Renzo Y Loyaga-Rendon1, Milena Jani2, David Fermin2, Jennifer K McDermott2, Diane Vancamp2, Sangjin Lee2. 1. Advanced Heart Failure and Heart Transplantation Section, Spectrum Health, 330 Barclay Avenue NE, Suite 200, MC258, Grand Rapids, MI, 49503, USA. Renzo.Loyagarendon@spectrumhealth.org. 2. Advanced Heart Failure and Heart Transplantation Section, Spectrum Health, 330 Barclay Avenue NE, Suite 200, MC258, Grand Rapids, MI, 49503, USA.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to describe the current knowledge in prevention and treatment of thrombotic (pump thrombosis and ischemic stroke) and bleeding (gastrointestinal and hemorrhagic stroke) complications in patients supported by continuous-flow left ventricular assist devices (CF-LVAD). RECENT FINDINGS: Left ventricular assist devices (LVADs) are now widely used for the management of end-stage heart failure. Unfortunately, in spite of the indisputable positive impact LVADs have on patients, the frequency and severity of complications are limitations of this therapy. Stroke, pump thrombosis, and gastrointestinal bleeding are among the most serious and frequent complications in these patients. The balance between hemorrhagic and thrombotic complications in patients supported with CF-LVAD is difficult as most patients do not necessarily fit a "bleeder" or a "clotter" profile but rather move from one side to the other of the thrombotic/bleeding spectrum. Further research is necessary to better understand the risk factors and mechanisms involved in the development of these complications.
PURPOSE OF REVIEW: The purpose of this review is to describe the current knowledge in prevention and treatment of thrombotic (pump thrombosis and ischemic stroke) and bleeding (gastrointestinal and hemorrhagic stroke) complications in patients supported by continuous-flow left ventricular assist devices (CF-LVAD). RECENT FINDINGS: Left ventricular assist devices (LVADs) are now widely used for the management of end-stage heart failure. Unfortunately, in spite of the indisputable positive impact LVADs have on patients, the frequency and severity of complications are limitations of this therapy. Stroke, pump thrombosis, and gastrointestinal bleeding are among the most serious and frequent complications in these patients. The balance between hemorrhagic and thrombotic complications in patients supported with CF-LVAD is difficult as most patients do not necessarily fit a "bleeder" or a "clotter" profile but rather move from one side to the other of the thrombotic/bleeding spectrum. Further research is necessary to better understand the risk factors and mechanisms involved in the development of these complications.
Authors: John M Stulak; Shannon M Dunlay; Shashank Sharma; Nicholas A Haglund; Mary Beth Davis; Jennifer Cowger; Palak Shah; Faraz Masood; Keith D Aaronson; Francis D Pagani; Simon Maltais Journal: J Heart Lung Transplant Date: 2015-12 Impact factor: 10.247
Authors: Randall C Starling; Yoshifumi Naka; Andrew J Boyle; Gonzalo Gonzalez-Stawinski; Ranjit John; Ulrich Jorde; Stuart D Russell; John V Conte; Keith D Aaronson; Edwin C McGee; William G Cotts; David DeNofrio; Duc Thinh Pham; David J Farrar; Francis D Pagani Journal: J Am Coll Cardiol Date: 2011-05-10 Impact factor: 24.094
Authors: Jennifer A Frontera; Randall Starling; Sung-Min Cho; Amy S Nowacki; Ken Uchino; M Shazam Hussain; Maria Mountis; Nader Moazami Journal: J Heart Lung Transplant Date: 2016-12-23 Impact factor: 10.247
Authors: Randall C Starling; Nader Moazami; Scott C Silvestry; Gregory Ewald; Joseph G Rogers; Carmelo A Milano; J Eduardo Rame; Michael A Acker; Eugene H Blackstone; John Ehrlinger; Lucy Thuita; Maria M Mountis; Edward G Soltesz; Bruce W Lytle; Nicholas G Smedira Journal: N Engl J Med Date: 2013-11-27 Impact factor: 91.245
Authors: Christopher T Sparrow; Michael E Nassif; David S Raymer; Eric Novak; Shane J LaRue; Joel D Schilling Journal: JACC Heart Fail Date: 2015-11-11 Impact factor: 12.035
Authors: Kelly Schlendorf; Chetan B Patel; Thomas Gehrig; Todd L Kiefer; G Michael Felker; Adrian F Hernandez; Laura J Blue; Carmelo A Milano; Joseph G Rogers Journal: J Card Fail Date: 2013-12-18 Impact factor: 5.712
Authors: Christopher T Holley; Laura Harvey; Samit S Roy; Rebecca Cogswell; Peter Eckman; Kenneth Liao; Ranjit John Journal: ASAIO J Date: 2015 Nov-Dec Impact factor: 2.872
Authors: Nader Moazami; Carmelo A Milano; Ranjit John; Benjamin Sun; Robert M Adamson; Francis D Pagani; Nicholas Smedira; Mark S Slaughter; David J Farrar; O Howard Frazier Journal: Ann Thorac Surg Date: 2012-12-20 Impact factor: 4.330
Authors: Ronald M Lazar; Peter A Shapiro; Brian E Jaski; Michael K Parides; Robert C Bourge; John T Watson; Laura Damme; Walter Dembitsky; Jeffrey D Hosenpud; Lopa Gupta; Anita Tierney; Tonya Kraus; Yoshifumi Naka Journal: Circulation Date: 2004-05-03 Impact factor: 29.690
Authors: Tomasz Dziodzio; Mariusz Kuśmierczyk; Andrzej Juraszek; Mikołaj Smólski; Piotr Kołsut; Jarosław Szymański; Paweł Litwiński; Krzysztof Kuśmierski; Joanna Zakrzewska-Koperska; Maciej Sterliński Journal: J Cardiothorac Surg Date: 2021-08-03 Impact factor: 1.637