Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II)

TY - JOUR

T1 - Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II)

AU - Klovaite, Jolanta

AU - Gustafsson, Finn

AU - Mortensen, Svend A

AU - Sander, Kåre

AU - Nielsen, Lars Bo

N1 - Keywords: Adult; Anti-Bacterial Agents; Blood Platelets; Female; Heart Failure; Heart-Assist Devices; Hemorrhage; Humans; International Normalized Ratio; Male; Middle Aged; Platelet Aggregation; Platelet Aggregation Inhibitors; Ristocetin; Stroke Volume; Ventricular Dysfunction, Left; Ventricular Function, Left; Young Adult; von Willebrand Factor

PY - 2009

Y1 - 2009

N2 - OBJECTIVES: This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function. BACKGROUND: HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies. METHODS: We measured agonist-induced platelet aggregation in 16 patients on HMII support. RESULTS: The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves. CONCLUSIONS: The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.

AB - OBJECTIVES: This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function. BACKGROUND: HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies. METHODS: We measured agonist-induced platelet aggregation in 16 patients on HMII support. RESULTS: The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves. CONCLUSIONS: The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.

U2 - 10.1016/j.jacc.2009.02.048

DO - 10.1016/j.jacc.2009.02.048

M3 - Journal article

C2 - 19497443

SN - 0735-1097

VL - 53

SP - 2162

EP - 2167

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 23

ER -