Diagnosis and Management of LVAD Thrombosis

Current Treatment Options in Cardiovascular Medicine

Volumn 17, Issue 2, 2015, Pages

  Birati, Edo Y ^a,b   Rame, J Eduardo ^a,b  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

^b HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

Management; Thrombosis; Ventricular assist device

Indexed keywords

ACETYLSALICYLIC ACID; CLOPIDOGREL; FIBRINOGEN RECEPTOR ANTAGONIST; HEPARIN; HYPERTENSIVE AGENT; INOTROPIC AGENT; TISSUE PLASMINOGEN ACTIVATOR; WARFARIN;

AWARENESS; CLINICAL FEATURE; COMPUTER ASSISTED TOMOGRAPHY; DISEASE ASSOCIATION; DISEASE COURSE; EARLY DIAGNOSIS; ECHOCARDIOGRAPHY; FIBRINOLYTIC THERAPY; HEART MUSCLE ISCHEMIA; HEMOLYSIS; HUMAN; KNOWLEDGE; LEFT VENTRICULAR ASSIST DEVICE; MORBIDITY; MORTALITY; PATHOPHYSIOLOGY; REVIEW; RISK FACTOR; THORAX RADIOGRAPHY; THROMBOSIS; TREATMENT PLANNING;

EID: 84922309522     PISSN: 10928464     EISSN: 15343189     Source Type: Journal    
DOI: 10.1007/s11936-014-0361-y     Document Type: Review

References (25)

1. Kirklin JK, Naftel DC, Pagani FD, Kormos RL, Stevenson LW, Blume ED, et al. Sixth INTERMACS annual report: a 10,000-patient database. J Heart Lung Transplant. 2014;33(6):555–64.
2. Starling RC, Moazami N, Silvestry SC, Ewald G, Rogers JG, Milano CA, et al. Unexpected abrupt increase in left ventricular assist device thrombosis. N Engl J Med. 2014;370(1):33–40. This is the first study to show the abrupt increase in the incidence of LVAD thrombosis.
3. Uriel N, Han J, Morrison KA, Nahumi N, Yuzefpolskaya M, Garan AR, et al. Device thrombosis in HeartMate II continuous-flow left ventricular assist devices: a multifactorial phenomenon. J Heart Lung Transplant. 2014;33(1):51–9.
4. Najjar SS, Slaughter MS, Pagani FD, Starling RC, McGee EC, Eckman P, et al. 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;33(1):23–34. This study summarizes the occurrence and risk factors of LVAD thrombosis in the intrapericardial HVAD pump.
5. Aaronson KD, Slaughter MS, Miller LW, McGee EC, Cotts WG, Acker MA, et al. Use of an intrapericardial, continuous-flow, centrifugal pump in patients awaiting heart transplantation. Circulation. 2012;125(25):3191–200.
6. Goldstein DJ, John R, Salerno C, Silvestry S, Moazami N, Horstmanshof D, et al. Algorithm for the diagnosis and management of suspected pump thrombus. J Heart Lung Transplant. 2013;32(7):667–70. The first consensus paper published on the diagnosis and treatment of VAD thrombosis.
7. Chiu WC, Slepian MJ, Bluestein D. Thrombus formation patterns in the HeartMate II ventricular assist device: clinical observations can be predicted by numerical simulations. ASAIO J. 2014;60(2):237–40.
8. Ledford ID, Labedi M, Kfoury AG, et al. Thrombus within the HeartMate II left ventricular assist device (LVAD): Are all clots created equal? J Heart Lung Transplant. 2012;4:S85–6.
9. Selgrade BP, Truskey GA. Computational fluid dynamics analysis to determine shear stresses and rates in a centrifugal left ventricular assist device. Artif Organs. 2012;36:E89–96.
10. Kounis NG, Soufras GD, Davlouros P, Tsigkas G, Hahalis G. Thrombus Formation Patterns in HeartMate II continuous-flow left ventricular assist devices: a multifactorial phenomenon involving Kounis syndrome? ASAIO J. 2014 PMID:24727540.
11. Birati EY, Quiaoit Y, Wald J, Atluri P, Goldberg LR, JN Kirkpatrick, et al. Ventricular assist device thrombosis: A wide spectrum of clinical presentation. J Heart Lung Transplant. 2015 In Press. Our study describes for the first time that patients with VAD thrombosis can be completely asymptomatic, and provides details on the wide spectrum of clinical presentations of VAD thrombosis.
12. Uriel N, Morrison KA, Garan AR, Kato TS, Yuzefpolskaya M, Latif F, 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;60(18):1764–75. This is the most important study published thus far on the diagnosis of VAD thrombosis, validating the echocardiographic ramp study, which is essential in the diagnosis of this entity in many patients.
13. Nahumi N, Jorde U, Uriel N. Slope calculation for the LVAD ramp test. J Am Coll Cardiol. 2013;62(22):2149–50.
14. Sareyyupoglu B, Boilson BA, Durham LA, McGregor CG, Daly RC, Redfield MM, et al. Park SJ B-type natriuretic peptide levels and continuous-flow left ventricular assist devices. ASAIO J. 2010;56(6):527–31.
15. Trivedi JR, Sobieski MA, Schwartz S, Williams ML, Slaughter MS. Novel thrombosis risk index as predictor of left ventricular assist device thrombosis. ASAIO J. 2013;59(4):380–3.
16. Topilsky Y, Oh JK, Atchison FW, Shah DK, Bichara VM, Schirger JA, et al. Echocardiographic findings in stable outpatients with properly functioning HeartMate II left ventricular assist devices. J Am Soc Echocardiogr. 2011;24(2):157–69.
17. Fine NM, Topilsky Y, Oh JK, Hasin T, Kushwaha SS, Daly RC, et al. Role of echocardiography in patients with intravascular hemolysis due to suspected continuous-flow LVAD thrombosis. JACC Cardiovasc Imaging. 2013;6(11):1129–40.
18. Estep JD, Vivo RP, Cordero-Reyes AM, Bhimaraj A, Trachtenberg BH, Torre-Amione G, et al. A simplified echocardiographic technique for detecting continuous-flow left ventricular assist device malfunction due to pump thrombosis. J Heart Lung Transplant. 2014;33(6):575–86.
19. Taghavi S, Ward C, Jayarajan SN, Gaughan J, Wilson LM, Mangi AA. Surgical technique influences HeartMate II left ventricular assist device thrombosis. Ann Thorac Surg. 2013;96(4):1259–65.
20. Mak GS, Truong QA. Cardiac CT: imaging of and through cardiac devices. Curr Cardiovasc Imaging Rep. 2012;5(5):328–36.
21. Cheng A, Swartz MF, Massey HT. VADoscopy: a novel intraoperative technique to evaluate HeartMate II left ventricular assist device inflow obstruction and thrombosis. ASAIO J. 2013;59(6):671–4.
22. Slaughter MS, Pagani FD, Rogers JG, Miller LW, Sun B, Russell SD, et al. Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant. 2010;29(4 Suppl):S1–39.
23. Mehra MR, Stewart GC, Uber PA. The vexing problem of thrombosis in long-term mechanical circulatory support. J Heart Lung Transplant. 2014;33(1):1–11.
24. Hasin T, Deo S, Maleszewski JJ, Topilsky Y, Edwards BS, Pereira NL, et al. The role of medical management for acute intravascular hemolysis in patients supported on axial flow LVAD. ASAIO J. 2014;60(1):9–14.
25. Schlendorf K, Patel CB, Gehrig T, Kiefer TL, Felker GM, Hernandez AF, et al. Thrombolytic therapy for thrombosis of continuous flow ventricular assist devices. J Card Fail. 2014;20(2):91–7.