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Pexy of intraperitoneal LVAD driveline to relieve small bowel obstruction.

Authors
  • Cresse, Stephen M1
  • Urrechaga, Eva M1
  • Cioci, Alessia C1
  • Banerjee, Monisha N1
  • Cahill, Anthony1
  • Lieberman, Howard M1
  • 1 Dewitt-Daughtry Family Department of Surgery, Divisions of Trauma, Critical Care and Burn Surgery, University of Miami Miller School of Medicine and Ryder Trauma Center, Miami, Florida.
Type
Published Article
Journal
Journal of Cardiac Surgery
Publisher
Wiley (Blackwell Publishing)
Publication Date
Dec 03, 2019
Identifiers
DOI: 10.1111/jocs.14398
PMID: 31794108
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Left ventricular assist device (LVAD) implantation is a lifesaving intervention in advanced heart failure. However, LVAD is not without complication. In this case, an inadvertent intraperitoneal driveline caused small bowel obstruction, subsequently requiring pexy of the driveline to the abdominal wall to avoid future complications. A 37-year-old male with worsening, nonischemic, dilated cardiomyopathy underwent LVAD implantation. Postoperative day (POD) 15 he developed small bowel obstruction, and abdominal exploration showed transition point at an inadvertently placed intraperitoneal LVAD driveline. The patient was LVAD-dependent precluding removal, so the driveline was secured to the anterior abdominal wall. He subsequently improved and was discharged. While LVAD is increasingly common for heart failure patients, the tunneled driveline may inadvertently enter the peritoneal cavity where it can cause significant morbidity. In this case, we propose securing the driveline to the abdominal wall to prevent complications when LVAD removal is not an option. © 2019 Wiley Periodicals, Inc.

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