Case of the Week: Top 5 2020 Competition-Transient Ischemic Attack After Lvad Explantation

Transient Ischemic Attack After Lvad Explantation

Video Transcription

Video Summary

A 52-year-old woman recovered from influenza A myocarditis and LVAD support, then presented a year after LVAD explantation with transient diplopia. Echo raised concern for apical thrombus or noncompaction, but cardiac MRI and CT identified the expected LVAD felt plug in the LV apex. The plug was iso-intense to myocardium on cine and T2 images, non-enhancing on perfusion, hypo-intense on high-TI and PSIR, and surrounded by postoperative scar. No thrombus or noncompaction was found. This case describes the first cardiac MRI appearance of an LVAD felt plug and supports MRI safety after explantation when hardware is confirmed.

Keywords

LVAD felt plug

cardiac MRI

myocardial scar

apical thrombus

LVAD explantation