Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis: A Clinical Dilemma

Giuseppe M. Raffa, Giuseppe D'Ancona, Sergio Sciacca, Astrid Pietrosi, Cesar M. Hernandez Baravoglia, Marco Turrisi, Giuseppe Romano, Alessandro Armaro, Vincenzo Stringi, Francesco Clemenza, Michele Pilato

Research output: Contribution to journalArticlepeer-review

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 November 2010, 20 patients underwent HeartWare CF-LVAD 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.

Original languageEnglish
Pages (from-to)526-529
Number of pages4
JournalArtificial Organs
Volume39
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

Keywords

  • Continuous-flow pump
  • Thrombolysis
  • Vascular access-site complications

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

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