THROMBUS FORMATION IN LEFT VENTRICLE DURING CIRCULATORY SUPPORT

Abstract

Thrombus formation in the left ventricle is a serious complication which cause fatal systemic thromboembolism. We experienced 3 patients who complicated left ventricular thrombus during circulatory support after open heart surgery. In one patients who underwent with pneumatically driven left ventricular assist system heparin was administered intermittently keeping activated coagulation time (ACT) around 150seconds. In two patients with V-A by-pass (centrifugal pump, heparin coating tube and membrane oxygenator) we used continuous infusion of heparin and FUT controlling ACT around 200 seconds. Artificial materials implanted in the ventricle and stagnation of the blood stream seemed to be major risk factors of the left ventricular thrombus formation during circulatory support. We suggested that local heparinization by continuous heparin infusion into left ventricle or left atrium and promotion of natural heart ejection by administration of catecholamine were useful for prevention of the left ventricular thrombus formation.