In the setting of HeartWare left ventricular assist device (HVAD, Medtronic) implantation, pre-pump blood flow obstruction has been described due to intraventricular thrombus formation occluding the inflow cannula. This phenomenon often evolves in suboptimal pump performance, and requires prompt management to prevent its progression. However, to date, effective strategies and tools for the diagnosis and management of this complication are poorly described. We report a case of HVAD inflow cannula obstruction that drove later in-pump thrombosis and, eventually, complete cannula occlusion, and discuss gap of knowledge and limitations of currently available diagnostic and therapeutic tools in this scenario. Furthermore, we reinforce the value of time-frequency analysis of the HVAD log files to early identify abnormal pump operation associated with inflow cannula obstruction despite unremarkable trends of pump parameters.

在HeartWare左心室辅助设备（HVAD，Medtronic）植入的情况下，由于心室内血栓形成阻塞了流入套管，已经描述了泵前血流阻塞。这种现象通常会导致泵性能不佳，并且需要及时进行管理以防止其发展。然而，迄今为止，关于这种并发症的诊断和管理的有效策略和工具的描述很少。我们报告了一例HVAD流入套管阻塞的情况，该阻塞导致后来的泵内血栓形成，并最终使套管完全闭塞，并讨论了这种情况下的知识差距以及当前可用的诊断和治疗工具的局限性。此外，