Outflow thrombus in a left ventricular-assist device: visualization by CT angiography

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Left ventricular assist devices (LVADs) are critical for end-stage heart failure management.
• HeartMate II is a common continuous-flow LVAD used as a bridge to transplantation.
• LVAD thrombosis is a known but serious complication.

Observation:

• A 63-year-old male recipient of a HeartMate II LVAD presented with presyncope and dyspnea.
• Initial investigations including echocardiography did not reveal LVAD thrombosis.
• Computed tomography (CT) imaging was performed due to persistent symptoms.

Findings:

• CT revealed a mural thrombus in the proximal outflow cannula of the LVAD.
• This location is atypical for LVAD-related thrombus formation.
• The thrombus was successfully diagnosed using CT imaging.

Implications:

• CT imaging is valuable for diagnosing LVAD complications, especially in atypical presentations.
• Early and accurate diagnosis of LVAD thrombosis is essential for patient management.
• This case underscores the importance of considering advanced imaging for device-related issues.