References
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  2. Uriel N, Colombo PC, Cleveland JC et al. Hemocompatibility-Related Outcomes in the MOMENTUM 3 Trial at 6 Months: A Randomized Controlled Study of a Fully Magnetically Levitated Pump in Advanced Heart Failure. Circulation 2017;135:2003-2012.
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  6. Abraham J, Remick JD, Caulfield T et al. Left ventricular assist device outflow cannula obstruction treated with percutaneous endovascular stenting. Circ Heart Fail 2015;8:229-30.
  7. Berg KB, Klodell CT. Outflow graft thrombectomy during HeartMate II left ventricular assist device exchange. Interactive CardioVascular and Thoracic Surgery 2014;19:714-715.Figure Legends:Figure. (A) LVAD parameters derived from device interrogation before and at the time of low-flow alarms, (B) Cardiac CT tomography with 3D reconstruction depicting the site of outflow obstruction (blue arrow), (C) CT angiography 6 months prior without evidence of outflow cannula obstruction, (D) Cardiac CT tomography (coronal axis) suggestive of outflow cannula obstruction. Pathology panels: Cross section of the distal outflow cannula at the bend relief shows a clot consisting of fibrin and blood in the lumen (E) with corresponding representative H&E section (F). Microscopic examination revealed exuberant giant cell reaction between the Dacron and cannula (G). Fibrin platelet material in the lumen (H) does not demonstrate evidence of thrombus organization, confirmed by immunohistochemical stain for vimentin (I). Cross section of the proximal outflow graft at the bend relief shows a clot consisting of fibrin and blood in the lumen (J) and with corresponding representative H&E section (K). Microscopic examination revealed fibrin platelet material between the Dacron and bend relief without evidence of giant cell reaction (L). Clot material in the lumen demonstrated thrombus organization (M) confirmed by immunohistochemical stain for vimentin (N).