Thrombolytic therapy for thrombosis of continuous flow ventricular assist devices

Journal of Cardiac Failure
Kelly SchlendorfJoseph G Rogers

Abstract

Despite chronic systemic anticoagulation, advanced heart failure patients treated with a continuous-flow left ventricular assist device (LVAD) remain at risk for pump thrombosis. Pump thrombosis may initially be suspected in the setting of clinical and biochemical evidence for intravascular hemolysis, putatively related to shear stress on red blood cells propelled through a partially occluded pump. Limited data exist to guide management in these patients. We present a series of 8 LVAD patients who presented with intravascular hemolysis secondary to pump thrombosis who were treated with intraventricular thrombolytic therapy. In 3 patients, thrombolytic therapy led to complete and lasting resolution of hemolysis, suggesting successful dissolution of pump thrombus. In the remaining 5 patients, thrombolytic therapy ultimately failed to halt or reverse pump thrombosis and hemolysis: 1 patient required emergent pump exchange, 2 patients progressed to cardiogenic shock and died, 1 patient suffered a debilitating stroke after which care was withdrawn, and 1 patient underwent cardiac transplantation. In the setting of LVAD thrombosis, thrombolytic therapy is an alternate treatment strategy in a subset of patients. Candidacy for this alt...Continue Reading

References

Mar 12, 2008·Expert Review of Medical Devices·Gaurav Girdhar, Danny Bluestein
Oct 18, 2008·Stroke; a Journal of Cerebral Circulation·Nils WahlgrenUNKNOWN Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy Investigators
Nov 26, 2008·The Journal of Thoracic and Cardiovascular Surgery·Ranjit JohnAndrew Boyle
Jan 22, 2009·The Journal of Thoracic and Cardiovascular Surgery·Sheri CrowLyle Joyce
Sep 1, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Andrew J BoyleRanjit John
Nov 19, 2009·The New England Journal of Medicine·Mark S SlaughterUNKNOWN HeartMate II Investigators
Dec 1, 2009·The Journal of Thoracic and Cardiovascular Surgery·Castigliano M BhamidipatiJohn A Kern
Apr 20, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Mark S SlaughterFrancis D Pagani
Sep 14, 2010·Journal of Cardiovascular Translational Research·Mark S Slaughter
Feb 1, 2011·The Journal of Thoracic and Cardiovascular Surgery·Michael S KiernanNavin K Kapur
Oct 15, 2011·Stroke; a Journal of Cerebral Circulation·Christoph GumbingerPeter Ringleb
Dec 25, 2012·The Annals of Thoracic Surgery·Nader MoazamiUNKNOWN HeartMate II Investigators
Jun 26, 2013·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Daniel J GoldsteinUlrich Jorde
Apr 11, 2014·The New England Journal of Medicine·J Eduardo RameMichael A Acker

❮ Previous
Next ❯

Citations

Mar 17, 2015·JACC. Heart Failure·Randall C Starling
Oct 12, 2015·JACC. Heart Failure·J Eduardo Rame, Edo Y Birati
Nov 7, 2015·Current Problems in Cardiology·Navin K KapurMichael S Kiernan
Nov 19, 2015·Cardiovascular Engineering and Technology·William D ClarkWilliam M DeCampli
May 20, 2015·The Journal of Thoracic and Cardiovascular Surgery·Sirtaz AdatyaPeter M Eckman
Jan 9, 2015·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·John M StulakSimon Maltais
Feb 3, 2015·Current Treatment Options in Cardiovascular Medicine·Edo Y Birati, J Eduardo Rame
Jun 28, 2016·Critical Care : the Official Journal of the Critical Care Forum·Ayan SenJ Christopher Farmer
Jan 7, 2017·European Heart Journal. Acute Cardiovascular Care·Benedikt SchrageMarkus J Barten
Oct 22, 2016·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Jessica RimsansJean M Connors
Dec 17, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Geetanjali DangLisa Baumann Kreuziger
May 29, 2018·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Jessica D Nicholson, Yaman Kaakeh
Feb 27, 2017·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Atul Kumar
Jun 21, 2015·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Elizabeth HohnerMichael P Moranville
Mar 26, 2019·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Amy A LevesqueJean M Connors
Jun 5, 2018·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Jessica G Y LucJohn M Stulak
Dec 31, 2019·The International Journal of Artificial Organs·Noelia Bouzas-CruzStephan Schueler
Jan 16, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Cenk OezpekerMichiel Morshuis
Jun 4, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Serkan ErtugayMustafa Ozbaran
Aug 5, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jonathan ByrnesAngela Lorts
Jun 13, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Devin ChetanJennifer Conway
Apr 4, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Grant W RowlandsJames F Antaki
Oct 21, 2015·Current Cardiology Reports·Julie L Rosenthal, Randall C Starling
Mar 26, 2015·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Matthaeus ZerdzitzkiDaniele Camboni
Nov 24, 2016·Current Heart Failure Reports·Ann B NguyenSirtaz Adatya
Aug 5, 2017·The International Journal of Artificial Organs·Paolo CentofantiMauro Rinaldi
Jul 2, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Angela LortsAntonio Amodeo
Aug 19, 2018·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Ya-Li ZhouRui Li

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Related Papers

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Robert J MentzChetan B Patel
Journal of the American College of Cardiology
Francis D PaganiHeartMate II Investigators
Journal of the American College of Cardiology
Ohad ZivHasan Garan
© 2021 Meta ULC. All rights reserved