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Updated: Dec 30, 2025
07:41
Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
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Pneumopericardium suggesting left ventricular assist device-related gastrointestinal complication
Tomoki Ushijima1, Yoshihisa Tanoue2, Kazuto Hirayama2
1Department of Cardiovascular Surgery, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tomokius@heart.med.kyushu-u.ac.jp.
Summary
A ventricular assist device (VAD) infection led to a rare fistula between the heart and the gastrointestinal tract. Pneumopericardium may signal early gastrointestinal complications in VAD patients.
Area of Science:
- Cardiology
- Gastroenterology
- Infectious Disease
Background:
- Ventricular assist devices (VADs) are crucial for end-stage heart failure.
- VAD-related infections pose significant risks, including rare complications like fistulas.
Observation:
- A patient with a HeartMate II VAD developed fever and pneumopericardium.
- The patient later presented with melena, indicating gastrointestinal bleeding.
Findings:
- Colonoscopy revealed the VAD inflow conduit had penetrated the transverse colon.
- A fistula was confirmed between the splenic flexure and the pericardial cavity.
- Surgical intervention involved hemicolectomy, VAD explantation, and replacement with an Impella 5.0 device.
Implications:
- Pneumopericardium can be an early indicator of VAD-related gastrointestinal complications.
- Clinicians must maintain high vigilance for hidden gastrointestinal issues in VAD patients.
- This case highlights the importance of careful monitoring for apical VAD support.
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