Nonstandard usage of a left ventricular assist device in a patient with severe heart failure complicated by pulmonary artery thrombosis - case report

Jerzy Pacholewicz,Szymon Leonik,Maciej Sojka,Paweł Nadziakiewicz

doi:10.1186/s13019-020-01169-0

Jerzy Pacholewicz, Szymon Leonik + Show 2 more

Open Access

https://doi.org/10.1186/s13019-020-01169-0

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Abstract

BackgroundHeart failure complicated by pulmonary embolism is an extremely rare condition described in the literature. We report a case of very young patient with advanced heart failure against the background of dilated cardiomyopathy of unknown etiology with the presence of blood clots in both ventricles.Case presentationThe course of treatment was complicated by acute pulmonary embolism. In emergency setting the patient was qualified for combine surgery pulmonary embolization and implantation of a continuous flow pump as a bridge for heart transplantation. The post-operative course is described in detail as well as reimplantation of the pump due to early thrombosis.ConclusionsPerformed surgical procedures combined with alteration in anticoagulant drugs was sufficient to stabilize the clinical condition.

Highlights

Despite considerable advances in the treatment of severe heart failure, long-term survival is poor
Case report An 18-year-old patient was admitted to the ward with severe heart failure with a background of dilated cardiomyopathy of unknown aetiology
Due to postoperative acute renal failure and anuria, haemodiafiltration was carried out. These events had a negative impact on the patient’s condition and Discussion Heart failure complicated by pulmonary embolism is an extremely rare condition described in the literature

Summary

Introduction

Despite considerable advances in the treatment of severe heart failure, long-term survival is poor. Case report An 18-year-old patient was admitted to the ward with severe heart failure with a background of dilated cardiomyopathy of unknown aetiology. On admission day he was hemodynamically stable, during the night patient developed dyspnoea accompanied by haemodynamic instability and cardiogenic shock. A more than two-fold pump power consumption increase and a lactate dehydrogenase concentration exceeding the norm (up to 5775 IU/l) was observed This suggested haemolysis within the implanted LVAD. Due to postoperative acute renal failure and anuria, haemodiafiltration was carried out These events had a negative impact on the patient’s condition and

Discussion

Conclusion