Perna E
De Gasperis Cardio Center, Niguarda Ca’ Granda Hospital,
Piazza Ospedale Maggiore 3, 20162 Milan
Italy
Case Report
Between Scylla and Charybdis: Difficult Balance between Anticoagulation and Bleeding in the Management of LVAD Thrombosis: A Case Report
Author(s): Perna E, Cipriani MG, De Marco F, Macera F, Milazzo F, Garascia A, Ammirati E, D’Angelo L, Gagliardone MP, Russo CF and Frigerio MPerna E, Cipriani MG, De Marco F, Macera F, Milazzo F, Garascia A, Ammirati E, D’Angelo L, Gagliardone MP, Russo CF and Frigerio M
Case: The patient was a 67 years old male. The patient experienced an episode of LVAD thrombosis. Device replacement was not possible due to high surgical risk. The pharmacological strategy was adopted with intraventricular fibrinolysis+intravenous Tirofiban infusion. Outcome: Despite thrombosis resolution, two episodes of bleeding occurred. Thus we lowered antithrombotic drugs dose with subsequent relapse risk. At the end, a successful therapeutic strategy was achieved. Conclusion: Our case report shows how the balance between anticoagulation and bleeding is a tricky feature of LVAD thrombosis management. When device replacement is not an option, trying to remove the clot soon with aggressive antithrombotic therapy can be a winning strategy and can quickly stop the hemolysis. Unfortunately, it can produce major bleeding events, harmful and potentially life-threatening. To be aware of.. View More»
DOI:
10.4172/2329-6607.1000173