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Anticoagulation therapy for a LVAD patient with acquired warfarin resistance

  • Case Report
  • Artificial Heart (Clinical)
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Abstract

Anticoagulation therapy with warfarin is essential for postoperative management in patients with left ventricular assist device (LVAD). In this manuscript, we report the case of a patient who developed warfarin resistance after LVAD implantation. Although we administered a novel anticoagulant drug in addition to warfarin and aspirin therapy, the patient developed a major stroke. The patient needed continuous intravenous heparinization until heart transplantation for approximately 2 years. Meticulous management of anticoagulation therapy is essential for a LVAD with warfarin resistance. To our best knowledge, our case is the first case of warfarin resistance in a patient with LVAD.

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References

  1. Wever-Pinzon O, Naka Y, Garan AR, Takeda K, Pan S, Takayama H, et al. National trends and outcomes in device-related thromboembolic complications and malfunction among heart transplant candidates supported with continuous-flow left ventricular assist devices in the United States. J Heart Lung Transplant. 2016;35:884–92.

    Article  PubMed  Google Scholar 

  2. Topkara VK, Knotts RJ, Jennings DL, Garan AR, Levin AP, Breskin A, et al. Effect of CYP2C9 and VKORC1 gene variants on warfarin response in patients with continuous-flow left ventricular assist devices. ASAIO J. 2016;62:558–64.

    Article  CAS  PubMed  Google Scholar 

  3. KE OS, Meany B, Hurley JP. Warfarin resistance due to VKORC1 gene mutation in a patient following mechanical aortic valve replacement with an ON-X valve. Int J Cardiol. 2015;188:63–4.

    Article  Google Scholar 

  4. Yasar AS, Balbay Y, Maden O, Sasmaz H. Early mechanical mitral valve thrombosis in a patient with warfarin resistance. J Heart Valve Dis. 2007;16:200–2.

    PubMed  Google Scholar 

  5. Loebstein R, Dvoskin I, Halkin H, Vecsler M, Lubetsky A, Rechavi G, et al. A coding VKORC1 Asp36Tyr polymorphism predisposes to warfarin resistance. Blood. 2007;109:2477–80.

    Article  CAS  PubMed  Google Scholar 

  6. Gellatly RM. Intravenous warfarin as an alternative for anticoagulation. Pharmacotherapy. 2007;27:933–5.

    Article  CAS  PubMed  Google Scholar 

  7. Terrovitis JV, Ntalianis A, Kapelios CJ, Vakrou S, Diakos N, Katsaros L, et al. Dabigatran etexilate as second-line therapy in patients with a left ventricular assist device. Hellenic J Cardiol. 2015;56:20–5.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Yamadaoka, 2-2, Suita, Osaka, 565-0087, Japan

    Daisuke Yoshioka, Koichi Toda, Shunsuke Saito, Keitaro Domae & Yoshiki Sawa

  2. Department of Cardiology, Hiroshima University Hospital, Hiroshima, Japan

    Takayuki Hidaka

  3. Department of Pharmacology, Osaka University Graduate School of Medicine, Suita, Japan

    Soichiro Yasuda

Authors
  1. Daisuke Yoshioka
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  2. Koichi Toda
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  3. Takayuki Hidaka
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  4. Soichiro Yasuda
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  5. Shunsuke Saito
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  6. Keitaro Domae
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  7. Yoshiki Sawa
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Corresponding author

Correspondence to Yoshiki Sawa.

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Yoshioka, D., Toda, K., Hidaka, T. et al. Anticoagulation therapy for a LVAD patient with acquired warfarin resistance. J Artif Organs 20, 260–262 (2017). https://doi.org/10.1007/s10047-017-0947-8

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  • DOI: https://doi.org/10.1007/s10047-017-0947-8

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