Case Report of a Heartmate II Outflow Graft Obstruction by Extrinsic Compression

Left ventricular assist devices take an important place in the armamentarium of end-stage heart failure therapy. Outflow graft obstruction by extrinsic compression is a rare but possibly life-threatening complication of these types of devices. Pathophysiology is not completely elucidated but seems to be related to the common design of these devices, because of a porous Dacron graft surrounded within an impervious Teflon bend relief. In the absence of pump thrombosis, the pump replacement is not necessarily indicated, and only removal of the obstruction may be sufficient. Both surgical and interventional procedures are described. We reported a case successfully treated by angioplasty-stenting. We discussed the diagnosis, the pathophysiology, and the treatment of this specific complication of left ventricular assist devices. Finally, we open the discussion to the prevention of this complication.