CTICasesOutflow Cannula Obstruction of a HeartMate II Left Ventricular Assist Device (LVAD) Treated with Stenting
Imaging findings
Chest CT angiography of a patient with a HeartMate II LVAD reveals significant narrowing of the efferent outflow cannula due to a low-attenuation circumferential filling defect within the outer bend relief. Following an endovascular intervention, a metal stent is seen deployed within the outflow cannula, successfully expanding the lumen and restoring central blood flow.
Key takeaways
Outflow cannula obstruction in the HeartMate II LVAD is a serious complication that can present with low pump flows and low pressures. The narrowing can be caused by the accumulation of gelatinous debris, thrombus, or proteinaceous material between the inner graft and the outer silicone bend relief (the "tube within a tube" design), which compresses the inner graft. Endovascular stenting is a viable, minimally invasive technique to compress the debris and restore outflow patency.
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