Details

Autor(en) / Beteiligte

• Yi, M U
• Iyer, P S
• Hollis, I B

Titel

Early Experience with Elimination of Aspirin from the Antithrombotic Regimen of Patients with a HeartMate III TM Left Ventricular Assist Device

Ist Teil von

• The Journal of heart and lung transplantation, 2020-04, Vol.39 (4S), p.S211

Ort / Verlag

United States

Erscheinungsjahr

2020

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Patients implanted with a HeartMate III (HM3) LVAD have significantly less thrombotic events than other durable LVADs, but comparable rates of bleeding. To minimize this risk of bleeding, our institution recently eliminated aspirin from the postoperative regimen of HM3 patients. We sought to assess the rate of bleeding and thrombotic events in HM3 patients receiving warfarin alone as antithrombotic therapy. A retrospective chart review was performed to identify patients receiving a HM3 LVAD implant at our institution through June 30, 2019. Patients who never received postoperative aspirin were included in this descriptive series. Data on bleeding and thrombotic events was collected from the date of LVAD implantation until death, transplant, or the end of the study period. A total of 12 patients were treated with warfarin and never received aspirin at any time after HM3 placement. Seventeen percent of patients had ischemic cardiomyopathy; 58% had an alternative indication for aspirin (prior CAD, PAD, or CVA). There were 4 bleeding events in 3 patients and no thrombotic events from the time of HM3 LVAD implantation until death, transplant or the end of the study period. The one death was not due to bleeding or thrombotic event. The average time on HM3 LVAD support was 379 days and the average INR over this period was 2.09. Antithrombotic therapy with warfarin alone was not associated with increased risk of thrombotic events in this small series of patients with a HeartMate III LVAD. Prospective, controlled studies are needed to assess the safety and efficacy of aspirin in HM3 patients.