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A 42-year-old man was re-hospitalized by acute decompensated heart failure (HF) 4 days after discharge. Physical examination revealed a continuous machinery systolic murmur at the second right intercostal space. Transthoracic echocardiogram showed a slight pericardial effusion and no signs of valve dysfunction. A CT scan showed multiple kinks in the left ventricular assist device (LVAD) outflow graft (Fig. 1). The patient underwent reoperation. At surgery, several clots around the outflow graft and mediastinum were removed, and three kinks near the excessive long outflow graft were confirmed. We performed an uneventful LVAD replacement. He was discharged the next day from ICU and 14 days later from hospital.

Kinking, thrombosis and need for re-operation in a patient with a left ventricular assist device