Early Postoperative Aortic Root Thrombus After Heartmate 3

  • Jama Jahanyar Department of Cardiothoracic Surgery, Mayo Clinic Hospital, Scottsdale/Phoenix, AZ
  • Joshua M. Liao Department of Medicine, University of Washington, Seattle, WA
  • Patrick DeValeria Department of Cardiothoracic Surgery, Mayo Clinic Hospital, Scottsdale/Phoenix, AZ
  • D. Eric Steidley Division of Cardiology, Department of Medicine, Mayo Clinic Hospital, Scottsdale/Phoenix, AZ
  • Ryan Craner Department of Anesthesiology, Mayo Clinic Hospital, Scottsdale/Phoenix, AZ
  • Harish Ramakrishna Department of Anesthesiology, Mayo Clinic Hospital, Scottsdale/Phoenix, AZ
  • Robert L Scott Division of Cardiology, Department of Medicine, Mayo Clinic Hospital, Scottsdale/Phoenix, AZ

Abstract

As a bridge to heart transplantation or destination treatment, implantation of the Heartmate 3 (HM3) left ventricular assist device is a viable option for patients with end-stage congestive heart failure. The recent Momentum 3 trial has shown favorable outcomes compared with Heartmate 2. We report the first case of aortic root thrombus occurring early after HM3 implantation as a bridge to heart transplantation. Our case suggests that bridging with an Impella 5.0 preceding HM3 implantation could potentially predispose patients to aortic root thrombus after HM3 implantation, due to Impella-related injury to the aortic valve and aortic root stasis after durable LVAD support.

References

Assad-Kottner C, Chen D, Jahanyar J, et al. 2008. The use of continuous milrinone therapy as bridge to transplant is safe in patients with short waiting times. J Card Fail 14 (10): 839-43.

Fried J, Garan AR, Shames S, et al. 2018. Aortic root thrombosis in patients supported with continuous-flow left ventricular assist devices. J Heart Lung Transplant 37 (12): 1425-1432.

Lima B, Kale P, Gonzalez-Stawinski GV, Kuiper JJ, Carey S, Hall SA. 2016. Effectiveness and Safety of the Impella 5.0 as a Bridge to Cardiac Transplantation or Durable Left Ventricular Assist Device. Am J Cardiol 117 (10): 1622-1628.

Mehra MR, Uriel N, Naka Y, et al. 2019. A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report. N Engl J Med 380 (17): 1618-1627.

Published
2019-09-05
How to Cite
Jahanyar, J., Liao, J., DeValeria, P., Steidley, D., Craner, R., Ramakrishna, H., & Scott, R. (2019). Early Postoperative Aortic Root Thrombus After Heartmate 3. The Heart Surgery Forum, 22(5), E372-E374. https://doi.org/10.1532/hsf.2635
Section
Articles