(242) - Micro-Embolic Signals Correlate with Pump Thrombus Formation and Non-Thrombotic Outflow Graft Occlusion in Patients with Left Ventricular Assist Devices

Abstract

s S97 Methods: From June 2014 to October 2015 LVAD patients were systematically screed for HITS in the LVAD outflow graft by transthoracic echocardiography. The occurrence of HITS was then correlated with pump thrombus formation (PT) and non-thrombotic outflow graft occlusion. Results: HITS were detected in the outflow graft of 18 LVAD patients (Thoratec Heartmate II n= 12, Heartware HVAD n= 6). HITS correlated with PT in 12 patients (Heartmate II n= 7, HVAD n= 5) and non-thrombotic outflow graft stenosis in 6 patients (Heartmate II n= 5, HVAD n= 1). Patients with PT either underwent thrombolysis (n= 5), pump exchange (n= 2), LVAD weaning (n= 1) or no treatment if no hard clinical treatment indication was present (n= 5). In PT patients HITS disappeared after successful thrombolysis or pump exchange. Of note, pump thrombus formation or non-thrombotic outflow graft stenosis could be macroscopically assured at the time of transplant in the remaining patients. Conclusion: HITS detection by transthoracic echocardiography identifies patients with pump thrombus formation and non-thrombotic outflow graft occlusion and might develop as a very sensitive screening tool for pump pathology and hypocoagulation monitoring.