Patient With Hypofibrinolysis-mediated Thromboembolism Converted to a Hypercoagulable/Hyperfibrinolytic State via Ventricular Assist Device Placement

Academic Article

Abstract

  • Mechanical circulatory support with ventricular assist devices (VADs) for end-stage heart failure has been a focus of intense interest for nearly four decades. Despite improvements in VAD design and biomaterial composition, it is common to administer anti-coagulation (e.g., warfarin, anti-platelet agents) to prevent both device thrombosis and thromboembolism. We present a patient with pre-operative thrombophilia (pulmonary embolism, intracardiac thrombus) and hypofibrinolysis, who subsequently developed hypercoagulability with hyperfibrinolysis with normalization of clot lifespan after left VAD placement. Such complex patient-VAD-hemostatic-state interactions serve as the rationale for continuing investigation of the effects of mechanical circulation on the fibrinolytic system and thrombophilia. © 2008 International Society for Heart and Lung Transplantation.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Nielsen VG; Kirklin JK; Holman WL; George JF; Ellis TC; Steenwyk BL
  • Start Page

  • 1169
  • End Page

  • 1171
  • Volume

  • 27
  • Issue

  • 10