Intravenous thrombolytic therapy for patients with ventricular assist device thrombosis: An attempt to avoid reoperation
Open Access
- 1 January 2016
- journal article
- case report
- Published by Medknow in Annals of Cardiac Anaesthesia
- Vol. 19 (1), 192-6
- https://doi.org/10.4103/0971-9784.173047
Abstract
A growing number of patients are undergoing prolonged management of advanced heart failure with the use of continuous flow left ventricular assist devices (LVADs). Subsequently, an increasing number of patients are presenting with complications associated with these devices. Based on an analysis of three major LVAD institutions, the number of patients developing LVAD pump thrombosis may be much higher than originally projected. [1],[2] The management of this highly feared complication continues to be challenging, as the population of LVAD patients is very heterogeneous and heavily burdened with comorbidities. The standard protocol of increasing anticoagulation may fail to achieve successful resolution of thrombus. Difficulty and poor prognosis may make reoperation less than desirable. Here, we present a case of successful thrombolysis following intravenous administration of tissue plasminogen activator in the Intensive Care Unit setting.Keywords
This publication has 18 references indexed in Scilit:
- Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis: A Clinical DilemmaArtificial Organs, 2015
- Should device replacement be the first choice strategy in continuous-flow left ventricle assist device thrombosis? Analysis of 9 events and results after endoventricular thrombolysisInternational Journal of Cardiology, 2015
- Management of anticoagulation and antiplatelet therapy in patients with left ventricular assist devicesJournal of Thrombosis and Thrombolysis, 2014
- Acquired von Willebrand Syndrome in Patients With a Centrifugal or Axial Continuous Flow Left Ventricular Assist DeviceJACC: Heart Failure, 2014
- Unexpected Abrupt Increase in Left Ventricular Assist Device ThrombosisNew England Journal of Medicine, 2014
- Ambient hemolysis and activation of coagulation is different between HeartMate II and HeartWare left ventricular assist devicesThe Journal of Heart and Lung Transplantation, 2014
- An analysis of pump thrombus events in patients in the HeartWare ADVANCE bridge to transplant and continued access protocol trialThe Journal of Heart and Lung Transplantation, 2013
- Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) analysis of pump thrombosis in the HeartMate II left ventricular assist deviceThe Journal of Heart and Lung Transplantation, 2013
- Algorithm for the diagnosis and management of suspected pump thrombusThe Journal of Heart and Lung Transplantation, 2013
- What is the optimal anticoagulation in patients with a left ventricular assist device?Interactive CardioVascular and Thoracic Surgery, 2012