Document Detail

Hemostatic profiles of HeartMate ventricular assist device recipients.
MedLine Citation:
PMID:  8573914     Owner:  NLM     Status:  MEDLINE    
Candidates for ventricular assist devices often have hepatic dysfunction and concomitant coagulation abnormalities. Factors II, V, VII, XI, plasminogen, fibrinopeptide A (FpA), and D-dimers were measured in 19 HeartMate (ThermoCardiosystems, Inc., Woburn, MA) patients before device implantation; at 6 hr, 24 hr, and 2 weeks postimplantation; and before explantation. Ten patients had entry hepatic dysfunction (total bilirubin > 2 mg/dl; aspartate and alanine aminotransferases > 60 U/L); nine had normal hepatic function. All except one patient received perioperative aprotinin; all received only aspirin and dipyridamole after surgery. At preimplant, both patient groups had subnormal factor II, V, VII, XI, and plasminogen with elevated FpA and D-dimer. By 2 weeks postimplant, these factor levels had normalized, except for FpA and D-dimer levels, which suggest ongoing remodeling of fibrin deposits on the device surfaces. No statistically significant differences in the assayed hemostatic markers were observed between the two patient groups. Clinically, 15/19 (79%) patients survived to cardiac transplantation; 3/19 (16%) patients required reoperation for early bleeding. All three had low factor VII and XI; two of three also had hepatic dysfunction and subnormal levels of factor II and V. Most patients with entry hepatic dysfunction improve after device implantation; all four deaths were in patients with persistent hepatic dysfunction despite circulatory support.
I W Wang; K Kottke-Marchant; R L Vargo; P M McCarthy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  41     ISSN:  1058-2916     ISO Abbreviation:  ASAIO J.     Publication Date:    1995 Jul-Sep
Date Detail:
Created Date:  1996-03-12     Completed Date:  1996-03-12     Revised Date:  2006-05-23    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  M782-7     Citation Subset:  IM    
Department of Macromolecular Science, Case Western Reserve University, Cleveland, Ohio, USA.
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MeSH Terms
Blood Coagulation Factors / metabolism
Cardiomyopathies / physiopathology,  therapy
Heart Transplantation
Heart-Assist Devices* / adverse effects
Hemorrhage / etiology
Hemostasis / physiology*
Liver / physiopathology
Plasminogen / metabolism
Time Factors
Reg. No./Substance:
0/Blood Coagulation Factors; 9001-91-6/Plasminogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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