Low thromboembolic risk without anticoagulation using advanced-design left ventricular assist devices

James P. Slater, Eric A. Rose, Howard R. Levin, O. H. Frazier, J. Kirk Roberts, Alan D. Weinberg, Mehmet C. Oz

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

Background. A major limitation of cardiac assist devices has been the high incidence of thromboembolic events and their requirement for systemic anticoagulation. The Thermo Cardiosystems HeartMate 1000 IP left ventricular assist device (LVAD) employs a design that may reduce thromboembolic risk and obviate the need for systemic anticoagulation. Methods. Two hundred twenty-three patients with nonreversible heart failure were supported with the HeartMate LVAD as a bridge to heart transplantation. All patients were monitored prospectively for thromboembolic events. Anticoagulation regimens and occurrence of subclinical thromboembolic events, including those seen by transcranial Doppler examinations in selected patients, were also recorded. Results. Total time of LVAD support use was 531.2 patient-months. Twenty-three patients (10%) received warfarin postoperativeLy for 42.4 patient-months (8.2% of total support time). Six patients (2.7%) had thromboembolic events, representing 0.011 events per patient-month of device use. Conclusions. The thromboembolic complication rate associated with this LVAD is acceptably low despite the minimal anticoagulation employed in this series, allowing consideration of long-term device use for the treatment of heart failure.

Original languageEnglish (US)
Pages (from-to)1321-1328
Number of pages8
JournalAnnals of Thoracic Surgery
Volume62
Issue number5
DOIs
StatePublished - Jan 1 1996

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Heart-Assist Devices
Equipment and Supplies
Heart Failure
Warfarin
Heart Transplantation
Treatment Failure
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Slater, James P. ; Rose, Eric A. ; Levin, Howard R. ; Frazier, O. H. ; Roberts, J. Kirk ; Weinberg, Alan D. ; Oz, Mehmet C. / Low thromboembolic risk without anticoagulation using advanced-design left ventricular assist devices. In: Annals of Thoracic Surgery. 1996 ; Vol. 62, No. 5. pp. 1321-1328.
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abstract = "Background. A major limitation of cardiac assist devices has been the high incidence of thromboembolic events and their requirement for systemic anticoagulation. The Thermo Cardiosystems HeartMate 1000 IP left ventricular assist device (LVAD) employs a design that may reduce thromboembolic risk and obviate the need for systemic anticoagulation. Methods. Two hundred twenty-three patients with nonreversible heart failure were supported with the HeartMate LVAD as a bridge to heart transplantation. All patients were monitored prospectively for thromboembolic events. Anticoagulation regimens and occurrence of subclinical thromboembolic events, including those seen by transcranial Doppler examinations in selected patients, were also recorded. Results. Total time of LVAD support use was 531.2 patient-months. Twenty-three patients (10{\%}) received warfarin postoperativeLy for 42.4 patient-months (8.2{\%} of total support time). Six patients (2.7{\%}) had thromboembolic events, representing 0.011 events per patient-month of device use. Conclusions. The thromboembolic complication rate associated with this LVAD is acceptably low despite the minimal anticoagulation employed in this series, allowing consideration of long-term device use for the treatment of heart failure.",
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Low thromboembolic risk without anticoagulation using advanced-design left ventricular assist devices. / Slater, James P.; Rose, Eric A.; Levin, Howard R.; Frazier, O. H.; Roberts, J. Kirk; Weinberg, Alan D.; Oz, Mehmet C.

In: Annals of Thoracic Surgery, Vol. 62, No. 5, 01.01.1996, p. 1321-1328.

Research output: Contribution to journalArticle

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T1 - Low thromboembolic risk without anticoagulation using advanced-design left ventricular assist devices

AU - Slater, James P.

AU - Rose, Eric A.

AU - Levin, Howard R.

AU - Frazier, O. H.

AU - Roberts, J. Kirk

AU - Weinberg, Alan D.

AU - Oz, Mehmet C.

PY - 1996/1/1

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N2 - Background. A major limitation of cardiac assist devices has been the high incidence of thromboembolic events and their requirement for systemic anticoagulation. The Thermo Cardiosystems HeartMate 1000 IP left ventricular assist device (LVAD) employs a design that may reduce thromboembolic risk and obviate the need for systemic anticoagulation. Methods. Two hundred twenty-three patients with nonreversible heart failure were supported with the HeartMate LVAD as a bridge to heart transplantation. All patients were monitored prospectively for thromboembolic events. Anticoagulation regimens and occurrence of subclinical thromboembolic events, including those seen by transcranial Doppler examinations in selected patients, were also recorded. Results. Total time of LVAD support use was 531.2 patient-months. Twenty-three patients (10%) received warfarin postoperativeLy for 42.4 patient-months (8.2% of total support time). Six patients (2.7%) had thromboembolic events, representing 0.011 events per patient-month of device use. Conclusions. The thromboembolic complication rate associated with this LVAD is acceptably low despite the minimal anticoagulation employed in this series, allowing consideration of long-term device use for the treatment of heart failure.

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