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A Case of Successful Use of the “Anchoring Technique” for Percutaneous Treatment of Left Ventricular Assist Device Graft Occlusion

Author

Listed:
  • Rocco Edoardo Stio

    (Division of Interventional Cardiology, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Andrea Montalto

    (Cardiac Surgery Unit and Heart Transplantation Center, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Alfredo Intorcia

    (Division of Interventional Cardiology, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Vincenzo Polizzi

    (Cardiac Surgery Unit and Heart Transplantation Center, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Mariano Feccia

    (Cardiac Surgery Unit and Heart Transplantation Center, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Carmine Musto

    (Division of Interventional Cardiology, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Mauro Pennacchi

    (Division of Interventional Cardiology, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Luca Paolucci

    (Division of Interventional Cardiology, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Regina Stumpo

    (Division of Vascular Surgery, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Emilio D’Avino

    (Department of Cardiovascular Anaesthesia, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Francesco De Felice

    (Division of Interventional Cardiology, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Domenico Gabrielli

    (Division of Interventional Cardiology, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

  • Francesco Musumeci

    (Cardiac Surgery Unit and Heart Transplantation Center, Department of Heart and Vessels, San Camillo-Forlanini Hospital, 00152 Rome, Italy)

Abstract

Left ventricular assist device (LVAD) obstruction can be a dramatic and life-threatening complication in patients with advanced heart failure (HF). Despite surgical redo is often required in these patients, it is associated with a high risk of periprocedural negative outcome. We report the case of a 68-year-old male with a thrombotic stenosis of the LVAD proximal outflow-graft. Following Heart Team debate, a percutaneous intervention was planned during veno-arterial Extra Corporeal Membrane Oxygenation (ECMO) assistance. To achieve the needed catheter support, we used the “distal balloon anchoring technique” through the outflow-graft and managed to implant a covered stent, rapidly restoring the flow through the LVAD. The patient was discharged without further complications. Our case shows that, in selected cases, percutaneous treatment of LVAD obstructions can be feasible, especially using advanced techniques derived from the experiences in coronary interventions and under ECMO assistance. More cases and prospective studies are mostly needed to explore long-term patency of the LVADs and clinical outcomes in these high-risk patients.

Suggested Citation

  • Rocco Edoardo Stio & Andrea Montalto & Alfredo Intorcia & Vincenzo Polizzi & Mariano Feccia & Carmine Musto & Mauro Pennacchi & Luca Paolucci & Regina Stumpo & Emilio D’Avino & Francesco De Felice & D, 2022. "A Case of Successful Use of the “Anchoring Technique” for Percutaneous Treatment of Left Ventricular Assist Device Graft Occlusion," IJERPH, MDPI, vol. 19(4), pages 1-6, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:2441-:d:753934
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    Cited by:

    1. Rocco Edoardo Stio & Marina Comisso & Luca Paolucci & Silvio Coletta & Vincenzo Cesario & Michele Gioia & Marco Stefano Nazzaro & Guglielmo Saitto & Carlo Contento & Emilio D’Avino & Francesco De Feli, 2022. "A Redo Percutaneous Emergency Intervention of Left Ventricular Assist Device Graft Occlusion," IJERPH, MDPI, vol. 19(10), pages 1-8, May.

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