LVAD-Outflow Graft Perforation Due to Erosion From the Internal Driveline-Cable
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Updated: Oct 30, 2026

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Published on: July 18, 2014
Isabel B A Peto-Madew1, Anika Nagel1, Anna Stegmann1
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Background:
Bleeding from the exit site of the driveline in patients with an implanted left ventricular assist device is uncommon. We report an unusual case of severe hemorrhage caused by erosion of the outflow graft by the driveline cable in a 51-year-old man.
Case Summary:
The patient presented with severe bleeding from the driveline exit site, which stopped after manual compression but restarted after 24 hours. Computed tomography angiography demonstrated a contained rupture of the outflow graft with pseudoaneurysm formation and a hematoma extending along the driveline tunnel, likely secondary to graft erosion. A covered stent was placed; however, bleeding persisted postintervention, ultimately requiring surgical repair.
Discussion:
We report a rare case of outflow graft erosion caused by the driveline cable, presenting a diagnostic and therapeutic challenge.
Take-Home Message:
Bleeding from the driveline as a late-stage complication after left ventricular assist device implantation may conceal a serious underlying pathology and requires prompt multidisciplinary evaluation and intervention.
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