{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:20:56Z","timestamp":1760232056536,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T00:00:00Z","timestamp":1652486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In patients with advanced heart failure (HF), left ventricular assist devices (LVADs) have demonstrated to be effective in improving the quality of life and reducing further hospitalizations. Although uncommon, LVAD outflow graft obstruction (OGO) is a potentially life-threatening complication and percutaneous treatment has been proposed as a standard intervention strategy in such cases. We report the case of a 69 year old man admitted due to LVAD failure causing unstable HF. Past medical history included percutaneous intervention on the outflow graft with stent implantation one year before. The patient was under chronic treatment with vitamin K antagonists (VKA). Emergent percutaneous angiography was performed, showing recurrent OGO due to thrombosis located at a kinking site, distally to the previously treated segment. Using distal anchoring technique, a balloon-expandable 10 \u00d7 79 mm endoprosthesis (GORE\u00ae Viabahn\u00ae VBX) was effectively positioned and post-dilated. Final angiography confirmed the patency of the stent implanted one-year before. Despite the procedure succeeding in restoring LVAD function, the patient died due to septic shock ten days after. Our case suggests that recurrent OGO can be effectively treated with percutaneous redo and that long-term stent patency can be achieved with a standard antithrombotic treatment, despite further thrombotic events in other segments of the graft are still possible (especially at the kinking site). Moreover, other noncardiac conditions as infective complications, can dramatically impact the clinical course and lead to unfavorable outcomes.<\/jats:p>","DOI":"10.3390\/ijerph19105976","type":"journal-article","created":{"date-parts":[[2022,5,14]],"date-time":"2022-05-14T09:27:56Z","timestamp":1652520476000},"page":"5976","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Redo Percutaneous Emergency Intervention of Left Ventricular Assist Device Graft Occlusion"],"prefix":"10.3390","volume":"19","author":[{"given":"Rocco Edoardo","family":"Stio","sequence":"first","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Comisso","sequence":"additional","affiliation":[{"name":"Department of Heart and Vessels, Cardiac Surgery and Heart Transplantation Center, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Paolucci","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9282-1003","authenticated-orcid":false,"given":"Silvio","family":"Coletta","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1092-8518","authenticated-orcid":false,"given":"Vincenzo","family":"Cesario","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Gioia","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Stefano","family":"Nazzaro","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9860-765X","authenticated-orcid":false,"given":"Guglielmo","family":"Saitto","sequence":"additional","affiliation":[{"name":"Department of Heart and Vessels, Cardiac Surgery and Heart Transplantation Center, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Contento","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anaesthesia, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"D\u2019Avino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anaesthesia, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"De Felice","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3392-0527","authenticated-orcid":false,"given":"Domenico","family":"Gabrielli","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, Department of Heart and Vessels, Division of Interventional Cardiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Musumeci","sequence":"additional","affiliation":[{"name":"Department of Heart and Vessels, Cardiac Surgery and Heart Transplantation Center, San Camillo-Forlanini Hospital, 00152 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contributio","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jchf.2020.01.014","article-title":"Advanced Heart Failure: Epidemiology, Diagnosis, and Therapeutic Approaches","volume":"8","author":"Truby","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3454","DOI":"10.1093\/eurheartj\/ehy513","article-title":"Six-month outcomes after treatment of advanced heart failure with a full magnetically levitated continuous flow left ventricular assist device: Report from the ELEVATE registry","volume":"39","author":"Gustafsson","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1161\/CIRCULATIONAHA.113.002836","article-title":"Assessment and management of heart failure after left ventricular assist device implantation","volume":"129","author":"Burke","year":"2014","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1002\/ccd.29785","article-title":"Outflow graft obstruction in patients with the HM 3 LVAD: A percutaneous approach","volume":"98","author":"Milwidsky","year":"2021","journal-title":"Catheter. Cardiovasc. Interv. Off. J. Soc. Card. Angiogr. Interv."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1002\/ehf2.13205","article-title":"Extracorporeal membrane oxygenation-assisted emergency percutaneous treatment of left ventricular assist device graft occlusion","volume":"8","author":"Stio","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2758","DOI":"10.1016\/j.jacc.2016.03.573","article-title":"Diagnosis and Treatment Algorithm for Blood Flow Obstructions in Patients With Left Ventricular Assist Device","volume":"67","author":"Scandroglio","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Stio, R.E., Montalto, A., Intorcia, A., Polizzi, V., Feccia, M., Musto, C., Pennacchi, M., Paolucci, L., Stumpo, R., and D\u2019Avino, E. (2022). A Case of Successful Use of the \u201cAnchoring Technique\u201d for Percutaneous Treatment of Left Ventricular Assist Device Graft Occlusion. Int. 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Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.1002\/ehf2.13333","article-title":"Outflow graft obstruction after left ventricular assist device implantation: A retrospective, single-centre case series","volume":"8","author":"Agrawal","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/MAT.0000000000000936","article-title":"LVAD Outflow Graft Role in Pump Thrombosis","volume":"66","author":"Barac","year":"2020","journal-title":"ASAIO J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e004275","DOI":"10.1161\/CIRCHEARTFAILURE.117.004275","article-title":"Outflow Graft Occlusion of the HeartMate 3 Left Ventricular Assist Device","volume":"10","author":"Moayedi","year":"2017","journal-title":"Circ. Heart Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jaccas.2019.09.027","article-title":"Percutaneous Management of Outflow Graft Obstruction in Patients With Continuous Flow Left Ventricular Assist Devices","volume":"2","author":"Davila","year":"2020","journal-title":"JACC. Case Rep."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/10\/5976\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:10:45Z","timestamp":1760137845000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/10\/5976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,14]]},"references-count":13,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["ijerph19105976"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19105976","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2022,5,14]]}}}