CTICasesLVAD Outflow Cannula Extraluminal Fluid Mimicking Thrombus
Imaging findings
In a patient with a longstanding left ventricular assist device presenting with new low-flow alarms, CT of the outflow cannula shows near-total luminal collapse with an unusual star- or propeller-shaped configuration, distinct from the more typical eccentric appearance of true thrombus.
Key takeaways
This appearance represented fluid accumulated within the graft lining between the outflow cannula and its outer sheath rather than true thrombus; drainage of the fluid immediately improved flow, and the atypical propeller/star shape -- rather than an eccentric thrombus-like mass effect -- is a useful clue that a low-flow LVAD alarm reflects extraluminal fluid rather than intraluminal thrombus.
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