PMC6447749_01
Post-operative seroma formation.. Axial CT image shows fluid density collection anterior to LVAD conduit consistent with seroma.
gr1.jpg
PMC6447749_01_gr1.jpg
fig0005
CT of the chest, abdomen and pelvis was performed. CT images demonstrated a homogenous fluid density area anterior to the LVAD conduit, however no adjacent fat stranding was seen (Fig. 1). Three-dimensional volume rendered reconstruction provides better understanding of make-up of these devices, particularly the co-axial arrangement of the outflow grafts (Fig. 2, video 1).
CTA and Volume Rendered Images.. Multiplanar sagittal image (A) and Volume Rendered image (B) shows potential space in the outflow cannula created between inner polyester and outer Gore-Tex coaxial grafts. AAO: Ascending aorta; LV: Left ventricle
gr2.jpg
PMC6447749_01_gr2.jpg
fig0010
Peripheral low-density material was seen surrounding the conduit from the LVAD device to the ascending aorta. (Fig. 2, Fig. 3 video 1 in Supplementary). Three-dimensional volume rendered reconstruction provides better understanding of make-up of these devices, particularly the co-axial arrangement of the outflow grafts (Fig. 2, video 1).
Repeat CTA performed 4 days later.. Multiplanar sagittal (A) and axial (B) images show no change in appearance of outflow cannula and seroma.
gr4.jpg
PMC6447749_01_gr4.jpg
fig0020
CT demonstrated a stable exam with no change in appearance of the conduit and no evidence of thrombus (Fig. 4). CT angiography was also repeated a month later with similar appearance of the outflow graft and of the fluid collection seen anterior to the graft.
HeartWare assist device.. Graphical representation (5A, 5B) of the HeartWare left ventricular assist device and its parts
gr5.jpg
PMC6447749_01_gr5.jpg
fig0025
A strain relief is slid over the outflow graft (co-axial) to prevent kinking and securing the outflow graft to the pump (Fig. 5).