Blutungen am VAD-System

Sind die Probleme mit den Geräten der 3. Generation behoben?
  • A. Hoffmeier
  • H.A. Welp
  • A. Rukosujew
  • M. Scherer
  • S. Martens
  • M. Köhler
  • H.H. Scheld
  • J.R. Sindermann
Kardiotechnik/EKZ
  • 204 Downloads

Zusammenfassung

Die Auswirkungen von VADs („ventricular assist devices“) auf das Gerinnungssystem sind noch nicht abschließend geklärt. Der Abfall des HMW-vWF („high molecular weight von Willebrand factor“) nach Implantation eines CF-LVAD („continuous flow left VAD“) ist gut durch Studien belegt. Jedoch erleiden nicht alle CF-LVAD-Empfänger Blutungskomplikationen, sodass weitere Untersuchungen notwendig sind, um zusätzliche Risikofaktoren zu identifizieren. Wären weitere Prädiktoren bekannt, würde dies die Entwicklung individualisierter Strategien zur Antikoagulation und Thrombozytenaggregationshemmung bei VAD-Empfängern erleichtern. Angesichts der beträchtlichen Letalität, die mit Blutungen verbunden ist, bleibt diese Komplikation ein wichtiges Hindernis bei der Verbesserung der Behandlungsergebnisse, das es zu überwinden gilt.

Schlüsselwörter

VAD Blutung Therapie Blutungskomplikationen Risikofaktoren 

Hemorrhages in ventricular assist devices

Are the problems with the third generation devices solved?

Abstract

The effects of ventricular assist devices (VADs) on the coagulation system are not yet fully understood. The high molecular weight (HMW) von Willebrand factor (vWF) decrease observed after continuous flow left VAD (CF-LVAD) implantation has been well documented by several studies. However, not all CF-LVAD recipients suffer from bleeding complications so that additional risk factors need to be identified by further studies. If predictors of bleeding complications were known in more detail this would facilitate the development of individualized strategies for anticoagulation and antiplatelet therapy in VAD recipients. In the face of the significant mortality associated with bleeding this complication remains a major obstacle in improving patient outcome which should be overcome.

Keywords

Ventricular assist device Therapy Thrombocyte aggregation inhibition Hemorrhage complications Risk factors 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • A. Hoffmeier
    • 1
  • H.A. Welp
    • 1
  • A. Rukosujew
    • 1
  • M. Scherer
    • 1
  • S. Martens
    • 1
  • M. Köhler
    • 2
  • H.H. Scheld
    • 1
  • J.R. Sindermann
    • 1
  1. 1.Klinik für HerzchirurgieUKM, Westfälische Wilhelms-Universität MünsterMünsterDeutschland
  2. 2.Institut für klinische Radiologie (IKR)Universitätsklinikum MünsterMünsterDeutschland

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