CTICasesLVAD Outflow Graft Compression
Imaging findings
Contrast-enhanced chest CT in a patient with a HeartMate II LVAD presenting with device alarms and low flow shows a large, concentric hematoma/thrombus within the outflow graft wrap, compressing and severely narrowing the graft lumen. The CT reformats show a dislodged modular bend relief connector at the outflow elbow, which eroded the graft and created a micro-perforation, letting blood leak into the wrap.
Key takeaways
LVAD outflow graft compression is a recognized mechanical complication of the HeartMate II device. Dislodgement of the modular bend relief connector creates a sharp edge that can erode through the Dacron graft wall, causing a micro-perforation. Blood leaks into the surrounding gelatin wrap, creating a high-pressure hematoma that compresses the lumen, requiring surgical repair or endovascular stenting.
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