Fibrin Sealant Patch for the Management of Intractable Bleeding From an LVAD Apex Cannula

Background: Intractable bleeding from the apical cannulation site of a left ventricular assist device (LVAD) is a dreaded complication. Case report: A 52-year-old male suffering from dilative cardiomyopathy (DCM) with fixed pulmonary hypertension underwent reoperative LVAD implantation after previous mitral valve surgery. The patient underwent three rethoracotomies for bleeding from the apex cannulation site without achieving hemostasis. Conventional techniques and application of fibrin sealants and polymeric sealing devices did not fix the problem. The bleeding stopped after application of the EVARREST (R) Fibrin Sealant Patch (FSP), and he needed no further transfusions. Conclusion: This patch might become a useful tool for intractable bleeding problems in LVAD surgery.