Flow pattern of outflow graft is useful for detecting pump thrombosis in a patient with left ventricular assist device

Research output: Contribution to journalArticle

Abstract

Summary Pump thrombosis (PT) is a serious complication after continuous-flow left ventricular assist device (LVAD) implantation. To detect PT, echocardiographic ramp test using left ventricular end-diastolic diameter (LVEDD) is known to be useful. However, this method has several limitations. In this study, we propose an alternative novel ramp test using the flow velocity of outflow graft (OG). A 46-year-old man underwent continuous-flow LVAD (HeartMate II, Abbott Laboratories, Lake Forest, IL, USA) implantation for advanced heart failure due to idiopathic dilated cardiomyopathy. About 2 years after implantation, he suffered from hemolysis and symptoms of heart failure, and PT was strongly suspected. The change in LVEDD was minimal with increase in pump speed (−0.06 cm/400 rotations per minute (rpm)), suggesting PT. The systolic to diastolic velocity (S/D) ratio of OG flow, which we proposed as a new indicator of PT, also showed minimal change (−0.07/400 rpm). His clinical symptoms improved with anticoagulation therapy, and the changing slope of the S/D ratio dramatically improved to −0.92/400 rpm. Although its consistency should be verified in many other cases, this novel method can be useful for detecting PT and evaluating its clinical course.

Original languageEnglish
Pages (from-to)994-997
Number of pages4
JournalInternational heart journal
Volume60
Issue number4
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Heart-Assist Devices
Thrombosis
Transplants
Architectural Accessibility
Heart Failure
Dilated Cardiomyopathy
Lakes
Hemolysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{a73b4a463e384eae9849be2345a11aab,
title = "Flow pattern of outflow graft is useful for detecting pump thrombosis in a patient with left ventricular assist device",
abstract = "Summary Pump thrombosis (PT) is a serious complication after continuous-flow left ventricular assist device (LVAD) implantation. To detect PT, echocardiographic ramp test using left ventricular end-diastolic diameter (LVEDD) is known to be useful. However, this method has several limitations. In this study, we propose an alternative novel ramp test using the flow velocity of outflow graft (OG). A 46-year-old man underwent continuous-flow LVAD (HeartMate II, Abbott Laboratories, Lake Forest, IL, USA) implantation for advanced heart failure due to idiopathic dilated cardiomyopathy. About 2 years after implantation, he suffered from hemolysis and symptoms of heart failure, and PT was strongly suspected. The change in LVEDD was minimal with increase in pump speed (−0.06 cm/400 rotations per minute (rpm)), suggesting PT. The systolic to diastolic velocity (S/D) ratio of OG flow, which we proposed as a new indicator of PT, also showed minimal change (−0.07/400 rpm). His clinical symptoms improved with anticoagulation therapy, and the changing slope of the S/D ratio dramatically improved to −0.92/400 rpm. Although its consistency should be verified in many other cases, this novel method can be useful for detecting PT and evaluating its clinical course.",
author = "Tasuku Sato and Takeo Fujino and Taiki Higo and Kisho Ohtani and Hiasa, {Ken Ichi} and Takafumi Sakamoto and Akiko Chishaki and Akira Shiose and Hiroyuki Tsutsui",
year = "2019",
month = "1",
day = "1",
doi = "10.1536/ihj.18-600",
language = "English",
volume = "60",
pages = "994--997",
journal = "International Heart Journal",
issn = "1349-2365",
publisher = "International Heart Journal Association",
number = "4",

}

TY - JOUR

T1 - Flow pattern of outflow graft is useful for detecting pump thrombosis in a patient with left ventricular assist device

AU - Sato, Tasuku

AU - Fujino, Takeo

AU - Higo, Taiki

AU - Ohtani, Kisho

AU - Hiasa, Ken Ichi

AU - Sakamoto, Takafumi

AU - Chishaki, Akiko

AU - Shiose, Akira

AU - Tsutsui, Hiroyuki

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Summary Pump thrombosis (PT) is a serious complication after continuous-flow left ventricular assist device (LVAD) implantation. To detect PT, echocardiographic ramp test using left ventricular end-diastolic diameter (LVEDD) is known to be useful. However, this method has several limitations. In this study, we propose an alternative novel ramp test using the flow velocity of outflow graft (OG). A 46-year-old man underwent continuous-flow LVAD (HeartMate II, Abbott Laboratories, Lake Forest, IL, USA) implantation for advanced heart failure due to idiopathic dilated cardiomyopathy. About 2 years after implantation, he suffered from hemolysis and symptoms of heart failure, and PT was strongly suspected. The change in LVEDD was minimal with increase in pump speed (−0.06 cm/400 rotations per minute (rpm)), suggesting PT. The systolic to diastolic velocity (S/D) ratio of OG flow, which we proposed as a new indicator of PT, also showed minimal change (−0.07/400 rpm). His clinical symptoms improved with anticoagulation therapy, and the changing slope of the S/D ratio dramatically improved to −0.92/400 rpm. Although its consistency should be verified in many other cases, this novel method can be useful for detecting PT and evaluating its clinical course.

AB - Summary Pump thrombosis (PT) is a serious complication after continuous-flow left ventricular assist device (LVAD) implantation. To detect PT, echocardiographic ramp test using left ventricular end-diastolic diameter (LVEDD) is known to be useful. However, this method has several limitations. In this study, we propose an alternative novel ramp test using the flow velocity of outflow graft (OG). A 46-year-old man underwent continuous-flow LVAD (HeartMate II, Abbott Laboratories, Lake Forest, IL, USA) implantation for advanced heart failure due to idiopathic dilated cardiomyopathy. About 2 years after implantation, he suffered from hemolysis and symptoms of heart failure, and PT was strongly suspected. The change in LVEDD was minimal with increase in pump speed (−0.06 cm/400 rotations per minute (rpm)), suggesting PT. The systolic to diastolic velocity (S/D) ratio of OG flow, which we proposed as a new indicator of PT, also showed minimal change (−0.07/400 rpm). His clinical symptoms improved with anticoagulation therapy, and the changing slope of the S/D ratio dramatically improved to −0.92/400 rpm. Although its consistency should be verified in many other cases, this novel method can be useful for detecting PT and evaluating its clinical course.

UR - http://www.scopus.com/inward/record.url?scp=85070727531&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070727531&partnerID=8YFLogxK

U2 - 10.1536/ihj.18-600

DO - 10.1536/ihj.18-600

M3 - Article

C2 - 31257336

AN - SCOPUS:85070727531

VL - 60

SP - 994

EP - 997

JO - International Heart Journal

JF - International Heart Journal

SN - 1349-2365

IS - 4

ER -