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FIGURE 5-37 Complications of left ventricular assist devices (LVADs). (A and B) Thrombotic deposits at the pump outflow and bladder/housing junction, respectively. (C) Fungal infection in LVAD outflow graft. (D and E) Focal calcification of clinical left ventricular assist device. (D) A gross photograph. (E) Histologic section demonstrating calcification (black) (von Kossa stain). (F) Cuspal tear in inflow valve of LVAD. This patient was not a transplant candidate and had been on the LVAD as destination therapy for about 12 months before the tear occurred causing regurgitation. The valve was replaced without incident. (G) Dehiscence of the bladder of a left ventricular assist device. (A and B: Reproduced with permission from Fyfe B, Schoen FJ: Pathologic analysis of 34 explanted Symbion ventricular assist devices and 10 explanted Jarvik-7 total artificial hearts. Cardiovasc Pathol 1993; 2:187. C, D, E, and G: reproduced with permission from Schoen FJ, Edwards WD: Pathology of cardiovascular interventions, including endovascular therapies, revascularization, vascular replacement, cardiac assist/replacement, arrhythmia control and repaired congenital heart disease, in Silver MD, Gotlieb AI, Schoen FJ (eds): Cardiovascular Pathology, 3d ed. Philadelphia, WB Saunders, 2001; p 678.)