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CARDIOVASCULAR ANESTHESIOLOGY

Thromboembolic Complications During Weaning from Right Ventricular Assist Device Support

Corinna Velik-Salchner, MD^*, Christoph Hoermann, MD^*, Daniel Hoefer, MD, Josef Margreiter, MD^*, and Peter Mair, MD^*

From the Departments of *Anaesthesiology and Intensive Care Medicine, and Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria.

Address correspondence and reprint requests to Corinna Velik-Salchner, MD, Department of Anaesthesiology and Intensive Care Medicine, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. Address e-mail to corinna.velik{at}i-med.ac.at.

Abstract

We report on two patients who experienced life-threatening thromboembolic complications during prolonged weaning from Levitronix® CentriMag right ventricular assist device support. Right ventricular assist device flow in both patients was reduced below 2 L/min for a period of 72 or 36 h to closely monitor patients' hemodynamics and echocardiography because the extent of right ventricular recovery was difficult to assess. Thrombus formation occurred despite adjusting the heparin dosage to achieve partial prothrombin time values between 60 and 70 s. Periods of reduced flow during Levitronix® CentriMag support must be kept short, and an additional bolus dose of heparin should be considered.