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Updated: Dec 6, 2025

In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Thromboelastometry-guided anticoagulation reversal in a patient with ventricular assist device with intracranial
Veronica A Bonderski1, Josue Portillo2, Lydia Sharp2
1Department of Pharmacy, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, United States.
Abstract:
Intracranial hemorrhage (ICH) is a known complication in patients with ventricular assist devices (VAD). We present a case of a 42-year-old male with a VAD and on warfarin who presented to the emergency department with ICH necessitating anticoagulant reversal. An attenuated dose of 15 units/kg of 4-factor prothrombin complex-concentrates (4F-PCC) was given and the patient's coagulation profile was subsequently assessed using rotational thromboelastometry (ROTEM®) to determine appropriateness of reversal. ROTEM® analysis showed adequate reversal at the time of assessment and the patient ultimately returned home without further functional deficits, highlighting the role of ROTEM® to guide anticoagulation reversal in the VAD patient population.
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