Published online Aug 16, 2014. doi: 10.12998/wjcc.v2.i8.373
Revised: May 20, 2014
Accepted: June 10, 2014
Published online: August 16, 2014
Processing time: 185 Days and 11.2 Hours
A 50-year-old male who underwent a HeartMate II left ventricular assist device placement for ischemic cardiomyopathy presented with discolored urine and hemolysis 3 mo after the operation. His hemolysis was thought to be due to thrombosis within the pump. Imaging studies were not able to visualize a left ventricular thrombus. Medical management with anticoagulation failed and he underwent surgery for a pump exchange. Intraoperatively, a firm thrombus was found within the pump of the HeartMate II, and the color of the urine changed dramatically from cola-colored to yellow which enabled us to confirm the diagnosis.
Core tip: Diagnosis of pump thrombosis is difficult, but the intraoperative change of the color of urine may be seen almost immediately after pump exchange. This report also highlights the technical aspect of replacing the HeartMate II pump, and we believe the images are educational for the readers.