Early Aspirin Nonresponders Identification by Routine Use of Aggregometry Test in Patients With Left Ventricle Assist Devices Reduces the Risk of Pump Thrombosis

Montalto, Andrea; Comisso, Marina; Cammardella, Antonio Giovanni; Nicolò, Francesca; Gherli, Riccardo; Palermo, Alessandro; Pulcinelli, Fabio M.; Musumeci, Francesco

doi:10.1016/j.transproceed.2019.04.099

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…The interaction of pump, patient and external factors will create a unique combination in an specific individual, which requires individualized approaches prevent bleeding/ thrombotic events. For example, genetic variations are associated with differential responses to warfarin, aspirin, and clopidogrel, and identification of these patients early on could be an strategy to prevent bleeding/thromboembolic events (42).…”

Section: Exogenous Factorsmentioning

confidence: 99%

Antiplatelet and anticoagulation strategies for left ventricular assist devices

2021

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Left ventricular assist devices (LVAD) have revolutionized the management of advanced heart failure. However, complications rates remain high, among which hemorrhagic and thrombotic complications are the most important. Antiplatelet and anticoagulation strategies form a cornerstone of LVAD management and may directly affect LVAD complications. Concurrently, LVAD complications influence anticoagulation and anticoagulation management. A thorough understanding of device, patient, and management, including anticoagulation and antiplatelet therapies, are important in optimizing LVAD outcomes. This article provides a comprehensive state of the art review of issues related to antiplatelet and anticoagulation management in LVADs. We start with a historical overview, the epidemiology and pathophysiology of bleeding and thrombotic complications in LVADs. We then discuss platelet and anticoagulation biology followed by considerations prior to, during, and after LVAD implantation. This is followed by discussion of anticoagulation and the management of thrombotic and hemorrhagic complications. Specific problems, including management of heparin-induced thrombocytopenia, anticoagulant reversal, novel oral anticoagulants, artificial heart valves, and noncardiac surgeries are covered in detail.

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Section: Exogenous Factorsmentioning

confidence: 99%

Antiplatelet and anticoagulation strategies for left ventricular assist devices

2021

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“…Platelet aggregometry may be used to identify aspirin nonresponders, but is not yet routinely performed. 32 Some centers use a second platelet inhibitor; mostly dipyridamole in the United States and clopidogrel in Europe. 33…”

Section: Perioperative Anticoagulation Managementmentioning

confidence: 99%

Anticoagulation in Critically Ill Adults during Extracorporeal Circulation

et al. 2021

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(English)Extracorporeal circuits including renal replacement therapy, extracorporeal membrane oxygenation, and ventricular assist devices are increasingly used in critically ill patients. The need for anticoagulation to provide circuit patency and avoid thrombosis remains a challenging task for treating physicians. In the presence of overall low scientific evidence concerning the optimal anticoagulants, monitoring tests, and therapeutic target ranges, recommendations are largely expert opinions and most centers use individual “in-house” anticoagulation protocols. This review gives a practical view on current concepts of anticoagulation strategies in patients with extracorporeal assist devices.

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