
Results:
Two patients died due to sepsis and multiorgan failure. None of the patients experienced a neurological event, pump thrombosis, or pump malfunction. Two subjects underwent re-explorations due to hemorrhage. Two candidates underwent successfull transplantation without any evidence of thrombosis in the explanted heart or device.
Conclusion:
We believe that patients with a LV thrombus and preserved right ventricular function are good candidates for implantation of a LVAD after removing the intracavitary thrombus.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:24Cardiac Catheterization III: Left Heart Catheterization
01:22Heart Failure VI: Adjunct Therapies