Effect of high dose platelet inhibitor treatment on thromboembolism in Novacor patients.
BACKGROUND
Thromboembolism and bleeding are among the most hazardous complications following implantation of long-term left ventricular support systems. This report focuses on the effect of high dose platelet inhibitor treatment in patients with the Novacor system to prevent thromboembolic events.


METHODS
Thirty-eight (out of 58) Novacor patients (43+/-11 years old) were studied in a non-randomized manner. Postimplantation: 20 patients were treated with heparin only (control group), whereas in the other 18 patients aspirin (3x330 mg/day) and dipyridamol (3x75 mg/day) were added to the treatment protocol (aspirin group).


RESULTS
Age, body size, underlying heart disease and support interval were comparable among both groups, however, patients in the aspirin group were much sicker with regard to urgency status, postoperative right heart failure and hematologic disorders. Cerebral thromboembolic complications were lower in the aspirin group (33% of patients, 0.4+/-0.7 events) as compared to the control group (55% (P=0.18), 1.4+/-2.3 events (P=0. 048)). Non-cerebral thromboembolism of surgical relevance was rare. The incidence of bleeding complications was mildly increased in the aspirin group.


CONCLUSIONS
The addition of high dose platelet inhibitors seems to lower the incidence of thromboembolism in Novacor patients.
Schmid
C
C
Department of Cardiothoracic Surgery, Westfälische Wilhelms-University Münster, Germany. schmid@uni-muenster.de
Wilhelm
M
M
Rothenburger
M
M
Nabavi
D
D
Deng
M C
MC
Hammel
D
D
Scheld
H H
HH
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006353:Heart-Assist Devices; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013923:Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin