Percutaneous stenting for late outflow graft obstruction in left ventricular assist device: A case report

Left ventricular assist device (LVAD) outflow graft obstruction (OGO) is an uncommon but serious late complication requiring individualized treatment. We describe a 71-year-old HeartMate 3 recipient with long-segment OGO stenosis more than 3 years after implantation. Because surgical revision was high risk, overlapping self-expanding venous stents were implanted percutaneously, with brief LVAD deactivation enabling controlled proximal deployment near the pump. Imaging confirmed restored graft patency and improved flow. A later distal thrombotic stenosis was managed conservatively with intensified anticoagulation. Percutaneous stenting with tailored procedural safeguards can safely treat complex late LVAD OGO in selected patients.