E-mail this Article (login required)
E-mail the Author (login required)
Post a Comment (login required)
VIEW COMPLETE HTML
VIEW COMPLETE PDF
Ventricular Assist Device-Related Haemolysis Presenting with Acute Pancreatitis
Sanna Fatima, Yaser Alhamshari, Moiz Salahuddin
http://dx.doi.org/10.12890/2017_000557
European Journal of Case Reports in Internal Medicine - © EFIM

ABSTRACT

Acute pancreatitis is one of the rare complications in patients fitted with a left ventricular assist device (LVAD). We herein report a case of acute pancreatitis in a patient with LVAD triggered by intravascular haemolysis. A 44-year-old man with non-ischaemic cardiomyopathy (NICM) after VAD implantation presented with epigastric pain. Laboratory work-up showed acute pancreatitis and haemolysis. As there was concern that device thrombosis was causing haemolysis, the patient was started on unfractionated heparin infusion. The patient was discharged when haemolysis and pancreatitis had resolved. To our knowledge, VAD-associated haemolysis presenting with acute pancreatitis is infrequently described in the literature.

KEYWORDS

VAD thrombosis; VAD complication; acute pancreatitis; hemolysis

References
  1. Cavallini G, Frulloni L, Bassi C, et al. Prospective multicentre survey on acute pancreatitis in Italy (ProInf-AISP): results on 1005 patients. Dig Liver Dis 2004;36:205.
  2. Gullo I, Migliori M, Olah A, et al. Acute pancreatitis in five European countries: etiology and mortality. Pancreas 2002;24:223–227.
  3. Al-Haddad M, Wallace MB. Diagnostic approach to patients with acute idiopathic pancreatitis, what should be done? World J Gastroenterol 2008;14:1007–1010.
  4. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2013;128:1810.
  5. Robertson JO, Okada S, Joseph SM, et al. Left ventricular assist device-related hemolysis and acute pancreatitis: a case series. J Heart Lung Transplant 2013;32:846–848.
  6. Swanson KE, Ward EM, Wolfsen HC. Painless pancreatitis after implantation of a biventricular assistive device. Transplant Proc 35;4:1546–1548.
  7. Costantini TW, Taylor JH, Beilman GJ. Abdominal complications of ventricular assist device placement. Surg Infect 2006;6:409–418.
  8. Saruç M, Yuceyar H, Turkel N, et al. The role of heme in hemolysis-induced acute pancreatitis. Med Sci Monit 2007;13:BR67–72.
  9. Katz JN, Jensen BC, Chang PP, et al. A multicenter analysis of clinical hemolysis in patients supported with durable, long-term left ventricular assist device therapy. J Heart Lung Transplant 2015;34:701–709.
  10. Druml W, Laggner AN, Lenz K, et al. Pancreatitis in acute hemolysis. Ann Hematol 1991;63:39–41.
  11. Goldstein DJ, John R, Salerno C, et al. Algorithm for the diagnosis and management of suspected pump thrombus. J Heart Lung Transplant 2013;32:667–670.
  12. Ravichandran AK, Parker J, Novak E, et al. Hemolysis in left ventricular assist device: a retrospective analysis of outcomes. J Heart Lung Transplant 2014;33:44–50.


© EFIM Copyright 2016