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Enterocutaneous fistula formation after cardiac transplantation due to injury from LVAD driveline migration
  1. Derek W Tan1,2,
  2. Crystal Lihong Yan3,4,
  3. Daniel Dante Yeh5 and
  4. Nina Thakkar-Rivera6,7
  1. 1Department of Anesthesiology, Jackson Memorial Hospital, Miami, Florida, USA
  2. 2Department of Anesthesiology, University of Miami Hospital and Clinics, Miami, Florida, USA
  3. 3Department of Internal Medicine, Jackson Memorial Hospital, Miami, Florida, USA
  4. 4Department of Internal Medicine, University of Miami Hospital and Clinics, Miami, Florida, USA
  5. 5Department of Surgery, University of Colorado Denver, Denver, Colorado, USA
  6. 6Department of Cardiology, Jackson Memorial Hospital, Miami, Florida, USA
  7. 7Department of Cardiology, University of Miami Hospital and Clinics, Miami, Florida, USA
  1. Correspondence to Dr Derek W Tan; derek.tan{at}


A man in his early 20s with heart failure with reduced ejection fraction secondary to non-compaction cardiomyopathy (Titin (TTN) gene mutation positive) was transitioned from left ventricular assist device (LVAD) mechanical support to heart transplantation. Transplantation was successful; however, LVAD explantation resulted in innumerable complications secondary to penetration of the driveline into the peritoneal cavity. He developed an enterocutaneous fistula which led to concurrent malnutrition, poor wound healing, systemic infection, and allograft rejection in a patient less than 1 month after heart transplantation on immunosuppression.

  • Heart failure
  • Drug therapy related to surgery
  • Infections
  • Cardiothoracic surgery
  • Nutritional support

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  • Contributors DWT, CLY, NTR and DDY were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. DWT, CLY, NTR and DDY gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.