Heart transplantation in a patient with left ventricular assist device after pump thrombosis –The first case report in Serbia

Duško Terzić; Svetozar Putnik; Emilija Nestorović; Ilija Bilbija; Ljiljana Bukarica; Vladimir Jovičić; Jovana Rajković; Miljko Ristić

doi:10.2298/VSP180701182T

Duško Terzić Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia
Svetozar Putnik Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia
Emilija Nestorović Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia
Ilija Bilbija Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia
Ljiljana Bukarica Faculty of Medicine, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Belgrade, Serbia
Vladimir Jovičić Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia
Jovana Rajković Faculty of Medicine, Institute of Pharmacology, Clinical Pharmacology and Toxicology, Belgrade, Serbia
Miljko Ristić Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP180701182T

Keywords: device removal;, heart-assist devices;, heart transplantation;, thrombosis;, treatment outcome

Abstract

Introduction. The device thrombosis is one of the most serious complications of the left ventricle assist device implantation with a high mortality and morbidity rate. Case report. A 59-year-old male was implanted by left ventricular assist device Heart Mate II as a bridge to transplantation seventeen months before the onset of a potentially fatal complication – the thrombosis with the complete obstruction of the device. Despite the aggressive pharmacological treatment following the initial suspicion of the pump thrombosis, the patient condition got worse with the final “pump off” alarm that marked the discontinuance of the pump work as a result of the complete obstruction by the thrombus. An appropriate occurrence of an adequate donor resulted in a successful surgical treatment – the heart transplantation. Conclusion. The urgent heart transplantation by the first priority rank, or the device replacement, although technically extremely demanding procedures, are successful treatment options for these patients.

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