Low-intensity anti-coagulation using Vitamin K antagonists and Factor X activity: A validation analysis of the MAGENTUM-1 study

The continuous-flow centrifugal HeartMate 3 left ventricular assist device (Abbott, Abbott Park, IL) is associated with a low risk of de-novo pump thrombosis. In a previous study (the Minimal AnticoaGulation EvaluatioN To aUgment heMocompatibility [MAGENTUM-1] study, ClinicalTrials.gov No. NCT03078374; funded by Abbott and the Ministry of Health, Czech Republic), we reported results of a prospective, observational, pilot trial of reduced intensity warfarin (target international normalized ratio [INR] range 1.5 –1.9) with aspirin in 15 patients implanted with a HeartMate 3 pump and enrolled after 6 weeks.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: RESEARCH CORRESPONDENCE Source Type: research

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Pump thrombosis (PT) is a severe complication of continuous flow Left Ventricular Assist Devices (LVADs) (1-3), which is driven by patient- and device-specific characteristics that synergize with systemic factors to the development of the thrombotic event (2,4-7). PT can occur due to in-pump thrombus build up or ingestion of a mobilized thrombus (8,9). Treatment is based on intravenous anticoagulation and/or thrombolytic therapy (10). Its success rate is highest at an early stage of PT and decreases in the case of late diagnosis (11).
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Anticoagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 pump. Current anticoagulation guidelines target a goal INR of 2.0 –3.0 with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HeartMate 3 (HM3), have demonstrated a marked decrease in the incidence of pump thrombosis compared to mechanical bearing axi...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
Anti-coagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 (HM3) pump. Current anti-coagulation guidelines target a goal international normalized ratio (INR) of 2.0 to 3.0, with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HM3, have demonstrated a marked decrease in the incidence of pump thrombosis compared w...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: CASE ANECDOTES, COMMENTS AND OPINIONS Source Type: research
Pump thrombosis (PT) is a severe complication of continuous-flow Left Ventricular Assist Devices (LVADs),1 –3 which is driven by patient- and/or device-specific characteristics that synergize with systemic factors to the development of the thrombotic event.2,4–7 PT can occur because of in-pump thrombus build up or ingestion of a mobilized thrombus.8,9 Treatment is based on intravenous anticoagulation and/or thrombolytic therapy.10 Its success rate is the highest at an early stage of PT and decreases in the case of late diagnosis.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: ORIGINAL CLINICAL SCIENCE Source Type: research
Shanshan Zhang1, Dongli Yuan2 and Ge Tan1* 1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 2The Institute of Medical Information, Chongqing Medical University, Chongqing, China Primary systemic vasculitis can affect every structure in both the central and peripheral nervous system, causing varied neurological manifestations of neurological dysfunction. Early recognition of the underlying causes of the neurological symptoms can facilitate timely treatment and improve the prognosis. This review highlights the clinical manifestations of primary systemic vasc...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Although regions of stasis such as the left atrial appendage (LAA) may be potential sites of thrombus formation during atrial fibrillation (AF), its thrombotic contribution during high flow mechanical unloading is unknown. Moreover, registry studies only show a mixed association of AF and stroke during continuous flow left ventricular assist device (CF LVAD) support. Since a lower peak Left Atrial Appendage Emptying Velocity (LAAEV) of less than 40 cm/s during AF, mechanistically contributes to thrombosis and stroke in non-CF LVAD populations, we sought to evaluate the LAAEV in CF LVAD patients with and without AF.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 88 Source Type: research
Our prior work demonstrated Bleeding and thrombosis events (BTEs) are common in adult patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) but risk factors for these complications are not well understood.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 57 Source Type: research
Early and late right ventricular failure (RVF) are major complications during left ventricular assist device (LVAD) support. Therapies to treat RVF are limited, leading to significant morbidity and increased mortality. Intravenous inotropes are a therapy for severe, persistent cases of RVF, but long-term use carries significant risks of infection and thrombosis associated with venous access. CRD-102 is a novel, extended-release form of oral milrinone. The aim of this study is to evaluate the safety of CRD-102 in LVAD patients with chronic RVF.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 25 Source Type: research
Cardiac allograft vasculopathy (CAV) remains a leading challenge to long-term survival after heart transplantation (HTx). Imaging of the coronary artery wall with optical coherence tomography has revealed layered fibrotic plaques resembling organized clots. Thus, thrombosis is suggested as a potential mechanism contributing to development and progression of CAV. We aimed to clarify whether HTx-patients with CAV have increased platelet aggregation compared with HTx-patients without CAV and healthy individuals.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 221 Source Type: research
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