Left coronary artery occlusion caused by a large thrombus on the left coronary cusp in a patient with a continuous-flow ventricular assist device

Seiko Nakajima, Osamu Seguchi, Yoshihiro Murata, Tomoyuki Fujita, Hiroki Hata, Takafumi Yamane, Michinari Hieda, Takuya Watanabe, Takuma Sato, Haruki Sunami, Masanobu Yanase, Junjiro Kobayashi, Takeshi Nakatani

研究成果: ジャーナルへの寄稿学術論文査読

8 被引用数 (Scopus)

抄録

Despite continual improvements in ventricular assist device (VAD) therapy, various clinical issues are emerging. Importantly, various types of thromboembolic complications have been reported to date. Recently, we encountered a rare continuous-flow VAD-related thromboembolic event that resulted in acute myocardial infarction. A 26-year-old female who just underwent HeartMate II® VAD implantation suddenly developed widespread anterolateral myocardial infarction on postoperative day 16. Echocardiography and aortography revealed a large thrombus on the left coronary cusp of the aortic valve that almost completely occluded the left coronary ostium. After VAD implantation, her aortic valve did not open, even at relatively low pump speeds; this was thought to be one of the causes for thrombus formation. Continuous suction of blood from the left ventricle and non-pulsatile flow into the ascending aorta resulted in a continuously closed aortic valve and stagnation of blood in the coronary cusp. Furthermore, both small body size (body surface area <1.3 m 2) and postoperative right ventricular failure may have exacerbated blood stagnation and thrombus formation in this patient. We should have adjusted the anticoagulation and antiplatelet therapy protocols based on the patient's condition. She underwent off-pump coronary artery bypass surgery and remained in clinically stable condition afterwards.

本文言語英語
ページ(範囲)197-201
ページ数5
ジャーナルJournal of Artificial Organs
17
2
DOI
出版ステータス出版済み - 06-2014
外部発表はい

All Science Journal Classification (ASJC) codes

  • 医学(その他)
  • 生体材料
  • 生体医工学
  • 循環器および心血管医学

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