Author/Authors :
Butera, Brian C. Department of Internal Medicine - Division of Cardiovascular Medicine - University of Southern California, Los Angeles, USA , Grazette, Luanda P. Department of Internal Medicine - Division of Cardiovascular Medicine - University of Southern California, Los Angeles, USA , Lawrence, Tracy Department of Internal Medicine - Division of Cardiovascular Medicine - University of Southern California, Los Angeles, USA , Bowdish, Michael E. Department of Surgery - Division of Cardiothoracic Surgery - University of Southern California, Los Angeles, USA , Yoon, Andrew J. Department of Internal Medicine - Division of Cardiovascular Medicine - University of Southern California, Los Angeles, USA
Abstract :
The incidence of ramp test echocardiogram-associated embolic events in the setting of therapeutic anticoagulation is likely rare and
has not been reported. We present such a case in a patient with a HeartMate II left ventricular assist device (LVAD) whose serial
head computed tomography images, deteriorating clinical course, and the multiembolic nature of the event suggest causality. If the
pretest probability of pump thrombosis in an individual LVAD patient is sufficiently high, the potential risks of performing a ramp
study echocardiogram may not be warranted, even in the setting of adequate anticoagulation.
