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

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Difficult Decisions in Cardiothoracic Critical Care Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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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.

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Correspondence to Mark S. Slaughter .

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Appendix (Tables 21.3 and 21.4)

Appendix (Tables 21.3 and 21.4)

Table 21.3 Overview of PREVENT surgical recommendations
Table 21.4 Definition of pump thrombosis

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Schumer, E.M., Slaughter, M.S. (2019). The LVAD Patient with Dark Urine and Elevated LDH: Diagnosis and Treatment of Pump Thrombosis. In: Lonchyna, V. (eds) Difficult Decisions in Cardiothoracic Critical Care Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-04146-5_21

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  • DOI: https://doi.org/10.1007/978-3-030-04146-5_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04145-8

  • Online ISBN: 978-3-030-04146-5

  • eBook Packages: MedicineMedicine (R0)

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