Effect of high dose platelet inhibitor treatment on thromboembolism in Novacor patients

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Abstract
Background: Thromboembolism and bleeding are among the most hazardous complications following implantation of long-term left ventricular support systems. This report focuses on the effect of high dose platelet inhibitor treatment in patients with the Novacor system to prevent thromboembolic events. Methods: Thirty-eight (out of 58) Novacor patients (43±11 years old) were studied in a non-randomized manner. Postimplantation: 20 patients were treated with heparin only (control group), whereas in the other 18 patients aspirin (3×330 mg/day) and dipyridamol (3×75 mg/day) were added to the treatment protocol (aspirin group). Results: Age, body size, underlying heart disease and support interval were comparable among both groups, however, patients in the aspirin group were much sicker with regard to urgency status, postoperative right heart failure and hematologic disorders. Cerebral thromboembolic complications were lower in the aspirin group (33% of patients, 0.4±0.7 events) as compared to the control group (55% (P=0.18), 1.4±2.3 events (P=0.048)). Non-cerebral thromboembolism of surgical relevance was rare. The incidence of bleeding complications was mildly increased in the aspirin group. Conclusion: The addition of high dose platelet inhibitors seems to lower the incidence of thromboembolism in Novacor patients.