Percutaneous Stenting of LVAD Outflow Graft Obstruction: A Multimodality Imaging Case Series

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2026-07-03 Epub Date: 2026-04-14 DOI:10.1002/ccd.70627

Ahmed Ahmed, Fahad Eid, Mohamed Eid, Akshay Joshi, Farhad Abtahian, Abdallah Bitar, Ryan Lydonz, Scott Feitell, Soidjon Khodjaev

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引用次数: 0

Abstract

Background

Outflow graft obstruction (OGO) is an increasingly recognized complication of continuous-flow left ventricular assist devices (CF-LVADs), particularly the HeartMate 3. Surgical revision is often high risk, and percutaneous alternatives are emerging.

Aims

To evaluate the feasibility, safety, and outcomes of endovascular stenting for the treatment of LVAD OGO using a multimodality imaging approach.

Methods

We retrospectively reviewed all HeartMate 3 patients undergoing percutaneous treatment of OGO at our institution between September 2023 and April 2025. Clinical presentation, multimodality imaging findings, procedural characteristics, and outcomes were analyzed.

Results

Eight patients underwent endovascular intervention. All presented with persistent low-flow alarms and variable syncope or neurologic symptoms. Technical success was achieved in all cases. Median LVAD flow improved from 2.8 L/min pre-intervention to 4.4 L/min post-intervention. Two access-related bleeding complications and one hemothorax occurred, all managed successfully. At a median follow-up of 7 months, no recurrent OGO was observed.

Conclusions

Endovascular stenting guided by multimodality imaging is a feasible and effective alternative to surgical revision for LVAD OGO in selected patients.

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左心室辅助器流出部移植物梗阻的经皮支架置入：多模态影像病例系列。

背景：流出部移植物梗阻（OGO）是连续血流左心室辅助装置（cf - lvad）的并发症，尤其是HeartMate 3。手术翻修往往是高风险的，经皮的替代方案正在出现。目的：利用多模态成像方法评估血管内支架治疗LVAD OGO的可行性、安全性和结果。方法：我们回顾性分析了2023年9月至2025年4月期间在我院接受经皮OGO治疗的所有HeartMate 3患者。分析临床表现、多模态影像学表现、手术特点和结果。结果：8例患者行血管内介入治疗。所有患者均出现持续性低血流报警和变异性晕厥或神经系统症状。在所有情况下都取得了技术上的成功。中位LVAD流量从干预前的2.8 L/min提高到干预后的4.4 L/min。发生2例通路相关出血并发症和1例血胸，均处理成功。在中位随访7个月时，未观察到复发性OGO。结论：多模态成像引导下血管内支架植入术是一种可行且有效的治疗LVAD OGO的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.