Advanced fusion imaging in the percutaneous decommissioning of a left ventricular assist device

Here, we describe the first use of fusion imaging for percutaneous decommissioning of an LVAD. A 57-year-old male with pump thrombosis and hemolysis underwent occlusion of the outflow graft of his LVAD using three Amplater devices. Fusion imaging enabled the accurate placement and deployment of several closure devices in order to achieve immediate pump deactivation. The patient experienced a rapid improvement in hemodynamic and hemolytic parameters, making the percutaneous treatment of an LVAD a reasonable alternative to the classical open procedure. • LVAD thrombosis may present with hemolysis, heart failure, jaundice, or sudden death. • Early recognition is paramount in the diagnosis and treatment of such pathology. • Use of vascular plugs in percutaneous LVAD decommissioning offers an option to surgery for high-risk patients. • CT-guided fusion imaging supports accurate execution of complex structural procedures.