Work

Percutaneous management and outcomes of outflow graft obstruction in patients with left ventricular assist device: A single-center experience

Year: 2025

Type: article

Abstract: Background Outflow graft obstruction (OGO) is a rare but potentially fatal complication of left ventricular assist device (LVAD) therapy. Timely diagnosis and intervention are critical to prevent hemodynamic compromise and death. Methods We retrospectively reviewed 191 LVAD patients treated between January 2016 and April 2025. Seven (3.66%) had imaging-confirmed OGO. One died before intervention; 6 underwent intravascular ultrasound (IVUS)-guided stenting. LVAD flows, pressure gradient, and 12-month survival were analyzed. Results Patients had a mean age of 59.0 ± 13.8 years with a mean LVAD support duration of 63.6 ± 25.3 months. After stenting, mean LVAD flow improved from 1.98 to 4.70 L/min ( p = 0.006), while gradients decreased from 74.67 to 31.67 mmHg ( p = 0.027). No major complications occurred; all were discharged on warfarin and clopidogrel. The 12-month survival was 83.3% with 2 hemorrhagic strokes. Conclusion Intravascular ultrasound-guided stenting of OGO is safe and effective. Timely intervention may improve survival. Further research is needed for optimal antiplatelet strategies in LVAD patients undergoing stenting for OGO.

Source: JHLT Open

DOI: 10.1016/j.jhlto.2025.100464