A patient was admitted in cardiogenic shock and a constant decrease of pump flow requiring combined inotropic support. To evaluate the cause, echocardiography and a ramp test were performed. The results suggested a LVAD related problem - particularly a suspected outflow graft obstruction. Wether CT scan nor angiography confirmed the assumption. However, a post-mortem LVAD examination revealed an outflow obstruction caused by a fungal thrombus formation invisible for standard imaging procedures.

中文翻译：

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缺少由真菌感染引起的 HeartMate 3 LVAD 流出道移植物阻塞中的盲点

一名患者因心源性休克和泵流量持续减少而入院，需要联合正性肌力支持。为了评估原因，进行了超声心动图和斜坡测试。结果表明存在与 LVAD 相关的问题——尤其是疑似流出道移植物阻塞。CT扫描和血管造影证实了这一假设。然而，尸检 LVAD 检查显示流出阻塞是由标准成像程序看不到的真菌血栓形成引起的。