Document Detail


Development of Acquired von Willebrand Syndrome During Short-term Micro Axial Pump Support: Implications for Bleeding in a Patient Bridged to a Long-term Continuous Flow Left Ventricular Assist Device.
MedLine Citation:
PMID:  24614358     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Percutaneous continuous-flow (CF) micro axial blood pumps, like the Impella 5.0, are commonly used for short-term (ST) mechanical circulatory support in patients with acute decompensated heart failure (1). The Impella device often serves as a bridge to implantation of a long-term (LT) CF left ventricular assist device (CF-LVAD), such as the centrifugal-flow HeartWare (HVAD). All patients supported with axial CF-LVADs develop acquired von Willebrand syndrome (AVWS) as a result of mechanical shear stress. Increased shear stress leads to excessive proteolysis of von Willebrand factor (vWF) and loss of high molecular weight (HMW) multimers, thus contributing to platelet dysfunction and increased gastrointestinal bleeding (2-4). Bleeding events associated with AVWS have been reported in patients supported with LT CF-LVADs (5-7), however the relationship between early perioperative bleeding complications and AVWS remains poorly characterized in ST CF-LVADs. We sought to describe the relationship between the development of AVWS and excessive intraoperative bleeding in a patient who was sequentially bridged with a ST micro axial device to a LT centrifugal CF-LVAD. This case highlights the importance of monitoring these hemostatic changes when bridging to LT CF-LVADs.
Authors:
Mary E Davis; Nicholas A Haglund; Nicole M Tricarico; Mary E Keebler; Simon Maltais
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-7
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  -     ISSN:  1538-943X     ISO Abbreviation:  ASAIO J.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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