Antithrombotic therapy for ventricular assist devices in children: do we really know what to do?

被引：18

作者：

Massicotte, M. P. ^{[1
,2
]}

Bauman, M. E. ^{[1
,2
]}

Murray, J. ^{[3
,4
]}

Almond, C. S. ^{[3
,4
]}

机构：

[1] Stollery Childrens Hosp, KIDCLOT Pediat Thrombosis, Edmonton, AB, Canada

[2] Univ Alberta, Edmonton, AB, Canada

[3] Lucile Packard Childrens Hosp Stanford, Div Cardiol, Stanford, CA USA

[4] Stanford Univ, Stanford, CA 94305 USA

来源：

JOURNAL OF THROMBOSIS AND HAEMOSTASIS | 2015年 / 13卷

关键词：

drug therapy; heart failure; heart-assist device; pediatrics; thrombosis; EXTRACORPOREAL MEMBRANE-OXYGENATION; VON-WILLEBRAND-FACTOR; HEART MATE II; CIRCULATORY SUPPORT; ANTICOAGULATION THERAPY; PUMP THROMBOSIS; TISSUE FACTOR; COAGULATION; PLATELET; HEPARIN;

D O I：

10.1111/jth.12928

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The use of ventricular assist devices (VADs) in children is increasing. Stroke and device-related thromboembolism remain the most feared complications associated with VAD therapy in children. The presence of a VAD causes dysregulation of hemostasis due to the presence of foreign materials and sheer forces intrinsic to the device resulting in hypercoagulability and potentially life-threatening thrombosis. The use of antithrombotic therapy in adults with VADs modulates this disruption in hemostasis, decreasing the risk of thrombosis. Yet, differences in hemostasis in children (developmental hemostasis) may result in variances in dysregulation by these devices and preclude the use of adult guidelines. Consequently, pediatric device studies must include safety and efficacy estimates of device-specific antithrombotic therapy guidelines. This review will discuss mechanisms of hemostatic dysregulation as it pertains to VADs, goals of VAD antithrombotic therapy for children and adults, and emerging antithrombotic strategies for VAD use in children.

引用

页码：S343 / S350

页数：8

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