Issue |
J Extra Corpor Technol
Volume 48, Number 1, March 2016
|
|
---|---|---|
Page(s) | 27 - 34 | |
DOI | https://doi.org/10.1051/ject/201648027 | |
Published online | 15 March 2016 |
Original Articles
Multi-Targeted Antithrombotic Therapy for Total Artificial Heart Device Patients
Address correspondence to: Angeleah Ramirez, BS, MS, CCP, Division of Cardiovascular Surgery, Mayo Clinic Minnesota, 200 1st Street Southwest, Rochester, MN 55902. E-mail: ramirez.angeleah@mayo.edu
Received:
16
November
2015
Accepted:
23
February
2016
To prevent thrombotic or bleeding events in patients receiving a total artificial heart (TAH), agents have been used to avoid adverse events. The purpose of this article is to outline the adoption and results of a multi-targeted antithrombotic clinical procedure guideline (CPG) for TAH patients. Based on literature review of TAH anticoagulation and multiple case series, a CPG was designed to prescribe the use of multiple pharmacological agents. Total blood loss, Thromboelastograph® (TEG), and platelet light-transmission aggregometry (LTA) measurements were conducted on 13 TAH patients during the first 2 weeks of support in our institution. Target values and actual medians for postimplant days 1, 3, 7, and 14 were calculated for kaolinheparinase TEG, kaolin TEG, LTA, and estimated blood loss. Protocol guidelines were followed and anticoagulation management reduced bleeding and prevented thrombus formation as well as thromboembolic events in TAH patients postimplantation. The patients in this study were susceptible to a variety of possible complications such as mechanical device issues, thrombotic events, infection, and bleeding. Among them all it was clear that patients were at most risk for bleeding, particularly on postoperative days 1 through 3. However, bleeding was reduced into postoperative days 3 and 7, indicating that acceptable hemostasis was achieved with the anticoagulation protocol. The multidisciplinary, multi-targeted anticoagulation clinical procedure guideline was successful to maintain adequate antithrombotic therapy for TAH patients.
Key words: multi-targeted antithrombotic therapy / total artificial heart / antithrombosis / aggregometry / thromboelastography
© 2016 AMSECT
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.