Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II).
OBJECTIVE
This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function.


BACKGROUND
HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies.


METHODS
We measured agonist-induced platelet aggregation in 16 patients on HMII support.


RESULTS
The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves.


CONCLUSIONS
The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.
Klovaite
Jolanta
J
Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Denmark.
Gustafsson
Finn
F
Mortensen
Svend A
SA
Sander
Kåre
K
Nielsen
Lars B
LB
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001792:Blood Platelets; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006470:Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D010975:Platelet Aggregation Inhibitors; D012310:Ristocetin / Q000009:adverse effects; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000628:therapy*; D016277:Ventricular Function, Left; D055815:Young Adult; D014841:von Willebrand Factor / Q000502:physiology*
D000900:Anti-Bacterial Agents; D010975:Platelet Aggregation Inhibitors; D014841:von Willebrand Factor; D012310:Ristocetin