Sifain Andrew R, Schwarz Karl Q, Hallinan William, Massey H Todd, Alexis Jeffrey D
From the Department of Medicine, Department of Surgery, and Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
ASAIO J. 2014 Mar-Apr;60(2):243-5. doi: 10.1097/MAT.0000000000000036.
Although ventricular assist devices (VADs) are lifesaving therapy for patients with severe heart failure, complications such as pump thrombosis can occur. In this report, we present a case of VAD thrombosis following recovery of left ventricular (LV) function. The patient had been supported with a VAD for 8 months, and at the time of presentation, echocardiography revealed near normal native systolic function, aortic valve opening with significant native heart ejection, reduced systolic flow in the outflow and inflow cannulae, and no forward flow through the VAD during diastole. The patient underwent successful VAD explant and examination of the pump revealed thrombus on the rotor. We propose that abnormal flow through the VAD seen with recovery of LV function may contribute to VAD thrombosis.
尽管心室辅助装置（VADs）是治疗严重心力衰竭患者的救命疗法，但仍可能发生诸如泵血栓形成等并发症。在本报告中，我们介绍了一例左心室（LV）功能恢复后发生VAD血栓形成的病例。该患者接受VAD支持治疗8个月，就诊时超声心动图显示，其自身收缩功能接近正常，主动脉瓣开放且自身心脏有显著射血，流出和流入插管的收缩期血流减少，舒张期无血流通过VAD。该患者成功进行了VAD植入物取出术，对泵的检查发现转子上有血栓。我们认为，LV功能恢复时VAD出现的异常血流可能导致VAD血栓形成。
