"Burnt out" dilated hypertrophic cardiomyopathy causing acute LVAD thrombosis

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Cumaraswamy Sivathasan1, Teing E E Tan1, David Sim1

  • 1National Heart Centre Singapore.

Clinical Case Reports
|July 18, 2015
PubMed

Insights

Dilated end-stage hypertrophic cardiomyopathy (HCM) can revert to its original morphology after ventricular assist device (VAD) implantation. Decompression via VAD may reverse HCM, requiring surgical intervention for pump replacement.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Device Technology

Background:

  • End-stage dilated cardiomyopathy presents complex challenges for ventricular assist device (VAD) implantation.
  • Hypertrophic cardiomyopathy (HCM) is a primary cardiac condition characterized by ventricular hypertrophy.

Observation:

  • A case report details obstruction during LVAD implantation in a patient with end-stage dilated hypertrophic cardiomyopathy.
  • Post-LVAD implantation, the patient's cardiac morphology reverted to HCM.
  • Pump replacement necessitated coring of the ventricular muscle due to the observed morphological changes.

Findings:

  • Decompression achieved by LVAD implantation can lead to the reversal of dilated end-stage hypertrophic cardiomyopathy.
  • The hypertrophic morphology of HCM can reappear after mechanical circulatory support is established.
  • Surgical intervention for VAD complications may be complicated by the dynamic changes in cardiac structure.

Implications:

  • This case highlights the potential for dynamic morphological changes in end-stage heart failure patients with coexisting HCM.
  • Understanding this phenomenon is crucial for surgical planning and management of VAD recipients.
  • Further research is warranted to explore the mechanisms and clinical significance of HCM reversal post-LVAD.

Keywords:
Dilated hypertrophic cardiomyopathyhypertrophic cardiomyopathyleft ventricular assist devicepump obstructionpump thtombosis

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