Lvads: A Case Study

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ECHO and CT provide great diagnostic tools in diagnosing complications associated with LVADs. The complications can further be subdivided into perioperative and late post-operative complications. In the perioperative period, low flow rates can cause hemodynamic stability which can be caused by an obstructing/malpositioned inflow cannula, hemorrhage, or tamponade (1-23). Later complications include thrombus of the inflow and outflow cannulas, bend relief malpositioning, aortic valve stenosis/insufficiency, and infection. Right sided heart failure can appear as an early or late complication (1). Inflow obstruction/malpositioning is a fairly common complication usually detected in the perioperative period by Echocardiography. Several etiologies for inflow obstruction include malpositioned cannula directed towards the interventricular septum, left ventricular hypertrophy, and kinking of the inflow cannula. Findings diagnostic to inflow obstruction on Echo with Doppler include high velocity flow, and variations of flow during systole including cessation of flow…show more content…
Normally, the aortic valve should remained closed in a properly functioning LVAD. Given the continuous closure state, the aortic valve leaflets can become fused with resultant stenosis. In patients who receive an LVAD for bridge to transplantation or final destination therapy, the resultant stenosis is not of clinical concern; however, for patients who are utilizing an LVAD for myocardial recovery, the degree of stenosis can cause further potential problems in which patient's may not be able to undergo explantation. Preimplantantion aoritic insufficiency is quite problematic in patient's who receive LVAD. The backflow of blood into the left ventricular chamber decreases forward systemic flow; in addition, aortic insufficiency worsens during the course of LVAD
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