Pan-Cardiac Cycle Fixed Mitral Valve Opening in an LVAD Patient Presenting with Hemorrhagic Shock

Andrew J Yoon; Jina Sohn; Luanda Grazette; Michael W Fong; Michael E Bowdish

doi:10.1111/echo.13150

Pan-Cardiac Cycle Fixed Mitral Valve Opening in an LVAD Patient Presenting with Hemorrhagic Shock

Echocardiography. 2016 Apr;33(4):644-6. doi: 10.1111/echo.13150. Epub 2015 Dec 17.

Authors

Andrew J Yoon¹, Jina Sohn¹, Luanda Grazette¹, Michael W Fong¹, Michael E Bowdish²

Affiliations

¹ Department of Internal Medicine, Division of Cardiology, University of Southern California, Los Angeles, California.
² Department of Cardiothoracic Surgery, University of Southern California, Los Angeles, California.

PMID: 26676075
DOI: 10.1111/echo.13150

Abstract

We present the case of a patient with a HeartMate II left ventricular assist device (LVAD) who underwent an elective cholecystectomy and abruptly decompensated on postoperative day 9. We highlight the uncommon echocardiogram finding of mitral valve leaflets fixed widely open throughout the cardiac cycle during an LVAD suction event. Bedside echocardiographic confirmation of a suction event enabled the rapid diagnosis and intervention for hemorrhagic shock before blood tests and radiographic results were available. Acoustic image quality can be limited in LVAD patients, and awareness of this uncommon finding may increase specificity for the echocardiographic diagnosis of LVAD suction events.

Keywords: left ventricular assist device; mitral valve.

Publication types

Case Reports

MeSH terms

Critical Care / methods
Diagnosis, Differential
Echocardiography / methods*
Heart-Assist Devices / adverse effects*
Humans
Male
Middle Aged
Mitral Valve Insufficiency / diagnostic imaging*
Mitral Valve Insufficiency / etiology*
Shock, Hemorrhagic / diagnostic imaging*
Shock, Hemorrhagic / etiology*