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Updated: Aug 28, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Long-Term Withdrawal of Anticoagulation and Antiplatelet Therapy in a HeartMate 3 Left Ventricular Assist Device

Kristina Menchaca1, Catherine A Ostos Perez1, Nemanja Draguljevic2

  • 1Internal Medicine, University of Miami/JFK (John Fitzgerald Kennedy) Medical Center, Atlantis, USA.

Cureus
|September 16, 2022
PubMed

Insights

A patient with end-stage heart failure received a HeartMate 3 device. Discontinuing anticoagulation for bleeding did not lead to adverse events like pump thrombosis or thromboembolism.

Area of Science:

  • Cardiology
  • Medical Devices
  • Mechanical Circulatory Support

Background:

  • End-stage heart failure necessitates advanced treatment options.
  • Left Ventricular Assist Devices (LVADs) improve survival and quality of life.
  • HeartMate 3 is an advanced LVAD for advanced heart failure management.

Observation:

  • A 73-year-old male with end-stage heart failure received a HeartMate 3 device.
  • Systemic anticoagulation and antiplatelet therapy were paused for 52 days due to postoperative bleeding.
  • Warfarin monotherapy was reinstituted post-hemorrhage, targeting an INR of 1.8-2.5.

Findings:

  • No pump thrombosis was reported eight months post-restart of anticoagulation.
  • No thromboembolic events occurred during the follow-up period.
  • No significant bleeding events were reported after resuming warfarin therapy.

Implications:

  • Temporary cessation of anticoagulation in LVAD patients may be feasible in specific bleeding scenarios.
  • Careful management of anticoagulation is crucial for LVAD recipients.
  • Further research is needed to establish optimal anticoagulation strategies for LVADs following bleeding complications.

Keywords:
anticoagulationantiplateletsbleedingheartmate 3left ventricular assist device (lvad)pump thrombosis

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