Ideal anticoagulation for use with a left ventricular assist device.
To establish ideal anticoagulation therapy for use with a left ventricular assist device, a study was done administering various anticoagulants: heparin, argatroban, a prostacyclin analogue combined with a protease inhibitor, or a protease inhibitor alone. Cardiac asisting by LVAD without any anticoagulants results in marked activation of blood coagulation or fibrinolysis. Administration of argatroban, as well as heparin, produces a bleeding tendency. Administration of a protease inhibitor (nafamostat mesilate, FUT-175) as a sole anticoagulant induces activation of the blood coagulation system to some extent, but it is within acceptable limits. Combined administration of a prostacyclin analogue (PG) and FUT-175 is most effective in maintaining balanced blood coagulation and fibrinolysis.
Takahama
T
T
First Department of Surgery, Saitama Medical Center, Saitama Medical College, Japan.
Kanai
F
F
Onishi
K
K
Yamazaki
Z
Z
Furuse
A
A
Yoshitake
T
T
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage*; D001120:Arginine / Q000031:analogs & derivatives; D001550:Benzamidines; D004285:Dogs; D004347:Drug Interactions; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives; D005174:Factor XII / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006146:Guanidines / Q000008:administration & dosage; D006353:Heart-Assist Devices; D006493:Heparin / Q000008:administration & dosage; D010314:Partial Thromboplastin Time; D010875:Pipecolic Acids / Q000008:administration & dosage; D011480:Protease Inhibitors / Q000008:administration & dosage; D013449:Sulfonamides; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D000925:Anticoagulants; D001550:Benzamidines; D006146:Guanidines; D010875:Pipecolic Acids; D011480:Protease Inhibitors; D013449:Sulfonamides; D000979:alpha-2-Antiplasmin; D005174:Factor XII; D005340:Fibrinogen; D006493:Heparin; D001120:Arginine; D011464:Epoprostenol; C031942:argatroban; C035847:ataprost; C032855:nafamostat