Key result
Covered stenting fails to stop LVAD outflow graft-induced driveline bleeding, requiring surgical repair.
Why the study?
Bleeding from the driveline exit site in patients with an implanted left ventricular assist device is uncommon, and severe hemorrhage caused by outflow graft erosion from the driveline cable is a rare diagnostic and therapeutic challenge.
Case Report (n=1)
Bleeding from an LVAD driveline exit site can conceal rare, life-threatening outflow graft erosion by the driveline cable, requiring prompt multidisciplinary evaluation and potentially surgical repair if endovascular stenting fails.
LVAD driveline bleeding warrants evaluation for outflow graft erosion; leaves open optimal surveillance or prevention strategies.
BACKGROUND: Bleeding from the exit site of the driveline in patients with an implanted left ventricular assist device is uncommon. We report an unusual case of severe hemorrhage caused by erosion of the outflow graft by the driveline cable in a 51-year-old man. CASE SUMMARY: The patient presented with severe bleeding from the driveline exit site, which stopped after manual compression but restarted after 24 hours. Computed tomography angiography demonstrated a contained rupture of the outflow graft with pseudoaneurysm formation and a hematoma extending along the driveline tunnel, likely secondary to graft erosion. A covered stent was placed; however, bleeding persisted postintervention, ultimately requiring surgical repair. DISCUSSION: We report a rare case of outflow graft erosion caused by the driveline cable, presenting a diagnostic and therapeutic challenge. TAKE-HOME MESSAGE: Bleeding from the driveline as a late-stage complication after left ventricular assist device implantation may conceal a serious underlying pathology and requires prompt multidisciplinary evaluation and intervention.
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Peto-Madew et al. (2026) conducted a case report in LVAD outflow graft perforation due to erosion from the internal driveline cable (n=1). Covered stent placement followed by surgical repair was evaluated on Resolution of bleeding from the driveline exit site. Covered stent placement failed to resolve severe driveline bleeding caused by LVAD outflow graft erosion in a 51-year-old man, ultimately requiring surgical repair.
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