Daily transient discontinuation of extracorporeal LVAD to prevent thromboembolism of mechanical aortic valve prosthesis.

Abstract

Patients with mechanical aortic valves are generally contraindicated for left ventricular assist device (LVAD) insertion because the prosthetic valve often becomes fixed in closed position. A 41-year-old woman with mechanical aortic valve prosthesis experienced sudden chest pain and developed cardiogenic shock. A paracorporeal pulsatile LVAD and a monopivot centrifugal pump as a right VAD (RVAD) were implanted. The mechanical aortic valve was intentionally left in place. Soon after the operation, LVAD support was discontinued daily for few seconds to allow the mechanical aortic valve to open and to avoid thrombus formation. The patient was successfully weaned off RVAD and received anticoagulation therapy with warfarin. On postoperative day 141, she was transferred to a university hospital where a HeartMate II LVAD was implanted, and the aortic valve was successfully replaced with a bioprosthetic valve. The patient is currently awaiting heart transplantation.

• Authors: Takamichi Inoue, Tadashi Kitamura, Shinzo Torii, Mitsuhiro Hirata, Toshiaki Mishima, Koichi Sughimoto, Hirotoki Ohkubo, Kensuke Kobayashi, Mamika Motokawa, Miyuki Shibata, Takuya Matsushiro, Yuta Tsuchida, Yurie Miyata, Minoru Ono, Kagami Miyaji
• Journal: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs (J Artif Organs) Vol. 20 Issue 3 Pg. 274-276 (Sep 2017) ISSN: 1619-0904 [Electronic] Japan
• PMID: 28488003 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Extracorporeal Membrane Oxygenation (adverse effects)
• Female
• Heart Valve Prosthesis
• Heart-Assist Devices (adverse effects)
• Humans
• Prosthesis Failure
• Thromboembolism (etiology, prevention & control)