Management of anticoagulant therapy after implantation of a new ventricular assist device
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(1. TEDA International Cardiovascular Hospital, Tianjin 300457, China.2. Rocket Heart Technology Co. Ltd, Tianjin 300457)

Clc Number:

R-33

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    Abstract:

    Objective To determine an effective anticoagulant treatment program by the management ofanticoagulants after the implantation of a new left ventricular assist device (LVAD) in sheep. Methods Six male healthysheep weight 80±5 kg were implanted with the same type of LVAD. Blood was collected once a day in the first two weeksand once a week thereafter. The sheep were observed and evaluated for 10 weeks. Results The physiological state of thesix experimental animals: the international normalized ratio (INR) was 1. 265±0. 146; activated partial thromboplastintime (APTT) was 41. 017±12. 530 s; lactate dehydrogenase (LDH) level was 411±119 U/ L. One to three days afteroperation, the control of INR and APTT by heparin and warfarin were 1. 4 and 1. 7 times higher. Heparin was stopped whenthe animal could eat again. INR was monitored continuously and the warfarin dosage was adjusted. Two weeks afteroperation, warfarin 7. 96±5. 45 mg/ d was used and the INR was 1. 89±0. 53. Ten weeks after operation, warfarin 11. 44±7. 80 mg/ d was used, the INR was 2. 01±0. 91 and the level of LDH was 509±92 U/ L. During the study, no thrombuscaused by the pump was found, and no gastrointestinal bleeding was found in experimental animals. Conclusions It isnecessary to apply heparin early after the operation. Under the premise of not changing the diet structure, the anticoagulanttreatment standard for each individual is established within 2 weeks. The use of warfarin only can achieve the expected anticoagulant effect.

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History
  • Received:December 11,2018
  • Online: August 01,2019
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