Intracranial bleed during bridge to transplant may not preclude a successful result.
We report the case of a 29-year-old man who suffered sub-arachnoid bleeding while stabilized on a biventricular assist device as a bridge to cardiac transplantation. We adjusted his anti-coagulation therapy to control the bleeding and to concurrently minimize thrombosis while on support. He underwent 2 craniotomy operations to evacuate sub-arachnoid hematomas, and he underwent a subsequent operation to debride and close the dura. Eighteen days later, he underwent successful orthotopic heart transplant and was discharged to home 3 weeks post-transplant.
Hoy
F B
FB
Division of Cardiovascular Medicine and Surgery, St. Francis Medical Center, Peoria, Illinois, USA.
Clemson
B S
BS
Geiss
D M
DM
Bond
L M
LM
Linett
C E
CE
Gomez
R C
RC
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001780:Blood Coagulation Tests; D003399:Craniotomy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D013345:Subarachnoid Hemorrhage / Q000209:etiology* / Q000601:surgery
D000925:Anticoagulants