Bilateral endovascular uterine artery embolization for dysfunctional uterine artery bleeding with heartware left ventricular assist support device
Zümrüt Tuba Demirözü, Özlem Akgül, Arzu Poyanlı, Deniz Süha Küçükaksu.
Abstract
We report a 40-year-old lady with post-partum cardiomyopathy for more than 4 years and had left ventricular assist device (LVAD)
implantation. She was New York Heart Association Class IV and Interagency Registry for Mechanically Assisted Circulatory Support Level
I. She had HeartWare (HeartWare Inc, Framingham, MA, USA) LVAD implantation. She was admitted to emergency department with
dysfunctional uterine bleeding with a hemoglobin level 3 gr/dL and a hematocrit level 10%, 3 months postoperatively. The ultrasonographic
evaluation revealed blood coagulum in the uterine cavity, she was diagnosed with dysfunctional uterine bleeding, and hospitalized. Since
there was a probability of LVAD pump thrombosis, a surgical intervention was not planned. Gonadotropin releasing hormone analogue
therapy and embolisation of bilateral uterine arteries prevented further dysfunctional uterine bleeding. We report the first case in the
literature with advanced heart failure supported with LVAD and bilateral uterine artery embolization due to dysfunctional uterus artery
bleeding with an endovascular procedure.
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