CTICasesLVAD Outflow Graft Thrombosis with Splenic Infarction
Imaging findings
CT angiography in a patient with a HeartMate II LVAD and known driveline staph infection demonstrates filling defects within the bend relief segment and at the anastomosis of the outflow graft to the ascending aorta, consistent with new thrombus formation. A wedge-shaped splenic infarction is identified, likely embolic from the graft thrombus.
Key takeaways
LVAD outflow graft thrombosis is a serious complication that manifests clinically as device alarms for elevated pressure or reduced flow. On CT, thrombus appears as filling defects within the metallic bend relief connector or at the aortic anastomosis. Embolic complications including splenic infarction, renal infarction, or stroke may result. Infection of the driveline or pocket is a risk factor for both thrombosis and device failure.
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