Open AccessChronic LDH Elevation after Left Ventricular Assist Device Implantation
Author(s) -
Hesham R. Omar,
Navin Rajagopalan,
Maya Guglin
Publication year - 2015
Publication title -
the vad journal
Language(s) - English
Resource type - Journals
ISSN - 2378-2706
DOI - 10.14434/vad.v1i0.27928
Subject(s) - ventricular assist device , medicine , cardiology , hemolysis , thrombus , lactate dehydrogenase , pannus , cannula , thrombosis , surgery , heart failure , chemistry , rheumatoid arthritis , biochemistry , enzyme
A 61-year-old woman who underwent HeartMate II left ventricular assist device placement for non-ischemic cardiomyopathy developed elevated lactate dehydrogenase within two weeks after implantation. After eight months of observation and several hospital admissions during which there was no evidence of pump thrombosis, she presented with clinically manifest hemolysis. During pump exchange there was notable pannus formation on the inflow cannula of the left ventricular assist device. The pannus around the inflow likely existed for several months, limiting the flow and creating a low- grade hemolysis and this low flow state stimulated thrombus formation triggering gross hemolysis. Thoratec analysis of the pump confirmed that the clot was present for about 5 days. Lactate dehydrogenase normalized after pump exchange.