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Effective treatment with a new protocol using tissue-type plasminogen activator thrombolysis for pump thrombosis with the HVAD device

Standard

Effective treatment with a new protocol using tissue-type plasminogen activator thrombolysis for pump thrombosis with the HVAD device. / Schrage, Benedikt; Grahn, Hanno; Wagner, Florian M; Bernhardt, Alexander; Rybczynski, Meike; Blankenberg, Stefan; Reichenspurner, Hermann; Barten, Markus J.

In: EUR HEART J-ACUTE CA, Vol. 7, No. 8, 12.2018, p. 766-770.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schrage, B, Grahn, H, Wagner, FM, Bernhardt, A, Rybczynski, M, Blankenberg, S, Reichenspurner, H & Barten, MJ 2018, 'Effective treatment with a new protocol using tissue-type plasminogen activator thrombolysis for pump thrombosis with the HVAD device', EUR HEART J-ACUTE CA, vol. 7, no. 8, pp. 766-770. https://doi.org/10.1177/2048872616688418

APA

Schrage, B., Grahn, H., Wagner, F. M., Bernhardt, A., Rybczynski, M., Blankenberg, S., Reichenspurner, H., & Barten, M. J. (2018). Effective treatment with a new protocol using tissue-type plasminogen activator thrombolysis for pump thrombosis with the HVAD device. EUR HEART J-ACUTE CA, 7(8), 766-770. https://doi.org/10.1177/2048872616688418

Vancouver

Schrage B, Grahn H, Wagner FM, Bernhardt A, Rybczynski M, Blankenberg S et al. Effective treatment with a new protocol using tissue-type plasminogen activator thrombolysis for pump thrombosis with the HVAD device. EUR HEART J-ACUTE CA. 2018 Dec;7(8):766-770. https://doi.org/10.1177/2048872616688418

Bibtex

@article{51125bef87434282adcec4e9c9d4767f,
title = "Effective treatment with a new protocol using tissue-type plasminogen activator thrombolysis for pump thrombosis with the HVAD device",
abstract = "BACKGROUND:: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis.METHODS:: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events. In all events we used a uniform treatment protocol.RESULTS:: All patients presented with a sufficient anticoagulation and had symptoms of heart failure. However, all patients were haemodynamically stable. Six of nine patients presented with a mean arterial pressure above 85 mm Hg and every patient presented with an infection. In all events we achieved short-term success with resolution of the pump thrombosis within a median time of nine hours. Three of nine patients developed recurrent pump thrombosis after >60 days. Besides one case of nonfatal intracranial haemorrhage and one case of minor bleeding, there were no adverse events.CONCLUSION:: Our data indicates that using a uniform treatment protocol that builds on usage of tissue-type plasminogen activator thrombolysis might be an effective tool for treatment of continuous flow left ventricular assist device pump thrombosis in haemodynamically stable patients. Additionally, our data indicates that infection may be a potential trigger for pump thrombosis.",
keywords = "Adult, Female, Fibrinolytic Agents/therapeutic use, Follow-Up Studies, Heart Failure/therapy, Heart-Assist Devices/adverse effects, Humans, Male, Middle Aged, Prosthesis Failure, Retrospective Studies, Thrombolytic Therapy/methods, Thrombosis/drug therapy, Tissue Plasminogen Activator/therapeutic use, Treatment Outcome, Young Adult",
author = "Benedikt Schrage and Hanno Grahn and Wagner, {Florian M} and Alexander Bernhardt and Meike Rybczynski and Stefan Blankenberg and Hermann Reichenspurner and Barten, {Markus J}",
year = "2018",
month = dec,
doi = "10.1177/2048872616688418",
language = "English",
volume = "7",
pages = "766--770",
journal = "EUR HEART J-ACUTE CA",
issn = "2048-8726",
publisher = "SAGE Publications",
number = "8",

}

RIS

TY - JOUR

T1 - Effective treatment with a new protocol using tissue-type plasminogen activator thrombolysis for pump thrombosis with the HVAD device

AU - Schrage, Benedikt

AU - Grahn, Hanno

AU - Wagner, Florian M

AU - Bernhardt, Alexander

AU - Rybczynski, Meike

AU - Blankenberg, Stefan

AU - Reichenspurner, Hermann

AU - Barten, Markus J

PY - 2018/12

Y1 - 2018/12

N2 - BACKGROUND:: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis.METHODS:: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events. In all events we used a uniform treatment protocol.RESULTS:: All patients presented with a sufficient anticoagulation and had symptoms of heart failure. However, all patients were haemodynamically stable. Six of nine patients presented with a mean arterial pressure above 85 mm Hg and every patient presented with an infection. In all events we achieved short-term success with resolution of the pump thrombosis within a median time of nine hours. Three of nine patients developed recurrent pump thrombosis after >60 days. Besides one case of nonfatal intracranial haemorrhage and one case of minor bleeding, there were no adverse events.CONCLUSION:: Our data indicates that using a uniform treatment protocol that builds on usage of tissue-type plasminogen activator thrombolysis might be an effective tool for treatment of continuous flow left ventricular assist device pump thrombosis in haemodynamically stable patients. Additionally, our data indicates that infection may be a potential trigger for pump thrombosis.

AB - BACKGROUND:: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis.METHODS:: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events. In all events we used a uniform treatment protocol.RESULTS:: All patients presented with a sufficient anticoagulation and had symptoms of heart failure. However, all patients were haemodynamically stable. Six of nine patients presented with a mean arterial pressure above 85 mm Hg and every patient presented with an infection. In all events we achieved short-term success with resolution of the pump thrombosis within a median time of nine hours. Three of nine patients developed recurrent pump thrombosis after >60 days. Besides one case of nonfatal intracranial haemorrhage and one case of minor bleeding, there were no adverse events.CONCLUSION:: Our data indicates that using a uniform treatment protocol that builds on usage of tissue-type plasminogen activator thrombolysis might be an effective tool for treatment of continuous flow left ventricular assist device pump thrombosis in haemodynamically stable patients. Additionally, our data indicates that infection may be a potential trigger for pump thrombosis.

KW - Adult

KW - Female

KW - Fibrinolytic Agents/therapeutic use

KW - Follow-Up Studies

KW - Heart Failure/therapy

KW - Heart-Assist Devices/adverse effects

KW - Humans

KW - Male

KW - Middle Aged

KW - Prosthesis Failure

KW - Retrospective Studies

KW - Thrombolytic Therapy/methods

KW - Thrombosis/drug therapy

KW - Tissue Plasminogen Activator/therapeutic use

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1177/2048872616688418

DO - 10.1177/2048872616688418

M3 - SCORING: Journal article

C2 - 28058856

VL - 7

SP - 766

EP - 770

JO - EUR HEART J-ACUTE CA

JF - EUR HEART J-ACUTE CA

SN - 2048-8726

IS - 8

ER -