title: Direct Thrombin Inhibitor for LVAD Thrombosis: A Closer Look.
abstract: Available options for the treatment of advanced heart failure have expanded to include the use of mechanical circulatory assist devices to improve quality of life in those both eligible and ineligible for heart transplant. Although there have been significant advancements in device technologies, anticoagulation protocols, and multidisciplinary team management, bleeding and thrombosis are the most common adverse effects. Management strategies for pump thrombosis and their outcomes vary considerably among mechanical circulatory support centers and include intensification of antithrombotic therapy (medical) and device exchange (surgical). We describe a successful case of medical therapy for pump thrombosis with bivalirudin monotherapy.
authors.affiliation: 1 Department of Pharmacy Services, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Rimsans
authors.affiliation: 1 Department of Pharmacy Services, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Katelyn W
authors.initials: KW
authors.lastname: Sylvester
authors.affiliation: 2 Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Connors
mesh_terms: D000991:Antithrombins / Q000627:therapeutic use*; D005112:Extracorporeal Circulation; D006333:Heart Failure / Q000601:surgery*; D006629:Hirudins; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013927:Thrombosis / Q000517:prevention & control*
chemical_list: D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin
keywords: LVAD; anticoagulants; bivalirudin; left ventricular assist device; thrombosis