Aortic Root Thrombus Directly After Left Ventricular Assist Device Implantation
Constantin Mork, MD,
Otmar Pfister, MD,
Luca Koechlin, MD,
Simon Scheifele,
Anne Morgen,
Lukas Altwegg, MD,
David Heppel, MD,
Denis Berdajs, MD,
Ayham Darwisch, MD,
Michael Kuehne, MD,
Oliver Reuthebuch, MD,
Ulrich Schurr, MD,
Martin Siegemund, MD,
Friedrich Eckstein, MD,
David Santer, MD, PhD,
Qian Zhou, MD
Affiliations
Constantin Mork, MD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Otmar Pfister, MD
Department of Cardiology, University Hospital Basel, Basel, Switzerland
Luca Koechlin, MD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Simon Scheifele
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Anne Morgen
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Lukas Altwegg, MD
Department of Cardiology, St Claraspital, Basel, Switzerland
David Heppel, MD
Department of Anesthesiology, Operative Intensive Care, Preclinical Emergency Medicine and Pain Management, University Hospital Basel, Basel, Switzerland
Denis Berdajs, MD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Ayham Darwisch, MD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Michael Kuehne, MD
Department of Cardiology, University Hospital Basel, Basel, Switzerland
Oliver Reuthebuch, MD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Ulrich Schurr, MD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
Martin Siegemund, MD
Intensive Care Unit, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland
Friedrich Eckstein, MD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
David Santer, MD, PhD
Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland; Corresponding author: Dr David Santer, Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland. Tel.: +41 (0) 61 265 25 25 (CH).
Qian Zhou, MD
Department of Cardiology, University Hospital Basel, Basel, Switzerland
A 70-year-old female heart failure patient could not be weaned from temporary left ventricular mechanical support with Impella CP (Abiomed Inc, Danvers, MA) after myocardial infarction; therefore, she underwent left ventricular assist device implantation (HeartMate 3; Abbott, Chicago, IL). After uneventful surgery, the patient had an early postoperative thrombus in the aortic root, and surgical thrombectomy on extracorporeal circulation was performed on the seventh postoperative day. The patient recovered well and presented in good condition with no neurologic symptoms at the 6-month follow-up visit. Surgical excision of aortic root thrombus is a feasible option even for frail patients with a left ventricular assist device. Résumé: Après un infarctus du myocarde, une patiente de 70 ans présentant une insuffisance cardiaque n'a pas pu être sevrée d'une assistance mécanique temporaire pour le ventricule gauche par dispositif Impella CP (Abiomed Inc, Danvers, MA); elle a donc subi l'implantation d'un dispositif d'assistance ventriculaire gauche (HeartMate 3; Abbott, Chicago, IL). Après une intervention sans incident, la patiente a présenté un thrombus postopératoire précoce dans l'anneau aortique, et une thrombectomie chirurgicale sous circulation extracorporelle a été réalisée le septième jour suivant l'intervention. La patiente s'est bien rétablie et semblait en bonne santé, sans symptômes neurologiques, au moment de la visite de suivi six mois plus tard. L'excision chirurgicale du thrombus de l'anneau aortique est une option réaliste même chez les patients fragiles ayant un dispositif d'assistance ventriculaire gauche.
