Bhamidipati Castigliano M, Pal Jay D, Jones Thomas K, McCabe James M, Reisman Mark, Smith Jason W, Mahr Claudius, Mokadam Nahush A
Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington.
Division of Cardiology, University of Washington Medical Center, Seattle, Washington.
Ann Thorac Surg. 2017 Jan;103(1):e101-e104. doi: 10.1016/j.athoracsur.2016.07.031.
The duration of support in patients with HeartMate II implantation as a bridge to transplant or as destination therapy is rising. As clinical experience continues to grow, physiologic changes contributing to pump malfunction are becoming apparent. Once malfunction is noted with increased power spikes, rises in lactate dehydrogenase and low-flow alarms, thrombosis of the pump is at risk. We describe outflow graft compression and offer an expeditious and definitive management strategy. Our novel management stenting strategy for outflow graft compression will continue to evolve as experience is gained.
