Related Experiment Video
Updated: Feb 4, 2026
09:15
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
1.2K
Postoperative bridging anticoagulation and left ventricular assist system thrombosis
David M Nemer1, Garrick C Stewart2, Maneka Puligandla3
1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk J3-129, Cleveland, OH, 44195, USA. nemerd@ccf.org.
Journal of Thrombosis and Thrombolysis
|September 27, 2018
Summary
Reduced emphasis on early postoperative bridging anticoagulation may increase HeartMate II pump thrombosis. Therapeutic anticoagulation bridges may lower 6-month thrombosis risk, but overall incidence remains unchanged. Further research is needed.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- HeartMate II (HM II) pump thrombosis incidence has increased.
- Reduced emphasis on early postoperative bridging anticoagulation is a suspected cause.
Purpose of the Study:
- To analyze initial postoperative anticoagulation practices and their impact on HM II pump thrombosis incidence.
Main Methods:
- Single-center analysis of 105 primary HM II implant patients (2009-2014).
- Defined parenteral bridge as anticoagulation before INR ≥ 2 on warfarin.
- Characterized bridges as early (≤3 days) and therapeutic (goal PTT for 3 days).
- Pump thrombosis "suspected" clinically, "confirmed" by device visualization.
Main Results:
- 70% received parenteral bridge, 68% started within 3 days.
- Therapeutic PTT achieved in 52% of bridged patients.
- Lower INTERMACS profiles and longer ICU stay in bridged patients.
- 6-month suspected thrombosis: 15.8% with therapeutic bridge vs. 29.9% without.
- 6-month confirmed thrombosis: 7.9% with therapeutic bridge vs. 16.4% without.
- Trend not sustained at 12 and 24 months; no overall difference in pump thrombosis incidence.
Conclusions:
- Initial postoperative parenteral bridging anticoagulation is common but often sub-therapeutic.
- Therapeutic bridging may reduce 6-month pump thrombosis but not overall incidence.
- Anticoagulation strategies require optimization for HeartMate II device safety.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
2.4K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.4K
01:15Design Example: Strain Gauge Bridge or Wheatstone Bridge
1.0K
The utilization of strain gauges as transducers for converting mechanical strain into electrical signals is a common practice in various engineering applications. These strain gauges are frequently integrated into Wheatstone bridge circuits to accurately measure parameters such as force or pressure. Within this context, each element within the circuit exhibits a resistance that undergoes subtle variations when subjected to mechanical strain. The primary objective is to convert minuscule...
1.0K
01:29Wheatstone Bridge
1.2K
An ohmmeter is a resistance-measuring device. It works by applying a voltage to a resistor of unknown resistance and measuring the current across the resistor. The resistance value is deduced using Ohm's law. Usually, the standard configuration of an ohmmeter comprises a voltmeter or an ammeter. However, such configurations are limited in accuracy because the meters alter the voltage applied to the resistor and the current that flows through it.
Thus, for accurate resistance measurements, a...
Thus, for accurate resistance measurements, a...
1.2K
01:24Bridge rectifier
1.6K
The bridge rectifier is essential in electronics for efficiently converting alternating current (AC) to direct current (DC). Comprised of four diodes configured in a bridge layout, this rectifier effectively processes both the positive and negative halves of the AC waveform, making it superior to half-wave and full-wave center-tapped rectifiers in terms of voltage regulation and output stability.
Operationally, the bridge rectifier allows current flow through two of its diodes during each...
Operationally, the bridge rectifier allows current flow through two of its diodes during each...
1.6K
01:30Venous Thrombosis I: Introduction
468
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
468
01:26Cross-bridge Cycle
122.8K
As muscle contracts, the overlap between the thin and thick filaments increases, decreasing the length of the sarcomere—the contractile unit of the muscle—using energy in the form of ATP. At the molecular level, this is a cyclic, multistep process that involves binding and hydrolysis of ATP, and movement of actin by myosin.
122.8K