Abstract
We successfully managed a splenic injury and delayed splenic rupture in a patient with an implantable left ventricular assist device (iLVAD). A 42-year-old man with an iLVAD for idiopathic dilated cardiomyopathy was admitted to our department complaining of dizziness. Laboratory data showed severe anemia, and computed tomography demonstrated a traumatic splenic injury. Following conservative treatment, partial splenic embolization was performed. Fifteen days after the intervention, the patient went into hemorrhagic shock due to delayed splenic rupture. Emergency total splenic embolization was performed, and total splenectomy was conducted later to prevent re-bleeding or abscess formation. His postoperative course was uneventful, and he was discharged on postoperative day 22. Finally, he underwent orthotropic heart transplantation without post-splenectomy sepsis or thrombotic complications 472 days after splenectomy. Splenic injury should be considered as a possible complication of iLVAD. In addition, careful follow-up after transcatheter arterial embolization for splenic injury is essential for managing delayed splenic rupture.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: spleen and liver (1994 revision). J Trauma. 1995;38:323–4.
Sosada K, Wiewiora M, Piecuch J. Literature review of non-operative management of patients with blunt splenic injury: impact of splenic artery embolization. Wideochir Inne Tech Maloinwazyjne. 2014;9:309–14.
Kindo M, Gerelli S, Billaud P, Epailly E, Mazucotelli JP, Eisenmann B. Splenic injury during biventricular assist device support as bridge to transplantation. Interact CardioVasc Thorac Surg. 2007;6:233–4.
Lin WC, Chen YF, Lin CH, Tzeng YH, Chiang HJ, Ho YJ, Shen WC, Chen JH. Emergent transcatheter arterial embolization in hemodynamically unstable patients with blunt splenic rupture. Acad Radiol. 2008;15:201–8.
Johnson N, Cevasco M, Askari R. Delayed presentation of perisplenic abscess following arterial embolization. Int J Surg Case Rep. 2013;4:108–11.
Garatti A, Bruschi G, Colombo T, Russo C, Milazzo F, Catena E, Lanfranconi M, Vitali E. Noncardiac surgical procedures in patient supported with long-term implantable left ventricular assist device. Am J Surg. 2009;197:710–4.
Bennett SK, Sheridan B, Meyers MO. Laparoscopic splenectomy despite the presence of a left ventricular assist device. Am Surg. 2010;76:1306–8.
Samoukovic G, Vassiliou M, Glannetti N, Al-Sabah S, Lash V, Cecere R. Laparoscopic splenectomy in a patient with a Heartmate(®) II left ventricular assist device. J Laparoendosc Adv Surg Tech A. 2011;21:553–8.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Kitahara, H., Nawata, K., Kinoshita, O. et al. A delayed splenic rupture after transcatheter arterial embolization required total splenectomy in a patient with an implantable left ventricular assist device. J Artif Organs 19, 392–395 (2016). https://doi.org/10.1007/s10047-016-0921-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10047-016-0921-x