[Clinical assessment of anticoagulation therapy during left ventricular assist with artificial heart: induction with protease inhibitor].
Left ventricular assist device was attached to five patients suffered from severe low cardiac output after open heart surgery. In two patients, anticoagulation therapy with heparin started just after the operation. Repeated operations for hemostasis were required because of massive bleeding in these two patients. Anticoagulation therapy was not performed in another one, and thrombus formation in the device was recognized in this patient. In the other two patients, anticoagulation therapy was started with large dose of protease inhibitor (gabexate mesilate or nafamstat mesilate). Heparin infusion was combined with protease inhibitor during the period of weaning from the device. Thrombosis and massive bleeding were not recognized in these two patients, and they were able to wean from the device successfully.
Masuda
M
M
Fukamachi
K
K
Matsuzaki
K
K
Asou
T
T
Toshima
Y
Y
Kinoshita
K
K
Mayumi
H
H
Tominaga
R
R
Miyamoto
K
K
Komori
M
M
D000368:Aged; D001243:Assisted Circulation; D001550:Benzamidines; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D016670:Gabexate; D006146:Guanidines / Q000627:therapeutic use; D006354:Heart, Artificial; D006353:Heart-Assist Devices; D006470:Hemorrhage / Q000517:prevention & control; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D011480:Protease Inhibitors / Q000627:therapeutic use*; D013927:Thrombosis / Q000517:prevention & control
D001550:Benzamidines; D006146:Guanidines; D011480:Protease Inhibitors; D016670:Gabexate; D006493:Heparin; C032855:nafamostat