33 research outputs found
IMPACT OF RUNOFF SCORE FOR THE OUTCOME FOLLOWING ENDOVASCULAR THERAPY IN SMALL FEMOROPOPLITEAL DISEASE
Clinical Outcome Following Endovascular Therapy for Femoropopliteal Lesion With TASCII Class A and B
IMPACT OF RUNOFF SCORE FOR THE OUTCOME FOLLOWING ENDOVASCULAR THERAPY IN SMALL FEMOROPOPLITEAL DISEASE
IMPACT OF DRUG-ELUTING STENT PLACEMENT COMPARED WITH BARE METAL STENT IN FEMOROPOPLITEAL DISEASE
Clinical Outcome Following Endovascular Therapy for Femoropopliteal Lesion With TASCII Class A and B
Clinical Impact of the Ankle-Brachial Index in Patients Undergoing Successful Percutaneous Coronary Intervention
Outflow graft obstruction after left ventricular assist device implantation: a retrospective, singleâcentre case series
Abstract Aims Outflow graft obstruction is a poorly described complication following left ventricular assist device (LVAD) surgery. We sought to define the incidence of LVAD outflow graft obstruction and assess clinical outcomes with a percutaneous treatment strategy. Methods and results From January 2012 to October 2020, 322 patients with LVAD were managed at our institution. Patients with LVAD outflow graft obstruction were identified by cardiac computed tomography with angiography and invasive haemodynamic assessment and were subsequently treated with percutaneous intervention. Poisson regression was used to analyse timeâdependent differences in the incidence of LVAD outflow graft obstruction. KaplanâMeier analysis was used to estimate survival. Twenty patients (6.2%) developed haemodynamically significant LVAD outflow graft obstruction at a rate of 0.03 events per patientâyear. Outflow graft obstruction presented a median of 33 (26â49) months after surgery. Patients presented with low estimated LVAD pump flow (95%), heart failure (90%), or both (85%), and 59% developed cardiogenic shock prior to intervention. The most common aetiology identified by cardiac computed tomography with angiography was external compression of the outflow graft (78%). On presentation, the median peak gradient in the outflow graft was 78 (64â100) mmHg. Outflow graft stenting was 100% successful with no inâhospital mortality, and it reduced the peak outflow graft gradient to 10 (2â17) mmHg (PÂ <Â 0.001). Outflow graft stenting was durable with two patients (10%) requiring a repeat procedure over a median followâup of 13 (7â20) months and did not impact survival. Conclusions Left ventricular assist device outflow graft obstruction is a relatively common and underappreciated cause of recurrent heart failure and LVAD dysfunction. Outflow graft stenting can be achieved with low morbidity and provides a longâterm solution to this complication