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In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
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Bivalirudin for left ventricular assist device thrombosis
Phillip Weeks1, Adam Sieg2, Indranee Rajapreyar3
1Department of Pharmacy, Memorial Hermann - Texas Medical Center, Houston, TX, USA. phillip.weeks@memorialhermann.org.
Journal of Thrombosis and Thrombolysis
|August 19, 2018
Summary
Bivalirudin therapy for ventricular assist device (VAD) pump thrombosis showed limited success, with high recurrence rates. Alternative treatments are suggested for managing this serious VAD complication.
Area of Science:
- Cardiology
- Medical Devices
- Thrombosis Research
Background:
- Pump thrombosis is a significant complication of ventricular assist device (VAD) therapy, increasing morbidity and mortality.
- Current management strategies for VAD pump thrombosis lack definitive evidence, relying on limited data and expert consensus.
- Direct thrombin inhibitors have yielded inconsistent outcomes in medical management of pump thrombosis.
Purpose of the Study:
- To evaluate the outcomes of bivalirudin therapy in patients with suspected pump thrombosis of an implantable left ventricular assist device (LVAD).
Main Methods:
- A retrospective, single-center observational study was conducted.
- Fifteen patients with suspected LVAD pump thrombosis treated with bivalirudin were analyzed.
- Outcomes including serum lactate dehydrogenase (LDH) levels and clinical response were assessed.
Main Results:
- Initial treatment with bivalirudin was unsuccessful in 60% of patients (9/15).
- Forty percent (6/15) showed initial improvement in LDH and were discharged.
- A high recurrence rate of 83.3% (5/6) was observed within six months among discharged patients.
Conclusions:
- Bivalirudin therapy did not consistently reduce LDH levels in LVAD patients with pump thrombosis.
- Clinical responses to bivalirudin were associated with high rates of recurrent thrombosis.
- Alternative therapeutic strategies should be explored for managing LVAD pump thrombosis.
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