Hello Everyone,
Left ventricular assist device (LVAD) is one of the modern management therapies in patients with advanced
heart failure, and it serves as a bridge to heart transplantation or even as destination therapy.
However, it is burdened with a high risk of thromboembolic, hemorrhagic, and infectious complications
despite prophylactic management. Splenic abscesses, as septic complications following implantation of
mechanical ventricular support, have not yet been described in the literature.
We report a patient with severe left ventricular insufficiency (NYHA II/III), pulmonary hypertension, and arrhythmia who
underwent implantation of the Heart Ware® pump for left ventricular support with simultaneous tricuspid valvoplasty, as a
bridge therapy to heart transplantation. During two years after LVAD implantation, the patient had three MRSA skin infections,
localized at the exit site of the drive-line connecting the artificial ventricle with external unit, that were complicated by
sepsis and treated with broad-spectrum antibiotics. A few months later, abdominal CT revealed two abscesses in the spleen,
and the patient was qualified for splenectomy. Open splenectomy was performed under full-dose anticoagulant therapy
with continuous intravenous infusions of unfractionated heparin (UFH). The intra- and postoperative course was uneventful.
UFH therapy was continued for 6 days, and oral anticoagulation was re-administered on day 4 after surgery. The patient
was discharged on day 7 after surgery with primary healed wound. Open splenectomy, performed with full-dose anticoagulant
therapy, proved to be an effective and definitive method of treatment without any complications.
Looking forward to hearing from you all soon
Regards
Dr.Afshan .Hashmi

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