Antithrombotic therapy in pediatric ventricular assist devices: Multicenter survey of the European EXCOR Pediatric Investigator Group

The International Journal of Artificial Organs
Oliver MieraAntonio Amodeo

Abstract

Mechanical circulatory support for pediatric heart failure patients with the Berlin Heart EXCOR ventricular assist system is the only approved and established bridging strategy for recovery or heart transplantation. In recent years, the burden of thromboembolic events has led to modifications of the recommended antithrombotic therapy. Therefore, we aimed to assess modifications of antithrombotic practice among the European EXCOR Pediatric Investigator Group members. We sent a questionnaire assessing seven aspects of antithrombotic therapy to 18 European hospitals using the EXCOR device for children. Returned questionnaires were analyzed and identified antithrombotic strategies were descriptively compared to "Edmonton protocol" recommendations developed for the US EXCOR pediatric approval study. Analysis of 18 received surveys revealed substantial deviations from the Edmonton protocol, including earlier start of heparin therapy at 6-12 h postoperatively and in 50% of surveyed centers, monitoring of heparin effectiveness with aPTT assay, administering vitamin K antagonists before 12 months of age. About 39% of centers use higher international normalized ratio targets, and platelet inhibition is changed in 56% including the use of...Continue Reading

References

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Citations

Dec 4, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Christina J VanderPluymJennifer Conway
Jan 5, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Rene SchrammJan F Gummert
Dec 28, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Oliver MieraTilman Humpl
Sep 6, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Theo M M H de ByUNKNOWN Contributing clinicians
Nov 18, 2019·Heart Failure Reviews·Giuseppe ComentaleGabriele Iannelli
Aug 3, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Christina J VanderPluymJennifer Conway
Jan 15, 2020·Deutsches Ärzteblatt International·Jan F GummertVolkmar Falk

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Software Mentioned

EXCOR

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