Related Experiment Video
Updated: Aug 23, 2026
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Real-World Hemocompatibility Outcomes With Aspirin Omission in a Novel Fully Magnetically Levitated Left Ventricular
Zelin Yin1, Yong Cui2, Zhengdong Hua3
1From the Department of Cardiovascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Aspirin omission in patients with the CH-VAD device, a novel magnetically levitated ventricular assist device, appears safe. Warfarin monotherapy did not increase hemocompatibility-related adverse events compared to aspirin plus warfarin.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- The HeartMate 3 device suggests aspirin omission may be safe.
- The CH-VAD device historically uses standard anticoagulation protocols.
- Assessing aspirin's impact on hemocompatibility is crucial for CH-VAD patients.
Purpose of the Study:
- To evaluate the safety and impact of aspirin omission on hemocompatibility-related adverse events (HRAE) in CH-VAD patients.
- To compare HRAE rates between CH-VAD patients on warfarin alone versus aspirin plus warfarin.
Main Methods:
- A multicenter, retrospective study of 220 CH-VAD patients.
- Patients were divided into two groups: warfarin alone (n=65) and aspirin plus warfarin (n=155).
- Primary endpoint: survival free from major nonsurgical HRAEs (stroke, pump thrombosis, bleeding, thromboembolism) beyond 14 days postimplantation.
Main Results:
- Median follow-up was 368 days.
- Twelve-month survival free from major nonsurgical HRAEs was similar: 85.7% for warfarin alone vs. 82.6% for aspirin plus warfarin (p=0.8771).
- No significant differences in thrombotic or hemorrhagic complication rates were observed.
Conclusions:
- Warfarin monotherapy is not associated with a higher rate of HRAEs in clinically stable CH-VAD recipients.
- Aspirin omission may be a safe alternative anticoagulation strategy for select CH-VAD patients.
- Baseline estimated glomerular filtration rate was the only independent predictor of HRAEs.
Abstract:
Evidence from the fully magnetically levitated HeartMate 3 has suggested that aspirin omission may be safe and potentially beneficial. CH-VAD, a novel fully magnetically levitated ventricular assist device, has historically used standard anticoagulation protocols. This multicenter, retrospective study aimed to assess the impact of aspirin omission on hemocompatibility-related adverse events (HRAE) in CH-VAD patients. Among 274 patients implanted with the CH-VAD across 13 centers in China, 220 met the inclusion criteria; 155 received aspirin plus warfarin, and 65 received warfarin alone. The primary endpoint was survival free from major nonsurgical HRAEs, defined as stroke, pump thrombosis, major bleeding, or peripheral arterial thromboembolism beyond 14 days postimplantation. During a median follow-up of 368 days (interquartile range [IQR], 173-597), 186 patients (84.5%) met the primary endpoint. Twelve month survival free from major nonsurgical HRAEs was 85.7% in patients treated with warfarin alone and 82.6% in those treated with warfarin and aspirin (log-rank p = 0.8771). Rates of thrombotic and hemorrhagic complications were not significantly different. In multivariable Cox modeling, baseline estimated glomerular filtration rate was the only independent predictor of HRAEs. In clinically stable CH-VAD recipients, warfarin monotherapy was not associated with a higher rate of HRAEs.
