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Related Experiment Videos

Hemostatic abnormalities in two patients implanted with total artificial hearts.

H al-Mondhiry1, W S Pierce

  • 1Department of Medicine, Pennsylvania State University College of Medicine, Hershey.

Artificial Organs
|October 1, 1989
PubMed
Summary

Total artificial hearts (TAH) frequently cause thromboembolic complications. Monitoring hemostatic parameters and autopsy findings in two TAH patients revealed ineffective anticoagulation and sustained coagulation activation, suggesting limited prevention strategies.

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Area of Science:

  • Biomedical Engineering
  • Cardiovascular Surgery
  • Hematology

Background:

  • Thromboembolic complications are a significant challenge for patients with total artificial hearts (TAH).
  • Understanding the hemostatic changes associated with TAH implantation is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate hemostatic parameters and autopsy findings in patients with TAH.
  • To evaluate the effectiveness of current anticoagulation strategies in preventing TAH-related thromboembolic events.

Main Methods:

  • Continuous monitoring of hemostatic parameters (beta-thromboglobulin, fibrinopeptide A) in two TAH patients.
  • Autopsy examination of patients who received TAH implants.

Main Results:

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  • Both patients exhibited elevated plasma beta-thromboglobulin and fibrinopeptide A, indicating sustained platelet and coagulation activation.
  • Autopsies revealed widespread thrombotic lesions in multiple organs, including the brain and lungs.
  • Warfarin and antiplatelet therapy appeared ineffective in preventing thromboembolic complications in these TAH patients.

Conclusions:

  • Blood contact with artificial surfaces in TAH leads to persistent activation of hemostasis.
  • Current anticoagulation regimens may be insufficient to prevent thromboembolic complications in TAH recipients.
  • Further research is needed to develop more effective strategies for managing thrombosis in TAH patients.