Thromboembolic complications during weaning from right ventricular assist device support.
We report on two patients who experienced life-threatening thromboembolic complications during prolonged weaning from Levitronix CentriMag right ventricular assist device support. Right ventricular assist device flow in both patients was reduced below 2 L/min for a period of 72 or 36 h to closely monitor patients' hemodynamics and echocardiography because the extent of right ventricular recovery was difficult to assess. Thrombus formation occurred despite adjusting the heparin dosage to achieve partial prothrombin time values between 60 and 70 s. Periods of reduced flow during Levitronix CentriMag support must be kept short, and an additional bolus dose of heparin should be considered.
Velik-Salchner
Corinna
C
Department of Anaesthesiology and Intensive Care Medicine, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. corinna.velik@i-med.ac.a
Hoermann
Christoph
C
Hoefer
Daniel
D
Margreiter
Josef
J
Mair
Peter
P
D054058:Acute Coronary Syndrome / Q000150:complications / Q000628:therapy; D001026:Coronary Artery Bypass; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000628:therapy; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D012770:Shock, Cardiogenic / Q000150:complications / Q000628:therapy; D013923:Thromboembolism / Q000209:etiology*; D014057:Tomography, X-Ray Computed