CTICasesLVAD Outflow Graft Extraluminal Debris Causing Low-Flow Alarms
Imaging findings
In a patient with a longstanding, previously revised LVAD presenting with low-flow alarms, CT of the outflow cannula shows substantial narrowing of the contrast-opacified inner lumen with material accumulating within the outer graft sheath surrounding the inner conduit.
Key takeaways
At surgery, the material causing outflow obstruction was yellow debris and serous fluid within the outer graft lining rather than true thrombus, so LVAD outflow narrowing that fails to respond to anticoagulation or thrombolytics should raise suspicion for extraluminal debris accumulation between the graft layers rather than intraluminal thrombus.
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