Abstract
28-year-old white man with history of end-stage heart failure caused by isolated left ventricular (LV) noncompaction cardiomyopathy had been implanted with the Jarvik 2000 LV assist device 3 years previously as a bridge to survival and to decision via a left posterolateral thoracotomy, off-pump, with outflow graft anastomosis to the descending aorta and postauricular pedestal. The patient had an excellent postoperative course free of adverse events for 1.5 years. The pump was operated at a rotational speed of 9000 rounds per minute. Anticoagulation included acenocoumarol aiming for an international normalized ratio of 3 to 3.5 and 100 mg of aspirin daily. On the 20th month of support, the patient presented with symptoms and signs of cardiogenic shock associated with a sudden increase in power consumption by the …
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