Vondran, Maximilian
[Author];
von Aspern, Konstantin
[Author];
Garbade, Jens
[Author];
Lässing, Johannes
[Author];
Kiefer, Philipp
[Author];
Rastan, Ardawan Julian
[Author];
Borger, Michael Andrew
[Author];
Schroeter, Thomas
[Author]
Is implantable cardioverter defibrillator surgery in patients with an implanted left ventricular assist device safe under uninterrupted oral anticoagulation?
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Media type:
E-Article
Title:
Is implantable cardioverter defibrillator surgery in patients with an implanted left ventricular assist device safe under uninterrupted oral anticoagulation?
Contributor:
Vondran, Maximilian
[Author];
von Aspern, Konstantin
[Author];
Garbade, Jens
[Author];
Lässing, Johannes
[Author];
Kiefer, Philipp
[Author];
Rastan, Ardawan Julian
[Author];
Borger, Michael Andrew
[Author];
Schroeter, Thomas
[Author]
Published:
Hoboken: Wiley, [2024]
Published in:Artificial Organs ; 46 (2022), Seite 1564-1572
Description:
AbstractBackground: Implantable cardioverter-defibrillator(ICD) surgery in patientswith implanted left ventricular assist devices (LVAD) is associated with an increasedrisk of bleeding complications because of the need to ensure that thesepatients are adequately anticoagulated. Our study aimed to evaluate the safetyof our new strategy of uninterrupted oral anticoagulation compared to heparin-bridgingduring the surgical interval.Methods: Between January 2009 and January 2020, 116 patients with LVADunderwent ICD surgery. Since January 2015, 60 patients were operated undercontinued sufficient oral anticoagulation with a vitamin k antagonist (VKAgroup). Fifty-sixpatients underwent a heparin-bridgingregimen (heparin group).Demographics, perioperative data, complications, and mortality were analyzed.Results: Bleeding complications attributable to the surgical intervention occurredmore often (19.6% vs. 10.0%, p = 0.142) and at a higher rate of re-exploratorysurgery(14.3% vs. 5.0%, p = 0.088) in the heparin group without reaching statisticalsignificance. Moreover, the heparin group patients' postoperative total length ofstay was 10 days longer (17.8 ± 23.8 days vs. 8.3 ± 9.5 days, p = 0.007). There wereno procedure-relateddeaths, no thromboembolic events, and no LVAD-relatedthrombosis.Conclusion: Our strategy of uninterrupted oral anticoagulation is safe and resultsin a reduction by more than half the number of days in hospital without anincrease in adverse events.