Retrograde Washout of a Pre-pump LVAD thrombosis in a patient on
The success of the left ventricular assist device (LVAD) as a treatment
for terminal left-side heart failure is still restrained by some severe
complications associated with mechanical circulatory support. Pump
thrombus still affects many patients. It is associated with high
morbidity and mortality. The therapeutic options include augmentation of
anticoagulation and antiplatelet medication, intravenous or
catheter-guided thrombolysis, and pump exchange. Heart transplantation
would be a desirable option in this population, but unfortunately, it is
only theoretical given the increasing number of LVAD implants and
decreasing number of organ donors. A retrograde washout maneuver may be
a treatment option in pre-pump thrombosis in selected patients.
Therefore, the decision should be made on an individual basis after
balancing the risks and benefits of different treatment approaches.