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 |
Year of first publication: | 2021 |
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 |
Files in This Item:
File | Description | Size | Format | ||
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role_of_acquired_von_willebra-20220811115355315.pdf | 989.15 kB | Adobe PDF | View/Open |