Mechanisms of bleeding and approach to patients with axial-flow left ventricular assist devices.


Journal Article (Review)

Axial-flow LVADs have become an integral tool in the management of end-stage heart failure. Consequently, nonsurgical bleeding has emerged as a major source of morbidity and mortality in this fragile population. The mechanisms responsible for these adverse events include acquired von Willebrand disease, GI tract angiodysplasia formation, impaired platelet aggregation, and overuse of anticoagulation therapy. Because of ongoing concerns for pump thrombosis and thromboembolic events, the thrombotic/bleeding paradigm has led to a difficult clinical dilemma for those managing patients treated with axial flow LVADs. As the field progresses, advances in the understanding of the pathological mechanisms underlying bleeding/thrombosis risk, careful risk stratification, and potential use of novel anticoagulants will all play a role in the management of the LVAD patient.

Full Text

Duke Authors

Cited Authors

  • Suarez, J; Patel, CB; Felker, GM; Becker, R; Hernandez, AF; Rogers, JG

Published Date

  • November 2011

Published In

Volume / Issue

  • 4 / 6

Start / End Page

  • 779 - 784

PubMed ID

  • 22086831

Pubmed Central ID

  • 22086831

Electronic International Standard Serial Number (EISSN)

  • 1941-3297

Digital Object Identifier (DOI)

  • 10.1161/CIRCHEARTFAILURE.111.962613


  • eng

Conference Location

  • United States