title: Left ventricular assist device pump thrombosis: is there a role for glycoprotein IIb/IIIa inhibitors?
abstract: Left ventricular assist devices (LVADs) fill a critical need by providing circulatory support to patients with end-stage heart failure who are either ineligible for heart transplant or too ill to stably wait for an eventual donor organ. Furthermore, they are critical to the arsenal of the heart failure cardiologist, given the supply/demand mismatch for donor organs. Unfortunately, these devices present their own complications. Despite antiplatelet agents and systemic anticoagulation, a number of patients present with pump thrombosis, a life-threatening event requiring either pump exchange or treatment with systemic thrombolytics. In an effort to avoid these morbid therapies, glycogen IIb/IIIa inhibitors, which have both antiplatelet and thrombolytic properties, have been proposed to treat pump thrombosis. We report here the largest case series using these agents and document a previously unreported high failure rate with this therapy.
authors: From the *Division of Cardiology, Yale School of Medicine, New Haven, Connecticut; and †Section of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut.
authors: Lavanya
authors: L
authors: Bellumkonda
authors: Lakshman
authors: L
authors: Subrahmanyan
authors: Daniel
authors: D
authors: Jacoby
authors: Pramod
authors: P
authors: Bonde
mesh_terms: D000328:Adult; D000077542:Eptifibatide; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077542:Eptifibatide