Pseudoaneurysm rupture presenting as bleeding from the cannulation site in a paediatric patient with dilated cardiomyopathy and congenital skin lesions requiring EXCOR® Paediatric ventricular assist device: a case report

Abstract

Abstract Background EXCOR® Paediatric is used worldwide as a bridge-to-transplant treatment. It provides improved patient stability during the waiting period compared with previous ventricular assist device (VAD). However, investigations into complications which may occur among the paediatric population during long waiting periods are still sparse. Case summary We describe the case of a 7-year-old girl who presented with severe heart failure due to dilated cardiomyopathy. She also had a skin lesion which appeared soon after birth. She had received an EXCOR® implant and was waiting for heart transplant. Her skin lesion worsened after implantation and she suffered recurrent infections. Multiple bleeding episodes from the cannulation site occurred; therefore, surgical exploration of the bleeding was performed. She passed away during the procedure due to massive bleeding caused by rupture of a pseudoaneurysm caused by blood-stream infection. Discussion Patients with skin disease may be at increased risk of infection when on a VAD. Infections that occur during VAD therapy may cause serious complications such as pseudoaneurysm. The possibility of pseudoaneurysm should be considered when bleeding occurs in a patient on VAD.