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KMID : 1149520220060040110
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Cardiovasclar Imaging Asia
2022 Volume.6 No. 4 p.110 ~ p.113
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An Unexpected Mass in a Patient With a Left Ventricular Assist Device
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Shariff Raja Ezman Faridz Raja
Beng Koh Hui
Yuen Beh Ting
Sin Tey Yee
Ghazi Azmee Mohd
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Abstract
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Left ventricular assist devices (LVAD) have helped improve survival, functional status, and quality of life for end-stage heart-failure patients, worldwide. Unfortunately, the risk of complications associated with such devices, including infections, has increased with improved survival. We report a unique case of pump pocket infections (PPI) and collection, diagnosed using multi-modality cardiovascular imaging in a young male patient implanted with a Heart-Ware LVAD. He had multiple admissions in the past for driveline infections (DLI). Transthoracic echocardiography revealed a 1.4×4.6-cm hyperechoic mass. An 18F-FDG PET-CT scan was performed revealing multiple foci of hypermetabolism seen along the driveline and pump, as well as from a lesion with high radiotracer uptake anterior to the right ventricle, suggesting collection. The patient underwent extensive wound debridement and prolonged intravenous antibiotics, followed by life-long oral antibiotics. Although uncommon, following the current trend in preferential use of centrifugal pumps, PPI remains a possibility, especially in the presence of chronic DLI. Our case highlights the value of multi-modality imaging, including PET-CT imaging, in managing LVAD-related infections, as it may alter the course of subsequent management.
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KEYWORD
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Left ventricular assist device, Pump pocket infection, Driveline infection, PET-CT imaging, Case report
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