Role of acquired von Willebrand syndrome in the development of bleeding complications in patients treated with Impella RP devices

dc.contributor.authorOezkur, Mehmet
dc.contributor.authorReda, Sara
dc.contributor.authorRühl, Heiko
dc.contributor.authorTheuerkauf, Nils
dc.contributor.authorKreyer, Stefan
dc.contributor.authorDuerr, Georg Daniel
dc.contributor.authorCharitos, Efstratios
dc.contributor.authorSilaschi, Miriam
dc.contributor.authorMedina, Marta
dc.contributor.authorZimmer, Sebastian
dc.contributor.authorPutensen, Christian
dc.contributor.authorTreede, Hendrik
dc.date.accessioned2022-08-11T10:05:44Z
dc.date.available2022-08-11T10:05:44Z
dc.date.issued2021
dc.description.abstractAxial 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.en_GB
dc.identifier.doihttp://doi.org/10.25358/openscience-7549
dc.identifier.urihttps://openscience.ub.uni-mainz.de/handle/20.500.12030/7563
dc.language.isoengde
dc.rightsCC-BY-4.0*
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subject.ddc610 Medizinde_DE
dc.subject.ddc610 Medical sciencesen_GB
dc.titleRole of acquired von Willebrand syndrome in the development of bleeding complications in patients treated with Impella RP devicesen_GB
dc.typeZeitschriftenaufsatzde
jgu.journal.titleScientific reportsde
jgu.journal.volume11de
jgu.organisation.departmentFB 04 Medizinde
jgu.organisation.nameJohannes Gutenberg-Universität Mainz
jgu.organisation.number2700
jgu.organisation.placeMainz
jgu.organisation.rorhttps://ror.org/023b0x485
jgu.pages.alternative23722de
jgu.publisher.doi10.1038/s41598-021-02833-8de
jgu.publisher.issn2045-2322de
jgu.publisher.nameMacmillan Publishers Limited, part of Springer Naturede
jgu.publisher.placeLondonde
jgu.publisher.year2021
jgu.rights.accessrightsopenAccess
jgu.subject.ddccode610de
jgu.type.dinitypeArticleen_GB
jgu.type.resourceTextde
jgu.type.versionPublished versionde

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