CTICasesHeartMate II LVAD Outflow Cannula Infection and Debris Accumulation
Imaging findings
Contrast-enhanced CT scans from two different cases demonstrate complications in HeartMate II outflow cannulas. The first shows a thin rim of fluid and inflammatory soft tissue enhancement surrounding the exterior of the outflow graft cannula, representing a perigraft infection. The second shows a low-attenuation circumferential filling defect within the graft at the level of the bend relief, compressing the inner lumen, which proved to be accumulated biological debris.
Key takeaways
Complications of HeartMate II LVAD outflow cannulas include both infectious and mechanical processes. Perigraft infection manifests as fluid and enhancement surrounding the outflow cannula and requires targeted antibiotic therapy. Mechanically, non-thrombotic proteinaceous debris can accumulate between the outer silicone bend relief and the inner vascular graft, mimicking thrombus on CT, and causing significant luminal stenosis that can be managed with endovascular stenting.
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