Thrombolysis for suspected intrapump thrombosis in patients with continuous flow centrifugal left ventricular assist device.
The current recommended anticoagulation regimen during continuous flow centrifugal left ventricular device support is a combination of antiplatelet therapy as well as oral anticoagulation. Despite this, pump thrombosis occurs in rare situations. We report the risk factors and nonsurgical management and outcomes of five patients implanted with continuous flow centrifugal left ventricular assist devices who displayed clinical, hemodynamic, and laboratory features of intrapump thrombosis. This information may support the use of intravenous thrombolytics for suspected pump thrombus in these newer generation devices.
Heart Failure and Transplant Unit, Failure and Transplant Unit, St. Vincent’s Hospital, Victoria St., Darlinghurst, Sydney, NSW 2010, Australia.
Kavitha
K
Muthiah
Desiree
D
Robson
Peter S
PS
Macdonald
Anne M
AM
Keogh
Eugene
E
Kotlyar
Emily
E
Granger
Kumud
K
Dhital
Phillip
P
Spratt
Paul
P
Jansz
Christopher S
CS
Hayward
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006439:Hemodynamics; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012307:Risk Factors; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors