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Management of intracranial hemorrhage in a child with a left ventricular assist device
Author(s) -
Haque Raqeeb,
Wojtasiewicz Teresa,
Gerrah Rabin,
Gilmore Lisa,
Saiki Yoshikatsu,
Chen Jonathan M.,
Richmond Marc,
Feldstein Neil A.,
Anderson Richard C. E.
Publication year - 2012
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2012.01650.x
Subject(s) - medicine , hematoma , chronic subdural hematoma , surgery , heart transplantation , ventricular assist device , transplantation , heart failure , cardiology
Haque R, Wojtasiewicz T, Gerrah R, Gilmore L, Saiki Y, Chen JM, Richmond M, Feldstein NA, Anderson RCE. Management of intracranial hemorrhage in a child with a left ventricular assist device. Abstract: Pediatric patients bridged to heart transplant with LVADs require chronic anticoagulation and are at increased risk of hemorrhagic complications, including intracranial hemorrhage. In this population, intracranial hemorrhage is often fatal. We report a case of successful management of a five‐yr‐old‐boy with DCM on an LVAD who developed a subdural hematoma. We initially chose medical management, weighing the patient’s high risk of thromboembolism from anticoagulation reversal against the risk of his chronic subdural hematoma. When head CT showed expansion of the hemorrhage with increasing midline shift, we chose prompt surgical evacuation of the hematoma with partial reversal of anticoagulation, given the increased risk of acute deterioration. The patient ultimately received an orthotopic heart transplant and was discharged with no permanent neurological complications. This represents a case of a pediatric patient on an LVAD who survived a potentially fatal subdural hematoma and was successfully bridged to cardiac transplantation.