Left Ventricular Assist Device Implantation in Heart Failure Patients With a Left Ventricular Thrombus

Engin, Çağatay; Yağdı, Tahir; Balcioglu, Ozlem; Erkul, Sinan; Baysal, Bora E.; Oğuz, Enis; Ayik, Fatih; Öztürk, Pelin; Özbaran, Mustafa

doi:10.1016/j.transproceed.2013.02.071

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…Finally, our patient had three relative contraindications (prothrombotic state, pre-existing LV thrombus and obesity) for LVAD implantation. However, after discussion with the multidisciplinary team and in light of published literature 5 it was felt unfair to deny advance therapies, given her age and baseline functional status. Low antithrombin III, Protein C and S could be due to congenital deficiency, and/or acute thrombosis.…”

Section: Discussionmentioning

confidence: 99%

A case report of extramedullary haematopoiesis within left ventricle myocardium and apical thrombus in acute heart failure: diagnosis, treatment, and long-term outcome

Pasupula

Malleshappa

Bhatt

et al. 2019

European Heart Journal - Case Reports

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Background Extramedullary haematopoiesis (EMH) within myocardium is a rare phenomenon, and its occurrence in left ventricle myocardium or apical thrombus of a young female has never been reported.Case summary A 23-year-old active female with progressive worsening of dyspnoea. A transthoracic echocardiogram demonstrated a left ventricular ejection fraction of 10–15% and apical thrombus. Bilateral upper extremity Doppler showed deep venous thrombus in the left arm and superficial vein thrombus in both arms. She had reduced activity of antithrombin III, deficiency of protein C and S. Computed tomography of the head showed right thalamic infarct. Having failed optimal medical therapy, rapidly worsening of symptoms (New York Heart Association Class IV and clinical Class C) and cardiogenic shock, she underwent HeartWare® left ventricular assist device (LVAD) placement as a bridge to heart transplant. Intraoperative apical thrombus was carefully extracted while maintaining adequate anticoagulation with heparin infusion. Pathology report of the excised apical myocardium and thrombus demonstrated haematopoietic cells. Twenty-six months since LVAD implantation, she remains active and Status 7 on transplant list (due to body mass index) without any further episodes of thromboembolic events.DiscussionWe report an unprecedented case of an active young female with EMH within left ventricular myocardium and apical thrombus. Although redirected differentiation and embolic haematopoietic cells seem to explain this phenomenon, the exact pathophysiology remains unknown. Despite having pre-existing apical thrombus and acute deep vein thrombus, the key towards success was meticulous extraction of apical thrombus while preserving inherent trabecular architecture and adequate anticoagulation.

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Section: Discussionmentioning

confidence: 99%

A case report of extramedullary haematopoiesis within left ventricle myocardium and apical thrombus in acute heart failure: diagnosis, treatment, and long-term outcome

Pasupula

Malleshappa

Bhatt

et al. 2019

European Heart Journal - Case Reports

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“…34 Currently, it can be done under very special circumstances, such as before placement of a left ventricular assist device or if the thrombus is large, to prevent embolism. 35,36 ■ BLEEDING COMPLICATIONS WITH TRIPLE ANTITHROMBOTIC THERAPY…”

Section: ■ What Complications Arise From Left Ventricular Thrombosis?mentioning

confidence: 99%

Left ventricular thrombosis can still complicate acute myocardial infarction

Tariq

Tan

et al. 2016

CCJM

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“…However, the proposed Polish LVAD is a unique design, because the blood chamber has a layered structure to reduce probability of thrombus formation and to improve hemocompatibility . Applying the biocompatible TiN nano‐coating on surface of the Religa Heart Ext can lead to a loss of cohesion of connection nano‐coating/substrate in a cyclic working conditions of the blood chamber.…”

Section: Introductionmentioning

confidence: 99%

Development and Application of Multi‐Scale Numerical Tool to Modeling Pneumatic Ventricular Assist Devices with Increased Athrombogenicity

Kopernik

2014

Adv Eng Mater

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The multi-scale numerical model of blood chamber of ventricular assist device (VAD) with deposited a biocompatible titanium nitride (TiN) nano-coating is introduced. The model is developed to optimize shape parameters of the blood chamber and to determine fracture parameters of the nano-coating. The development of finite element (FE) macro-model is combined with a digital image correlation data to validate a computed strain state. Contrary, on a micro-scale calibration and validation of a representative volume element (RVE) model of the wall of VAD composed of the TiN coating and substrate-polymer is realized by comparison with results of an experimental in situ SEM's micro-tensile test. The multi-scale model of VAD is enriched with materials research. Thus, tensile tests of VADs' polymers are performed to obtain the properties of designed materials of the VADs. On the other hand, on a micro-scale, the properties of TiN are identified based on a nanoindentation test and an inverse analysis for its interpretation. The profilometric studies and analytical model are presented to calculate a residual stress in the TiN. The final result of the paper is the multi-scale numerical tool to modeling pneumatic VADs with increased biocompatibility produced in Poland. REVIEW Fig. 2. The general conception of the multiÀscale model of VAD's blood chamber: (a) a residual stress modeling and (b) an active load modeling. Reproduced with permission. [15] Fig. 7. The distribution of displacement in Z direction on an external surface of the blood chamber of the VAD under pressure 37.3 kPa and in temperature 37 C: (a) the DIC's result, mm, (b) the FE model's result in the VADFEM code, mm, (c) standard deviation of the DIC's ZÀdirectional displacement (in mm), and (d) standard deviation of the DIC's XÀdirectional principal strains (shown values × 10 − 3 ). Reproduced with permission. [33] 285 REVIEW Fig. 9. Local distributions of (a) an effective strain and (b) a triaxiality factor in the model 4 of prototype of the Polish VAD. Reproduced with permission. [17] The AFM's image of topography of the TiN nano-coating of thickness 50 nm on the selected line of the area 100 nm Â 100 nm; (b) the AFM's image of topography of the TiN nano-coating of thickness 100 nm on the selected line of the area 1 mm Â 1 mm.

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Left Ventricular Assist Device Implantation in Heart Failure Patients With a Left Ventricular Thrombus

Cited by 6 publications

References 10 publications

A case report of extramedullary haematopoiesis within left ventricle myocardium and apical thrombus in acute heart failure: diagnosis, treatment, and long-term outcome

A case report of extramedullary haematopoiesis within left ventricle myocardium and apical thrombus in acute heart failure: diagnosis, treatment, and long-term outcome

Left ventricular thrombosis can still complicate acute myocardial infarction

Development and Application of Multi‐Scale Numerical Tool to Modeling Pneumatic Ventricular Assist Devices with Increased Athrombogenicity

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