Sudden right ventricular assist device dysfunction: The role of fluoroscopic evaluation in diagnosis

RVAD thrombosis is a well-described complication that requires a high index of suspicion, as it can precipitate irreversible hemodynamic collapse. Here, we present a case of a 51-year-old man with end-stage heart failure who was placed on biventricular support using 2 HeartMate 3 devices. The patient's postoperative course was complicated by sudden RVAD flow cessation suspicious for inflow obstruction due to pump thrombosis or transient anatomic inflow occlusion. As the patient remained hemodynamically stable, the decision was made to proceed to the catheterization laboratory for fluoroscopic evaluation using a novel catheter-based approach. In addition to providing diagnostic information, this technique offered the potential for immediate thrombectomy if thrombotic obstruction of the RVAD was confirmed.