Demetrios N Mallios*, Amy E Hackmann and Armin Kiankhooy
Department of Surgery, University of Southern California, USAFulltext PDF
Bleeding complications associated with long-term anticoagulation and antiplatelet therapy in the setting of Left Ventricular Assist Device (LVAD) are well-documented. We report the use of apixaban for anticoagulation in a patient who suffered recurrent pericardial effusion and tamponade while on aspirin and unfractionated heparin, necessitating multiple mediastinal re-explorations. Upon initiation of apixaban therapy in exchange for aspirin and unfractionated heparin, the patient had no subsequent bleeding episodes and was ultimately discharged to home on apixaban without further complication. In carefully chosen patients with otherwise limited options, use of apixaban may be an appropriate anticoagulation strategy in the setting of the HeartMate 3 LVAD.
Mallios DN, Hackmann AE, Kiankhooy A. Use of Apixaban for Anticoagulation in a Patient with Recurrent Pericardial Effusion in the Setting of Left Ventricular Assist Device: A Heartmate 3 Experience. Ann Surg Case Rep. 2019; 2(2): 1015.