Left ventricular assist device inflow cannula thrombus: Characterization with two-dimensional transthoracic echocardiography

Emil Missov

Research output: Contribution to journalArticlepeer-review

Abstract

Thrombotic complications are inherent to current generation nonpulsatile left ventricular assist devices. The clinical expression of device thrombosis ranges from catastrophic failure to protracted and indolent. We report the case of a 79-year-old patient who received a left ventricular assist device as destination therapy and presented only with vague clinical symptoms. He was found to have a large thrombus in close proximity with the inflow cannula at the left ventricular apex, raising the question of mechanical obstruction. We describe the step-by-step contrast-enhanced two-dimensional transthoracic echocardiographic examination which allowed to obtain diagnostic acoustic tomograms of the inflow cannula and obviated the need for any additional imaging modalities. Transthoracic echocardiography (TTE) is the most common imaging modality used in the clinical follow-up of left ventricular assist device recipients. A frequent clinical indication for TTE is to exclude left ventricular apical thrombus near the inflow cannula. Imaging of the inflow cannula at the left ventricular apex in the traditional apical 4 chamber, apical 2 chamber, and parasternal long axis views is challenging by TTE mainly because of poor acoustic windows, image artifacts, large body habitus, and operator experience.

Original languageEnglish (US)
Pages (from-to)662-663
Number of pages2
JournalASAIO Journal
Volume59
Issue number6
DOIs
StatePublished - Nov 1 2013

Keywords

  • left ventricular assist device
  • thrombosis
  • transthoracic echocardiography

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