Managing Anticoagulation in LVAD Patients: The Harefield Experience

Anticoagulation management in patients with Left Ventricular Assist devices (LVAD) continues to be a challenge. Patients and their clinicians are faced with the daily challenge of needing adequate anticoagulation versus the bleeding risks that are associated with anticoagulation.Warfarin is the recommended oral anticoagulant for all currently available LVAD devices.Warfarin is known to be a difficult medication to manage due to its narrow therapeutic window, and its many interactions .Dlott et al (2014) describe in Circulation the overall time in therapeutic range for patients on warfarin as 53.7%, Time in therapeutic range has been corelated with stroke, bleeding and mortality rates.The goal of our team was to maximise the time patients with VAD's spent in their therapeutic INR range.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research