Conclusion
This case highlights a rare but potentially devastating complication of
intrapericardial LVAD placement. Fortunately, the patient recovered well
and faces no major long-term consequences. However, symptoms of ongoing
chest wall trauma went unrecognized for three days, despite radiography
demonstrating the pump housing abutting the chest wall. In patients with
significant cardiomegally or left ventricular dilation, alternative
siting strategies should be considered, and a high index of suspicion
should be maintained for chest wall injury if the apical position is
used.