The use of extracorporeal assist devices in heart failure is associated with the risk
of thromboembolic complications [1]. Prove of thromboembolic material in the ventricles and tubes of the assist devices
is difficult, and the clinical relevance of thrombotic material in the tubes is not
clear. Here, we report on a patient with severe heart failure caused by endstage dilated
cardiomyopathy who was bridged to transplantation using a biventricular assist device
(BVAD). Five weeks aller implantation, transcranial Doppler sonography (TCD) revealed
high intensity transient signals (HITS) in basal cerebral arteries, suggesting continued
cerebral microembolism. Apart from a correlation of these Doppler sonographic findings
with neurological symptoms, macroscopic evidence of fibrin thrombi in the artificial
ventricle, and post mortem confirmation of cerebral infarction could be proved.
Key words:
Assist device - Transcranial doppler sonography - Thromboembolism
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Received for Publication: December 31,1999
Dr. med. Wolfgang Buhre
Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin Universität Göttingen
Robert-Koch-Straße 40 37075 Göttingen Germany
Phone: +49-551-398899
Fax: +49-551-398676
Email: wbuhre@gwdg.de