Left Ventricular Assist Device Thrombosis

Author: Nahush A. Mokadam, MD; Edward Verrier, MD
Institution: University of Washington
Date Reviewed: February 2014
Learning Domain: Adult Cardiac Surgery
Learning Objective: Management of LVAD Thrombosis
PowerPoint File: Left Ventricular Assist Device Thrombosis

Discussion Points for Conference

• Features of LVAD Thrombosis
  • Patient related
  • Pump – related
  • Management related
• Modes of Clinical Presentation
  • Hemolysis / Power increases / CHF
• Costs of LVAD Exchange?
• Technical Approaches to LVAD Exchange?
• How to Avoid?
• How many Exchanges?
  • Bridge to Transplant
  • Destination

Learning Points

• High Index of Suspicion
• Ramp Echo study may be of utility
• Thrombolytics seems to play little role but may assist in timing and decision making
• LVAD Exchange can be done safely in experienced centers