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LVAD Implantation in Patients with Factor V Leiden Mutation
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A3515 - LVAD Implantation in Patients with Factor V Leiden Mutation
Author Block: A. Critsinelis, F. Rubio, C. Kurihara, H. Lamba, F. Cheema, M. Kawabori, T. Sugiura, R. Delgado, L. Simpson, A. Nair, A. Civitello, T. Rosengart, O. H. Frazier, J. Morgan; Division of Cardiothoracic Transplantation and Circulatory Support, Baylor College of Medicine, Houston, TX, United States.
Introduction: Factor V Leiden (FVL) mutation is a R506Q mutation of the factor V gene that results in a hypercoagulable state. There is a paucity of data describing patients with FVL who have undergone continuous-flow left ventricular assist device (CF-LVADs) implantation. We describe our experience with 4 patients with FVL who underwent successful LVAD implantation. Case Reports: Four patients with FVL underwent HM 2 LVAD implantation. There were no intraoperative thrombotic complications during LVAD implantation. Heparin and Aspirin were started on postoperative day 1 and three patients received secondary anti-platelet therapy with dipyridamole. Aortic valve thrombus developed in one patient which was treated with Bivalirudin. Warfarin was started on postoperative day three. Three patients experienced bleeding events. All 4 patients were successfully bridged to orthotopic heart transplantation and are currently doing well two years after transplantation. Discussion: It is possible to safely implant CF-LVADs in patients with FVL. Additional investigation is required to further identify methods of reducing bleeding complications in this challenging cohort of patients.
Author Block: A. Critsinelis, F. Rubio, C. Kurihara, H. Lamba, F. Cheema, M. Kawabori, T. Sugiura, R. Delgado, L. Simpson, A. Nair, A. Civitello, T. Rosengart, O. H. Frazier, J. Morgan; Division of Cardiothoracic Transplantation and Circulatory Support, Baylor College of Medicine, Houston, TX, United States.
Introduction: Factor V Leiden (FVL) mutation is a R506Q mutation of the factor V gene that results in a hypercoagulable state. There is a paucity of data describing patients with FVL who have undergone continuous-flow left ventricular assist device (CF-LVADs) implantation. We describe our experience with 4 patients with FVL who underwent successful LVAD implantation. Case Reports: Four patients with FVL underwent HM 2 LVAD implantation. There were no intraoperative thrombotic complications during LVAD implantation. Heparin and Aspirin were started on postoperative day 1 and three patients received secondary anti-platelet therapy with dipyridamole. Aortic valve thrombus developed in one patient which was treated with Bivalirudin. Warfarin was started on postoperative day three. Three patients experienced bleeding events. All 4 patients were successfully bridged to orthotopic heart transplantation and are currently doing well two years after transplantation. Discussion: It is possible to safely implant CF-LVADs in patients with FVL. Additional investigation is required to further identify methods of reducing bleeding complications in this challenging cohort of patients.
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