Successful Outflow Graft Stent Placement for a Malfunctioning Left Ventricular Assist Device

Abstract

A 79-year-old man presented with hypertension and a 24-hour history of low flow alarms (flow <2.5 L/min) from his left ventricular assist device (LVAD, HeartMate II; Abbott Cardiovascular, Chicago, Illinois). At a 90-mm Hg pressure gradient, 90% stenosis of the 14-mm outflow graft tract was noted upon left heart catheterization, between the bend relief and aortic anastomosis. No standardized management has been established for graft stenosis because of technique-related challenges, including proximity of the LVAD motor to the wire, possible stent migration or slippage, and the risk of cerebral embolism.