A modified technique for implantation of the HeartWare™ left ventricular assist device when using bivalirudin anticoagulation in patients with acute heparin-induced thrombocytopenia

被引：10

作者：

Morshuis, Michiel ^{[1
]}

Boergermann, Jochen ^{[1
]}

Gummert, Jan ^{[1
]}

Koster, Andreas ^{[2
]}

机构：

[1] Ruhr Univ Bochum, Heart & Diabet Ctr NRW, Clin Heart Thorac & Cardiovasc Surg, Bad Oeynhausen, Germany

[2] Ruhr Univ Bochum, Heart & Diabet Ctr NRW, Inst Anaesthesiol, Bad Oeynhausen, Germany

来源：

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY | 2013年 / 17卷 / 02期

关键词：

Cardiopulmonary bypass; ECMO; Heparin-induced thrombocytopenia;

D O I：

10.1093/icvts/ivt187

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In patients with acute heparin-induced thrombocytopenia (HIT) needing urgent cardiac surgery, bivalirudin is recommended as a first-line strategy for intraoperative anticoagulation. However, due to the unique elimination process of bivalirudin, careful adjustment of the perfusion and surgical strategy is mandatory as blood stasis in the circuit or prolonged interruption of areas or compartments containing blood from the systemic circulation may result in thrombus formation. We report here a modified surgical strategy for the implantation of the HeartWare (TM) left ventricular assist device, which avoids prolonged disconnection of the blood-filled device from the systemic blood flow, so that bivalirudin can be safely used as anticoagulant.

引用

页码：225 / 226

页数：2

共 8 条

[1] Off-Pump Implantation of the HeartWare HVAD Left Ventricular Assist Device Through Minimally Invasive Incisions [J].

Cheung, Anson ;

Lamarche, Yoan ;

Kaan, Annemarie ;

Munt, Bradley ;

Doyle, Aaron ;

Bashir, Jamil ;

Janz, Paul .

ANNALS OF THORACIC SURGERY, 2011, 91 (04) :1294-1296

[2] Successful use of bivalirudin as anticoagulant for ECMO in a patient with acute HIT [J].

Koster, Andreas ;

Weng, Yuguo ;

Boettcher, Wolfgang ;

Gromann, Tom ;

Kuppe, Hermann ;

Hetzer, Roland .

ANNALS OF THORACIC SURGERY, 2007, 83 (05) :1865-1867

[3] Impact of heparin-induced thrombocytopenia on outcome in patients with ventricular assist device support: Single-institution experience in 358 consecutive patients [J].

Koster, Andreas ;

Huebler, Sabine ;

Potapov, Evgenij ;

Meyer, Oliver ;

Jurmann, Michael ;

Weng, Yuguo ;

Pasic, Miralem ;

Drews, Thorsten ;

Kuppe, Hermann ;

Loebe, Matthias ;

Hetzer, Roland .

ANNALS OF THORACIC SURGERY, 2007, 83 (01) :72-76

[4] Bivalirudin during cardiopulmonary bypass in patients with previous or acute heparin-induced thrombocytopenia and heparin antibodies: Results of the CHOOSE-ON trial [J].

Koster, Andreas ;

Dyke, Cornelius M. ;

Aldea, Gabriel ;

Smedira, Nicholas G. ;

McCarthy, Harry L., II ;

Aronson, Solomon ;

Hetzer, Roland ;

Avery, Edwin ;

Spiess, Bruce ;

Lincoff, A. Michael .

ANNALS OF THORACIC SURGERY, 2007, 83 (02) :572-577

[5] Treatment and Prevention of Heparin-Induced Thrombocytopenia Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines [J].

Linkins, Lori-Ann ;

Dans, Antonio L. ;

Moores, Lisa K. ;

Bona, Robert ;

Davidson, Bruce L. ;

Schulman, Sam ;

Crowther, Mark .

CHEST, 2012, 141 (02) :E495S-E530S

[6] Heparin-induced thrombocytopenia in patients receiving mechanical circulatory support [J].

Schenk, Soren ;

El-Banayosy, Aly ;

Prohaska, Wolfgang ;

Arusoglu, Latif ;

Morshuis, Michiel ;

Koester-Eiserfunke, Wilhelm ;

Kizner, Lukasz ;

Murray, Edward ;

Eichler, Petra ;

Koerfer, Reiner ;

Greinacher, Andreas .

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2006, 131 (06) :1373-U46

[7] Implantation of the HeartWare Left Ventricular Assist Device [J].

Slaughter, Mark S. .

SEMINARS IN THORACIC AND CARDIOVASCULAR SURGERY, 2011, 23 (03) :245-247

[8]

Veale James J, 2005, J Extra Corpor Technol, V37, P296

← 1 →