DOI: https://doi.org/10.22141/2224-0586.4.99.2019.173939

Analysis of non-surgical complications in patients with implanted left ventricular assist devices

O.P. Mazurenko, P. Nadzyakevych, O.A. Loskutov, L.V. Zgrzheblovskaya

Abstract


The work deals with the study of infectious, nephrotic, neurological and other complications in the early postoperative period in 10 patients with implanted left ventricular assist devices. The most common non-surgical complications include infections, ischemic hemorrhagic lesions of the brain, acute renal failure that arise in the postoperative period. Conducting optimal antithrombotic therapy in such patients is an important method of treatment, especially in the early postoperative period. Most infectious complications develop in the implanted device driveline exit site. An individual approach to preventive strategies is critical for improving patient outcomes. This article presents an analysis of complications that developed in the early postoperative period in 10 patients with implanted left ventricular assist devices of the Silesian Center for Heart Disease (Poland). Patients were divided into 2 groups: the control group receiving classical anticoagulant targeted therapy, which included heparin, warfarin and aspirin, and the study group receiving an alternative anticoagulant targeted therapy that consisted of clopidogrel, thrombin inhibitors in combination with classical anticoagulant targeted therapy.


Keywords


left ventricular assist device; anticoagulant targe­ted therapy; infectious, nephrotic, pulmonary, ischemic he­morrhagic complications

References


Wever-Pinzon O., Drakos S.G., Kfoury A.G. et al. Morbidity and mortality in heart transplant candidates supported with mechanical circulatory support: is reappraisal of the current. Circulation. 2013 Jan 29. 127(4). Р. 452-62.

Akhter S.A., Badami A., Murray M. et al. Hospital Readmissions After Continuous-Flow Left Ventricular Assist Device Implantation: Incidence, Causes, and Cost Analysis. Ann. Thorac. Surg. 2015 Sep. 100(3). Р. 884-9.

Slaughter M.S., Pagani F.D., McGee E.C. et al. HeartWare Bridge to Transplant ADVANCE Trial Investigators. HeartWare ventricular assist system for bridge to transplant: combined results of the bridge to transplant and continued access protocol trial. J. Heart Lung Transplant. 2013 Jul. 32(7). Р. 675-83.

Stulak J.M., Davis M.E., Haglund N. et al. Adverse events in contemporary continuous-flow left ventricular assist devices: A multi-institutional comparison shows significant differences. J. Thorac. Cardiovasc. Surg. 2016 Jan. 151(1). Р. 177-89.

Harvey L., Holley C., Roy S.S. et al. Stroke After Left Ventricular Assist Device Implantation: Outcomes in the Continuous-Flow Era. Ann. Thorac. Surg. 2015. 100(2). Р. 535-41.

Morgan J.A., Brewer R.J., Nemeh H.W. et al. Stroke while on long-term left ventricular assist device support: incidence, outcome, and predictors. ASAIO J. 2014 May-Jun. 60(3). Р. 284-9.

Xia Y., Stern D., Friedmann P., Goldstein D. Preoperative atrial fibrillation may not increase thromboembolic events in left ventricular assist device recipients on midterm follow-up. J. Heart Lung Transplant. 2016. 35(7). Р. 906-12.

Najjar S.S., Slaughter M.S., Pagani F.D. et al. HVAD Bridge to Transplant ADVANCE Trial Investigators. An analysis of pump thrombus events in patients in the HeartWare ADVANCE bridge to transplant and continued access protocol trial. J. Heart Lung Transplant. 2014 Jan. 33(1). Р. 23-34.

Uriel N., Morrison K.A., Garan A.R. et al. Development of a novel echocardiography ramp test for speed optimization and diagnosis of device thrombosis in continuous-flow left ventricular assist devices: the Columbia ramp study. J. Am. Coll. Cardiol. 2012 Oct 30. 60 (18). Р. 1764-75.

Maltais S., Kilic A., Nathan S. et al. Prevention of HeartMate II Pump Thrombosis Through Clinical Management (PREVENT). J. Heart Lung Transplant. 2016. 35(4). Р. S161-S162.

Starling R.C., Moazami N., Silvestry S.C. et al. Unexpected abrupt increase in left ventricular assist device thrombosis. N. Engl. J. Med. 2014. 370(1). Р. 33-40.

Saeed D., Maxhera B., Albert A., Westenfeld R., Hoffmann T., Lichtenberg A. Conservative approaches for HeartWare ventricular assist device pump thrombosis may improve the outcome compared with immediate surgical approaches. Interact. Cardiovasc. Thorac. Surg. 2016. 23(1). Р 90-5.

Haglund N.A., Davis M.E., Tricarico N.M., Keebler M.E., Maltais S. Readmissions After Continuous Flow Left Ventricular Assist Device Implantation: Differences Observed Between Two Contemporary Device Types. ASAIO J. 2015 Jul-Aug. 61(4). Р. 410-6.

Topkara V.K., Kondareddy S., Malik F. et al. Infectious complications in patients with left ventricular assist device: etiology and outcomes in the continuous-flow era. Ann. Thorac. Surg. 2010 Oct. 90(4). Р. 1270-7.

Leuck A.M. Left ventricular assist device driveline infections: recent advances and future goals. J. Thorac. Dis. 2015 Dec. 7(12). Р. 2151-7.

Levy D.T., Guo Y., Simkins J. et al. Left ventricular assist device exchange for persistent infection: a case series and review of the literature. Transpl. Infect. Dis. 2014 Jun. 16(3). Р. 453-60.

Schulman A.R., Martens T.P., Russo M.J. et al. Effect of left ventricular assist device infection on post-transplant outcomes. J. Heart Lung Transplant. 2009 Mar. 28(3). Р. 237-42.

Kretlow J.D., Brown R.H., Wolfswinkel E.M. et al. Salvage of infected left ventricular assist device with antibiotic beads. Plast. Reconstr. Surg. 2014. 133(1). Р. 28e-38e.

Deo S.V., Sharma V., Cho Y.H., Shah I.K., Park S.J. De novo aortic insufficiency during long-term support on a left ventri­cular assist device: a systematic review and meta-analysis. ASAIO J. 2014 Mar-Apr. 60(2). Р. 183-8.

Saeed D., Westenfeld R., Maxhera B. et al. Prevalence of De Novo Aortic Valve Insufficiency in Patients After HeartWare VAD Implantation with an Intermittent Low-Speed Algorithm. ASAIO J. 2016 Sep-Oct. 62(5). Р. 565-70.

Holman W.L., Acharya D., Siric F., Loyaga-Rendon R.Y. Assessment and management of right ventricular failure in left ventricular assist device patients. Circ. J. 2015. 79(3). Р. 478-86.

Ross D.W., Gerin R. et al. Left Ventricular Assist Devices and the Kidney. Clin. J. Am. Soc. Nephrol. 2018. 13. Р. 348-355.

Roehm В., Vest А.R., Weiner D.E. Left Ventricular Assist Devices, Kidney Disease, and Dialysis. Am. J. Kidney Dis. 2017. 71(2). Р. 257-266.




Copyright (c) 2019 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2019

 

   Seo анализ сайта