Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis: A Clinical Dilemma
Author(s) -
Raffa Giuseppe M.,
D'Ancona Giuseppe,
Sciacca Sergio,
Pietrosi Astrid,
Hernandez Baravoglia Cesar M.,
Turrisi Marco,
Romano Giuseppe,
Armaro Alessandro,
Stringi Vincenzo,
Clemenza Francesco,
Pilato Michele
Publication year - 2015
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12423
Subject(s) - medicine , ventricle , thrombolysis , groin , thrombosis , ventricular assist device , cardiology , surgery , heart failure , myocardial infarction
Abstract Endoventricular thrombolytic procedure ( ETP ) has been used to treat continuous‐flow left ventricle assist device ( CF ‐ LVAD ) thrombosis. The study aims to investigate the occurrence of complications after ETP . Data were retrospectively reviewed and analyzed in a series of patients who underwent CF ‐ LVAD followed by ETP . Since N ovember 2010, 20 patients underwent HeartWare CF ‐L VAD implantation at our institute. Four patients (20%) developed pump thrombosis and underwent a total of nine ETPs with tissue plasminogen activator infused into the left ventricle. The mean age was 60.2 ± 9 years. ETP was performed via either the femoral ( n = 6) or radial artery ( n = 3). Five ETPs (55.5%) were complicated by left and right radial artery occlusion, two by groin hematomas, and one by femoral artery false aneurysm. ETP carries a strong risk of vascular access complications that, in CF ‐ LVAD patients, may add to the already complex clinical profile and economic burden; thus, a less invasive treatment is advisable whenever required.