Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-7549
Authors: Oezkur, Mehmet
Reda, Sara
Rühl, Heiko
Theuerkauf, Nils
Kreyer, Stefan
Duerr, Georg Daniel
Charitos, Efstratios
Silaschi, Miriam
Medina, Marta
Zimmer, Sebastian
Putensen, Christian
Treede, Hendrik
Title: Role of acquired von Willebrand syndrome in the development of bleeding complications in patients treated with Impella RP devices
Online publication date: 11-Aug-2022
Language: english
Abstract: Axial flow pumps are standard treatment in cases of cardiogenic shock and high-risk interventions in cardiology and cardiac surgery, although the optimal anticoagulation strategy remains unclear. We evaluated whether laboratory findings could predict bleeding complications and acquired von Willebrand syndrome (avWS) among patients who were treated using axial flow pumps. We retrospectively evaluated 60 consecutive patients who received Impella devices (Impella RP: n = 20, Impella CP/5.0: n = 40; Abiomed Inc., Danvers, USA) between January 2019 and December 2020. Thirty-two patients (53.3%) experienced major or fatal bleeding complications (Bleeding Academic Research Consortium score of > 3) despite intravenous heparin being used to maintain normal activated partial thromboplastin times (40–50 s). Extensive testing was performed for 28 patients with bleeding complications (87.5%). Relative to patients with left ventricular support, patients with right ventricular support were less likely to develop avWS (87.5% vs. 58.8%, p = 0.035). Bleeding was significantly associated with avWS (odds ratio [OR]: 20.8, 95% confidence interval [CI]: 3.3–128.5; p = 0.001) and treatment duration (OR: 1.3, 95% CI 1.09–1.55; p = 0.003). Patients with avWS had longer Impella treatment than patients without avWS (2 days [1–4.7 days] vs. 7.3 days [3.2–13.0 days]). Bleeding complications during Impella support were associated with avWS in our cohort, while aPTT monitoring was not sufficient to prevent bleeding complications. A more targeted anticoagulation monitoring might be needed for patients who receive Impella devices.
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
ROR: https://ror.org/023b0x485
DOI: http://doi.org/10.25358/openscience-7549
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY
Information on rights of use: https://creativecommons.org/licenses/by/4.0/
Journal: Scientific reports
11
Pages or article number: 23722
Publisher: Macmillan Publishers Limited, part of Springer Nature
Publisher place: London
Issue date: 2021
ISSN: 2045-2322
Publisher DOI: 10.1038/s41598-021-02833-8
Appears in collections:JGU-Publikationen

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