Long-term discontinuation of warfarin in a patient with HeartMate 3 left ventricular assist device without thromboembolic events.
J Int Med Res
; 52(6): 3000605241258474, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38901839
ABSTRACT
The gold standard therapy for end-stage heart failure is cardiac transplantation. However, in the face of a donor shortage, a mechanical assist device such as the left ventricular assist device HeartMate 3 (Abbott Laboratories, Abbott Park, IL, USA) serves as bridging therapy to transplantation and/or destination therapy. Current guidelines recommend anticoagulation with a vitamin K antagonist in combination with low-dose aspirin. We herein report a challenging anticoagulation regimen in a patient with a HeartMate 3 in whom systemic anticoagulation with warfarin was not feasible for 4 years because of low compatibility and a rare X-factor deficiency. This is a rare hematological disorder, estimated to affect approximately 1 in every 500,000 to 1,000,000 people in the general population. The patient finally received a modified anticoagulation regimen involving the combination of rivaroxaban and clopidogrel without warfarin. Under this regimen, the patient remained free of thromboembolic complications for 4 years with in situ placement of the left ventricular assist device. This case illustrates that under specific circumstances, long-term absence of warfarin therapy is feasible in patients with a HeartMate 3.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tromboembolia
/
Varfarina
/
Coração Auxiliar
/
Anticoagulantes
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Int Med Res
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Alemanha