Related Experiment Video
Updated: Nov 22, 2025

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
Medical Management of Recurrent Left Ventricular Assist Device Thrombosis in a Patient With Biventricular Assist
Laura Onderko1, Sean H Novak2, Sanjeev A Francis1
1Cardiology, Maine Medical Center, Portland, USA.
Abstract:
Ventricular assist device (VAD) pump thrombosis is a known complication and while the preferred standard treatment is surgical pump exchange this procedure is not without risk and for some patients the risks are prohibitive. This is a case of a 68-year-old female with bilateral HeartWare ventricular assist devices (HVAD) implanted as destination therapy who presented with signs of recurrent pump thrombosis. Surgical pump exchange was deemed to confer prohibitive risk due to her underlying medical co-morbidities and therefore not an option for treatment. After careful consideration of possible options for treatment, she received systemic thrombolysis (Alteplase 5 mg IV bolus followed by 3 mg/hour infusion for 10 hours through a central line) which was successful. This case highlights, not only the rarity of bilateral VADs as destination therapy, but also demonstrates the safety and efficacy of using systemic thrombolytics in patients with bilateral HVADs for treatment of pump thrombosis.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Cardiomyopathy V: Interprofessional Care
Mitral Stenosis III: Medical Management
Aortic Regurgitation III: Medical Management
Mitral Regurgitation III: Medical Management
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

