Retained outflow graft following the explantation of left ventricular assist device

A 21-year-old man underwent coronary angiography because he presented with chest pain, serum troponin elevation, and a decline in left ventricular ejection fraction. His medical history included dilated cardiomyopathy, left ventricular assist device implantation (Heartmate II) 48 months prior, and the explantation of this device because of recovery 5 months prior (Figs. 1 and 2). Coronary angiography showed normal coronary arteries. During right coronary artery canalization attempts, the Judkins right catheter indwelled outside of the aorta easily, but we could not ascertain the reason for this. However, we observed a faint contrast efflux from the ascending aorta during nonselective aortography (Video 1). The angiography procedure concluded with no complications. Subsequently, we reviewed medical and operation records in detail. Although the pump of the device had been withdrawn, outflow graft had been retained in situ following its detachment from the pump. The inflow cannula had been withdrawn, and a plug had been placed within the retained sewing ring. The distal ostia of the outflow graft had been closed using a primary stitch, whereas the aortic ostia had remained open