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Neurosurgical intervention in children with ventricular assist devices: A single center case series review
CONCLUSIONS: Perioperative concerns for the anesthesiologist include VAD hemodynamic management, bleeding, VAD thrombosis, and prevention of secondary brain injury. A systematic, multidisciplinary approach to management is paramount to attain favorable outcomes.PMID:34478592 | DOI:10.1111/pan.14287
Source: Paediatric Anaesthesia - September 3, 2021 Category: Anesthesiology Authors: Jane Yu Jenna Murray Chandra Ramamoorthy Sharon Chen Sarah Lee Kathleen Ryan Katsuhide Maeda Manchula Navaratnam Source Type: research

Anticoagulation with direct factor Xa inhibitors in transplant recipients: Results from the DRESDEN NOAC REGISTRY (NCT01588119)
After solid organ or hematopoietic stem cell transplantation (HSCT), the risk of arterial or venous thromboembolism (VTE) is high (1 –7). Oral anticoagulation represents the mainstay for stroke prevention in atrial fibrillation (SPAF) and VTE treatment. The pharmacodynamic and pharmacokinetic profiles of vitamin k antagonists (VKA) represent a challenge especially in the setting of transplantation, also due to the high risk of bleeding (8) and due to complex co-medications of transplant recipients.
Source: Thrombosis Research - April 23, 2020 Category: Hematology Authors: Jan Beyer-Westendorf, Sandra Marten, Christiane Naue, Luise Tittl, Katja Sockel, Jan Moritz Middecke, Martin Bornh äuser Tags: Letter to the Editors-in-Chief Source Type: research

Cessation of Anticoagulation for Bleeding and Thrombosis Events with a Fully Magnetically Levitated Centrifugal Left Ventricular Assist Device
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 axial-f...
Source: The Journal of Heart and Lung Transplantation - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: Case Anecdotes, Comments and Opinions Source Type: research

Cessation of anti-coagulation for bleeding and subsequent thrombosis events with a fully magnetically levitated centrifugal left ventricular assist device
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 - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: CASE ANECDOTES, COMMENTS AND OPINIONS Source Type: research

A Review of the Use of Direct Oral Anticoagulant Use in Orthotopic Heart Transplantation Recipients
Over 60 years ago, the vitamin K antagonist (VKA) warfarin was approved and remained the only oral anticoagulation agent until recently [1]. Currently, within North America and Europe there are four DOACs available. Dabigatran, first approved in Europe and Canada in 2008, then in the United States of America in 2010, followed by rivaroxaban, apixaban, and most recently edoxaban. The introduction of direct oral anticoagulants (DOACs) has been a major advancement and these agents are the preferred to VKAs for many indications [2 –5], including stroke prevention in nonvalvular atrial fibrillation (NVAF), acute treatment and...
Source: Transplantation Reviews - April 16, 2018 Category: Transplant Surgery Authors: Rosaleen Boswell, Glen J. Pearson Tags: Review article Source Type: research

Therapeutic Plasma Exchange for Urgent Rivaroxaban Reversal.
Abstract Direct oral anticoagulants, which include the factor Xa inhibitor rivaroxaban, have some advantages over vitamin K antagonists in regard to stroke prevention in patients with atrial fibrillation. However, no antidotes to reverse the effect of oral anticoagulants are commercially available, which can complicate treating patients in whom reversal is urgent. We faced this challenge in a kidney transplant candidate, a 65-year-old man with end-stage renal disease who had been taking rivaroxaban for paroxysmal atrial fibrillation. When a deceased-donor kidney became available, we needed to rapidly reduce the pa...
Source: Texas Heart Institute Journal - April 1, 2018 Category: Cardiology Authors: Kumar V, Allencherril J, Bracey A, Chen AJ, Lam WW Tags: Tex Heart Inst J Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research