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17 July 2019 : Case report  Germany

Long-Term Left Ventricular Assist Device (LVAD): A Rare Case of 10 Years’ Support and Follow-Up

Unusual clinical course

Konstantin Zhigalov1ABDEF*, Ahmed Mashhour1BEF, Marcin Szczechowicz1BEF, Sabreen Mkalaluh1BEF, Aleksey Baranov2BEF, Jerry Easo1BEF, Steffen Altmann1BEF, Harald C. Eichstaedt1BEF, Alexander Weymann1ABDEF

DOI: 10.12659/AJCR.916404

Am J Case Rep 2019; 20:1035-1038

Abstract

BACKGROUND: We report a 66-year-old patient who received implantation of HeartMate II LVAD (St. Jude Medical, Minneapolis, MN, USA) as destination therapy 10 years ago.

CASE REPORT: Preoperatively, the patient developed acute heart failure due to transmural myocardial infarction requiring catecholamine therapy and intra-aortic balloon pump. Echocardiography revealed a left ventricular ejection fraction of 15%. We saw an indication for left ventricular assist device (LVAD) implantation. The intraoperative course was uncomplicated. The operation time was 153 minutes and the cardiopulmonary bypass time was 69 minutes. The procedure was performed in normothermia, and no further combined procedures were necessary. Only one re-hospitalization, due to driveline infection, was required. Once a month, the patient visited our heart failure outpatient clinic for laboratory control, echocardiographic examination, and device measurement. There was always a normal LVAD function. During the 10 years of follow-up, the patient did not have any other complications.

CONCLUSIONS: Patients with a strict indication for LVAD and fewer risk factors can show a relatively uncomplicated postoperative course. Our case report demonstrates the opportunity to care for a patient for years using LVAD. Modern LVADs are reliable cardiac support systems as destination therapy from the long-term perspective. Careful patient selection, timely decision on LVAD implantation, and structured patient care are critical.

Keywords: Artificial Organs, Cardiac Surgical Procedures, Heart Failure, Aged, Heart-Assist Devices, Time Factors

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923