Key result
LMWH and antiplatelet therapy for INCOR LVADs is linked to ~60% bridge-to-transplantation success.
Why the study?
Long-term management strategies for INCOR left ventricular assist devices using alternatives to oral anticoagulants require evaluation.
Is a long-term regimen of low molecular weight heparin and antiplatelet therapy feasible as an alternative to oral anticoagulants in patients with an implantable left ventricular assist device?
Observational (n=10)
Is a long-term regimen of low molecular weight heparin and antiplatelet therapy feasible as an alternative to oral anticoagulants in patients with an implantable left ventricular assist device?
Long-term management of INCOR assist devices using a combination of LMWH and antiplatelet therapy is feasible and may serve as an alternative to oral anticoagulants.
Should not yet change LVAD anticoagulation practice; leaves open optimal regimens for bridge-to-transplant.
Between January 2004 and December 2005, out of 14 patients with decompensated heart failure who were treated with an INCOR left ventricular assist device (Berlin Heart AG, Berlin, Germany), 10 patients were kept on a long-term regime of low molecular weight heparin (LMWH) and antiplatelet therapy. The treatment objective was bridge-to-transplantation. All patients received LMWH in therapeutic doses according to body weight, in combination with daily aspirin 160 mg, clopidogrel 75 mg, and three times dipyridamole 75 mg. Effectiveness of the low molecular weight regime was monitored through measurement of antifactor Xa activity (base and peak levels). Antiplatelet therapy was monitored through weekly platelet function tests. Within this group of 10 patients, six patients successfully received transplants and four patients died, the latest death after 405 days of INCOR support. Causes of death were sepsis, intestinal hemorrhage, acute right ventricular failure, and one major stroke. Long-term management of INCOR assist devices using a combination of LMWH and antiplatelet therapy is feasible. This treatment strategy can serve as an alternative to oral anticoagulants.
No takes yet. Share an insight, caveat, or question.
Meuris et al. (2007) conducted an observational in Decompensated heart failure (n=10). Low molecular weight heparin (LMWH) and antiplatelet therapy was evaluated on Bridge-to-transplantation success. Long-term management of an INCOR left ventricular assist device using LMWH and antiplatelet therapy resulted in successful bridge-to-transplantation in 60% (6 of 10) of patients.