title: The hemostatic history of a 15-month-old child implanted with a Berlin heart left ventricular assist device.
abstract: We documented the hemostatic changes associated with placement of a EXCOR Berlin Heart left ventricular assist device in a 15-month-old child before heart transplantation. The development of hypercoagulability was rapid, manifested first by a plasmatic and subsequently platelet-mediated increase in coagulation kinetics and strength that persisted for weeks. The patient had no thrombotic complications for 6 wk before transplant but required extraordinary blood product administration to achieve hemostasis secondary to aggressive, multimodal anticoagulation. In summary, when proscribing anesthetic and surgical management of patients with a Berlin Heart, consideration of hypercoagulable features and anticoagulant therapy must be made to maximize patient safety.
authors.affiliation: Department of Anesthesiology, The University of Alabama at Birmingham, Birmingham, AL 35294-2172, USA.
authors.forename: Brad L
authors.initials: BL
authors.lastname: Steenwyk
authors.forename: James K
authors.initials: JK
authors.lastname: Kirklin
authors.forename: William Q
authors.initials: WQ
authors.lastname: Gurley
authors.forename: Vance G
authors.initials: VG
authors.lastname: Nielsen
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D001777:Blood Coagulation; D002648:Child; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000628:therapy; D016027:Heart Transplantation / Q000379:methods*; D006353:Heart-Assist Devices; D006487:Hemostasis; D006801:Humans; D007223:Infant; D013927:Thrombosis / Q000517:prevention & control; D013997:Time Factors
chemical_list: D000925:Anticoagulants