Implantation of left ventricular assist device complicated by undiagnosed thrombophilia
Language English Country United States Media print
Document type Case Reports, Journal Article
PubMed
23109751
PubMed Central
PMC3461681
Knihovny.cz E-resources
- Keywords
- Anticoagulants/therapeutic use, blood coagulation disorders/complications, factor V Leiden, factor V/genetics, left ventricular assist device, perioperative care, postoperative complications, thrombophilia/genetics, thrombus/etiology/prevention & control,
- MeSH
- Echocardiography, Doppler, Color MeSH
- Cardiomyopathy, Dilated complications physiopathology MeSH
- Echocardiography, Transesophageal MeSH
- Factor V genetics MeSH
- Fatal Outcome MeSH
- Ventricular Function, Left * MeSH
- Genetic Predisposition to Disease MeSH
- Genetic Testing methods MeSH
- Prosthesis-Related Infections etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Methylenetetrahydrofolate Reductase (NADPH2) genetics MeSH
- Mutation MeSH
- DNA Mutational Analysis MeSH
- Protein S Deficiency complications diagnosis genetics MeSH
- Heart Diseases blood diagnostic imaging etiology genetics MeSH
- Heart-Assist Devices adverse effects MeSH
- Predictive Value of Tests MeSH
- Prosthesis Design MeSH
- Echocardiography, Doppler, Pulsed MeSH
- Heart Failure diagnostic imaging etiology physiopathology therapy MeSH
- Stroke Volume MeSH
- Thrombophilia blood complications diagnosis genetics MeSH
- Thrombosis blood diagnostic imaging etiology genetics MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Names of Substances
- factor V Leiden MeSH Browser
- Factor V MeSH
- Methylenetetrahydrofolate Reductase (NADPH2) MeSH
- MTHFR protein, human MeSH Browser
A patient with dilated cardiomyopathy and no history of thromboembolic events received a surgically implanted axial-flow left ventricular assist device. After implantation, transesophageal echocardiography revealed a giant thrombus on the lateral and anterior aspects of the left ventricle. The inflow cannula inserted through the apex of the left ventricle was not obstructed, and the device generated satisfactory blood flow. Laboratory screening for thrombophilia showed protein S deficiency, heterozygous factor V Leiden mutation, and heterozygous MTHFR C667T mutation. During the entire duration of circulatory support, no significant suction events were detected, and the patient was listed for heart transplantation. Ventricular assist device implantation can unmask previously undiagnosed thrombophilia; therefore, it should be necessary to identify thrombophilic patients before cardiac support implantation.
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