Single-center experience on anti-thrombotic strategies for left ventricular assist device patients
10.3760/cma.j.cn112148-20231019-00350
- VernacularTitle:左心室辅助装置植入术后抗栓策略的单中心经验
- Author:
Yahong YU
1
;
Xiaocheng LIU
;
Zhigang LIU
;
Yu SONG
;
Wei WANG
;
Kegang JIA
;
Yunqiang ZHANG
;
Zhengqing WANG
Author Information
1. 泰达国际心血管病医院药剂科，天津 300457
- Keywords:
Heart failure;
Left ventricular assist device;
Antithrombotic strategy;
Anti-platelet therapy;
Bleeding;
Thromboembolism
- From:
Chinese Journal of Cardiology
2024;52(5):500-504
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Preliminary explore the safety and efficacy of using only vitamin K antagonists without antiplatelet therapy after left ventricular assist devices (LVAD) implantation.Methods:This is a cohort study. Patients who underwent HeartCon LVAD implantation in TEDA International Cardiovascular Hospital from September 2020 to September 2022 were included. Oral warfarin sodium was given on postoperative days 1 to 2, with the target international standardized ratio (INR) of 2.0 to 2.5. Follow-up until September 2022, survival, INR level and occurrence of bleeding and thrombosis were recorded. Survival analysis was performed by the Kaplan-Meier method (censored for heart transplantation).Results:A total of 22 patients, including 16 male patients (72.7%), aged (51.0±13.3) years, were included. The duration of HeartCon LVAD support was (458±166) days and the INR during support was 2.28±0.26. One patient underwent the heart transplant at 307 d after implantation. One patient (4.5%) occured cardiac tamponade, two patients (9.1%) occured hemorrhagic stroke, five patients (22.7%) occured gastrointestinal bleeding, four patients (18.2%) occured gingival hemorrhage, two patients (9.1%) occured epistaxis, one patient (4.5%) occurred ischemic stroke, one patient (4.5%) occured pump thrombosis, and one patient (4.5%) occured aortic valve thrombosis. The survival rates were 100%, 95%, 95%, and 95% at 3 months, 6 months, 1 year, 2 years after implantation respectively.Conclusion:The single antithrombotic strategy using warfarin (target INR 2.0-2.5) without antiplatelet for patients with implantations of HeartCon type LVAD may be safe and effective.
