title: Anticoagulation therapy for a LVAD patient with acquired warfarin resistance.
abstract: Anticoagulation therapy with warfarin is essential for postoperative management in patients with left ventricular assist device (LVAD). In this manuscript, we report the case of a patient who developed warfarin resistance after LVAD implantation. Although we administered a novel anticoagulant drug in addition to warfarin and aspirin therapy, the patient developed a major stroke. The patient needed continuous intravenous heparinization until heart transplantation for approximately 2 years. Meticulous management of anticoagulation therapy is essential for a LVAD with warfarin resistance. To our best knowledge, our case is the first case of warfarin resistance in a patient with LVAD.
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka, 2-2, Suita, Osaka, 565-0087, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshioka
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka, 2-2, Suita, Osaka, 565-0087, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Toda
authors.affiliation: Department of Cardiology, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hidaka
authors.affiliation: Department of Pharmacology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka, 2-2, Suita, Osaka, 565-0087, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka, 2-2, Suita, Osaka, 565-0087, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Domae
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka, 2-2, Suita, Osaka, 565-0087, Japan. yoshioka@surg1.med.osaka-u.ac.jp.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008661:Metabolism, Inborn Errors; D020521:Stroke / Q000601:surgery
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: Anticoagulation therapy; Left ventricular assist device; Warfarin