Unusual complications following left ventricular assisted device implantation: case series

Amjad Shalabi,Eilon Ram,Leonid Sternik,Erez Kachel,Yigal Kassif,Liza Grosman-Rimon,Jacob Lavee,Muin Faqeeh,Offer Amir,Preisman Sergey,Wadi Kinany,Avishay Grupper

doi:10.1186/s13019-021-01445-7

Abstract

BackgroundWhile left ventricular assisted devices (LVAD) have revolutionized the treatment of advanced heart failure, they are associated with a wide range of complications, including bleeding and infection which are the most common complications reported in the literature. Our case series report four unusual complications not related to gastrointestinal bleeding and infections and their management.Case presentationA 61 year old female after LVAD implantation with late onset of severe symptomatic aortic regurgitation treated by transfemoral transcatheter valve implantation (TAVI) with good long term results.A 75 year old male patient with acute pump failure secondary to cable damage, who underwent urgent pump replacement. A 49 year old female patient with a history of myoma who developed massive uterine bleeding which was treated with emergent open hysterectomy after failed gonadotropin-releasing hormone therapy replacement. A 57 year old male patient with device display failure 1 month after LVAD implantation without the ability to monitor speed, power consumption and blood flow.ConclusionsLVAD patients can be presented with a great variety of complications. Physicians should be aware of their manifestations and the management options.

Highlights

While left ventricular assisted devices (LVAD) have revolutionized the treatment of advanced heart failure, they are associated with a wide range of complications, including bleeding and infection which are the most common complications reported in the literature
Between 2008 and 2019, 130 patients were implanted with assist devices. 3 of 73 HeartMate II patients (4%) and 1 of 49 HeartMate III (2%) had unusual complications not related to gastrointestinal bleeding (GI) bleeding and infection
We identified one patient with late symptomatic severe aortic regurgitation; one patient with massive uterine bleeding due to myoma, who was treated with emergent open hysterectomy; one patient with acute pump failure secondary to cable damage treated with urgent pump implantation, and an additional patient with display failure following HeartMate III implantation

Summary

Introduction

While left ventricular assisted devices (LVAD) have revolutionized the treatment of advanced heart failure, they are associated with a wide range of complications, including bleeding and infection which are the most common complications reported in the literature. Few studies have addressed unusual complications following LVAD implantations together with their therapeutic approaches. We identified one patient with late symptomatic severe aortic regurgitation; one patient with massive uterine bleeding due to myoma, who was treated with emergent open hysterectomy; one patient with acute pump failure secondary to cable damage treated with urgent pump implantation, and an additional patient with display failure following HeartMate III implantation. Case 1 A 61-year-old female patient with severe idiopathic dilated cardiomyopathy underwent HeartMate II LVAD (Abbott Laboratories, Abbott Park, IL, USA) implantation in November 2010 as a bridge to a heart transplant.

Results

Conclusion