HEMOSTATIC ALTERATIONS DURING LEFT VENTRICULAR ASSISTANCE AFTER POSTCARDIOTOMY

Abstract

We evaluated the hemostatic alteration in patients who were supported by left ventricular assist device (LVAD) because of postcardiotomy heart failure. The coagulation and the fibrinolytic system were strongly activated during prolonged cardiopulmonary bypass. In patients with LVAD, fibrinopeptide A and thrombin-antithrombin III complex increased markedly after the 3rd or 4th day during LVAD. And also fibrinogen/fibrin degradation product and α 2plasmin inhibitor-plasmin complex were markedly increased over entire course of LVAD. It suggests that the anticoagulant therapy including the protease inhibitor are required at least from 3rd and 4th day of LVAD to avoid the thromboembolic or bleeding complica-tions.