Anticoagulation management of left ventricular assist devices

Pediatric Acquired von Willebrand Disease With Berlin Heart Excor Ventricular Assist Device Support

“…1,2 Uncertainty persists as to the long-term management of accurate anticoagulation and control of the chronic inflammatory response now routinely seen. 3 von Willebrand factor (vWF) initiates and mediates thrombus formation by interacting with platelets at sites of vascular injury. 4 von Willebrand factor is composed of identical subunits that form proteins of varying sizes resulting in multimers of heterogeneous molecular weights; the highest molecular weight multimers tending to be the most thrombogenic.…”

Hemostatic complications associated with ventricular assist devices

“…From these trials, it was clear that VADs are associated with significant morbidity and mortality; morbidities include bleeding, infection, pump thrombosis, and stroke. An analysis of US registry data of cumulative event rates in 8644 patients found that approximately 29% experienced bleeding events and 17% experienced neurologic complications (stroke and hemorrhage) . Therefore, comorbid conditions are important in candidate selection, and prior clotting disorders or bleeding diatheses are important considerations.…”

Singularity now: using the ventricular assist device as a model for future humanrobotic physiology

“…Specifically, focus should be directed toward the development of new polymers that are immunologically and hematologically inert, as the interface between human blood and existing polymers almost immediately results in activation of the complement system and blood coagulation pathways, with particularly dire consequences observed in the cardiopulmonary bypass population. The consequences of this physiology as well as treatment will result in significant risks of morbidity and mortality [14].…”