Percutaneous Stenting of LVAD Outflow Graft Obstruction: A Multimodality Imaging Case Series
Department
Cardiology
Document Type
Article
Publication Title
Catheterization and Cardiovascular Interventions
Abstract
BACKGROUND: Outflow graft obstruction (OGO) is an increasingly recognized complication of continuous-flow left ventricular assist devices (CF-LVADs), particularly the HeartMate 3. Surgical revision is often high risk, and percutaneous alternatives are emerging.
AIMS: To evaluate the feasibility, safety, and outcomes of endovascular stenting for the treatment of LVAD OGO using a multimodality imaging approach.
METHODS: We retrospectively reviewed all HeartMate 3 patients undergoing percutaneous treatment of OGO at our institution between September 2023 and April 2025. Clinical presentation, multimodality imaging findings, procedural characteristics, and outcomes were analyzed.
RESULTS: Eight patients underwent endovascular intervention. All presented with persistent low-flow alarms and variable syncope or neurologic symptoms. Technical success was achieved in all cases. Median LVAD flow improved from 2.8 L/min pre-intervention to 4.4 L/min post-intervention. Two access-related bleeding complications and one hemothorax occurred, all managed successfully. At a median follow-up of 7 months, no recurrent OGO was observed.
CONCLUSIONS: Endovascular stenting guided by multimodality imaging is a feasible and effective alternative to surgical revision for LVAD OGO in selected patients.
First Page
26
Last Page
32
DOI
10.1002/ccd.70627
Volume
108
Issue
1
Publication Date
7-1-2026
Publisher
Wiley-Liss
Medical Subject Headings
Humans; Stents; Retrospective Studies; Male; Treatment Outcome; Endovascular Procedures; Female; Graft Occlusion, Vascular; Heart-Assist Devices; Feasibility Studies; Middle Aged; Multimodal Imaging; Time Factors; Ventricular Function, Left; Predictive Value of Tests; Adult; Vascular Patency; Heart Failure; Aged; Recovery of Function
PubMed ID
41979066
Recommended Citation
Ahmed, A., Eid, F., Eid, M., Joshi, A. C., Abtahian, F., Bitar, A., Lydon, R., Feitell, S., & Khodjaev, S. (2026). Percutaneous Stenting of LVAD Outflow Graft Obstruction: A Multimodality Imaging Case Series. Catheterization and Cardiovascular Interventions, 108 (1), 26-32. https://doi.org/10.1002/ccd.70627