Unusual clinical course
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Aleksey Baranov, Jerry Easo, Steffen Altmann, Harald C. Eichstaedt, Alexander Weymann
(Department of Cardiac Surgery, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Oldenburg, Germany)
Am J Case Rep 2019; 20:1035-1038
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