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Risk Of Pump Thrombosis With Once Daily Enoxaparin For Anticoagulation Bridging In Patients With Heartmate III
Most centers bridge patients with Left Ventricular Assist Device (LVAD) with heparin drip to avoid thromboembolic complications including stroke and pump thrombosis based on data from HeartMate II. Because of improved hemocompatibility of third generation HeartMateIII (HM3), particularly the decreased risk of in-pump thrombosis, outpatient treatment dose of low molecule weight heparin (LWMH) like Enoxaparin has been used to bridge to warfarin when the INR is subtherapeutic. Once daily dosing has been used in select patients with higher bleeding risk.
Source: Journal of Cardiac Failure - April 1, 2023 Category: Cardiology Authors: Modar Alom, Gurjaspreet Bhattal, Nitin Kabra, David Rawitscher, Amit Alam, Cesar Guerrero-Miranda, Sandra Carey, Timothy George, Aasim Afzal Tags: 180 Source Type: research

Increased Risk of Thromboembolic Events Following Gastrointestinal Bleeds among Left Ventricular Assist Device Patients
Introduction: Patients with left ventricular assist devices (LVADs) are typically treated with warfarin and aspirin to prevent pump thrombosis and ischemic stroke. It has been observed that LVAD patients have a high incidence of bleeding complications, most commonly from the gastrointestinal tract. Patients who experience gastrointestinal bleeds (GIB) requiring hospitalization typically undergo a reduction in their anticoagulation and/or antiplatelet regimen. Few studies have examined the relationship between GIB and thromboembolic (TE) events in this population.
Source: Journal of Cardiac Failure - August 1, 2017 Category: Cardiology Authors: Eric W. Rudofker, Saadia Sherazi, John D. Rice, Brent A. Johnson, Jeffrey D. Alexis Source Type: research

Apixaban Use in LVAD Patient with Recurrent GI Bleeding and Recent Embolic Stroke
Background: Left ventricular assist devices (LVAD) have been shown to improve quality of life and decrease mortality in patients with advanced heart failure. GI bleeding and pump thrombosis are major complications associated with LVAD therapy. Warfarin is the mainstay of anticoagulation for these patients. However, warfarin therapy can be challenging due to a narrow therapeutic window, drug/food interactions and need for frequent monitoring. The direct oral anticoagulants (DOACs) have been shown to be non-inferior or superior to warfarin for preventing stroke and reducing the risk of bleeding in patients with AF.
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Lisa Curran, Ali Cosgrove, Amy Clegg, Molly Reece, Bryan Bartle, Peter Van Trigt, Dalton McLean, Daniel Bensimhon Source Type: research