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A 70-year-old man with dilated cardiomyopathy underwent left ventricular assist device (LVAD) implantation, using a HeartWare ventricular assist device, as a bridge to candidacy. After 26 months, computed tomography (CT) angiography indicated stenosis in the LVAD outflow graft; however, the patient was asymptomatic, prompting a decision to manage his condition with close monitoring. Ten months later, the patient presented with dizziness and low-flow alerts. Subsequent CT angiography revealed a critical obstruction involving the entire LVAD outflow graft. The patient underwent emergency surgery, during which an organized seroma causing the graft obstruction was found between a wrapped expanded polytetrafluoroethylene (ePTFE) graft and a Dacron outflow graft. The covering of the outflow graft was removed, along with the organized seroma. Following removal of the ePTFE wrap and decompression of the outflow graft, normal LVAD flow was reestablished. The practice of wrapping the outflow graft with synthetic material, commonly done to facilitate later redo sternotomy, may pose a risk for outflow graft obstruction.
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http://dx.doi.org/10.5090/jcs.23.133 | DOI Listing |
Cureus
August 2025
Cardiology, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, MAR.
Subaortic membrane (SAM) is a subtype of left ventricular outflow obstruction, rarely seen in adults. In some cases, SAM may be associated with other congenital defects. The association of patent ductus arteriosus (PDA) and SAM is the rarest, especially in adult patients.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
September 2025
Department of Cardiovascular Surgery, Marmara University Pendik Research and Training Hospital, Istanbul, Turkey.
Complete detachment of the aortic root following a Bentall procedure is an exceptionally rare complication. The vast majority of reported cases are secondary to prosthetic valve endocarditis or underlying vasculitis. Currently, the most reliable treatment for aortic root dehiscence-particularly in the context of prosthetic valve endocarditis-is repeat root replacement, typically via a second Bentall procedure or with the use of a homograft or allograft.
View Article and Find Full Text PDFJ Vasc Access
September 2025
National Yang Ming Chiao Tung University, Taipei, Taiwan.
Purpose: Although stent grafts have demonstrated significant benefits over bare metal stents and conventional venoplasty at maintaining patency of dialysis vascular access, they are far from perfect and are prone to edge stenosis. A new strategy of placing stent graft to reduce the possible occurrence of edge stenosis is therefore proposed in this study.
Materials And Methods: A retrospective review between 2015 and 2023 identified 21 arteriovenous grafts (AVG) hemodialysis patients who underwent stent graft placement with the medial stent end in an outflow venous valve.
Ann Vasc Surg
September 2025
Interventional Radiology, Cleveland Clinic, Cleveland, OH, USA. Electronic address:
Objectives: As a two-dimensional modality, venography has limitations in its capacity to measure lumen caliber and to assess stenotic disease accurately. This has implications in the management of end-stage renal-disease (ESRD) patients "no-option" candidates access for arteriovenous fistula (AVF) or graft (AVG) creation secondary to high risk of vascular access failure. The incremental diagnostic and clinical impact of intravascular ultrasound (IVUS) was quantified in this tunneled dialysis catheter dependent ESRD cohort.
View Article and Find Full Text PDFRadiographics
October 2025
Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110.
CT angiography (CTA) of the aortoiliofemoral (AIF) arteries in the abdomen, pelvis, and lower extremities has become an invaluable tool in assessment of patients with peripheral arterial disease (PAD) and lower extremity trauma. AIF CTA provides rapid and comprehensive assessment of arterial inflow and outflow, guiding management of patients with chronic claudication and those with more acute manifestations, including atherothrombotic occlusion, embolic disease, or thrombosis of prior interventions such as bypass graft or stent placement. Careful attention to technique is critical in performing diagnostic AIF CTA, as pitfalls related to imaging too early or too late relative to the arrival of contrast material in the legs can lead to misdiagnosis or diagnostic uncertainty.
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