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The LVAD Patient with Dark Urine and Elevated LDH: Diagnosis and Treatment of Pump Thrombosis

  • Erin M. Schumer
  • Mark S. SlaughterEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Ventricular assist device therapy provides patients with end-stage heart failure a durable treatment that improves survival and quality of life; however, pump hemolysis and thrombosis remain critical issues contributing to morbidity and mortality. Currently, no consensus exists on the full explanation for these phenomena, but it is hypothesized that variability in surgical implantation and clinical management strategies are strong contributing factors. Adoption of surgical principles and strict adherence to anti-thrombotic, anti-hypertensive, and pump flow protocols is crucial to reducing pump thrombosis. Early identification of hemolysis and therefore pump thrombosis followed by early intervention is key to improving overall morbidity and mortality.

Keywords

Heart failure HeartMateII HeartMate III Hemolysis HVAD LDH LVAD Thrombosis 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular and Thoracic SurgeryUniversity of LouisvilleLouisvilleUSA

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