Hemostatic complications associated with ventricular assist devices. Issue 4 (9th June 2019)

• Record Type: Journal Article
• Authors: Hilal, Talal; Mudd, James; DeLoughery, Thomas G.
• Is Part Of: Research and practice in thrombosis and haemostasis. Volume 3:Issue 4(2019)
• Page Start: 589
• Page End: 598
• Publication Date: 2019-06-09
• Subjects: heart-assist devices -- hemostasis -- heparin‐induced thrombocytopenia -- thrombosis -- ventricular assist devices -- von Willebrand diseases; Thrombosis -- Periodicals; Hemostasis -- Periodicals; 616.135005
• DOI: 10.1002/rth2.12226
• Languages: English
• ISSNs: 2475-0379

Abstract

Abstract: Hemostatic complications are common in patients with ventricular assist devices. The pathophysiologic mechanisms that lead to dysregulated hemostasis involve complex interactions between device surface, sheer stress, and blood flow. These factors lead to various manifestations that require a thorough understanding of the interplay among platelets, coagulation factors, and red cells. In this article, we review the pathophysiology of hematologic complications (bleeding, acquired von Willebrand disease, heparin‐induced thrombocytopenia, hemolysis, stroke and pump thrombosis), the clinical manifestations, and the management of each. We summarize the evidence available for management of these entities and provide a pragmatic clinical review.