Kurien Sudha, Hughes Kylie A
Advocate Christ Medical Center, 4400 W 95th St., Oak Lawn, IL 60453, USA.
AACN Adv Crit Care. 2012 Jan-Mar;23(1):91-8. doi: 10.1097/NCI.0b013e31824124d0.
A left ventricular assist device (LVAD) is a lifesaving therapy for end-stage heart failure, but it is associated with major complications such as bleeding and thrombosis. Anticoagulation is an important part of LVAD therapy; it requires meticulous management and monitoring for prevention of thromboembolic and bleeding events. Recommendations for thromboprophylaxis vary among pulsatile and nonpulsatile devices and require multiple pharmacological agents to achieve adequate anticoagulation. Patients expected to undergo LVAD implantation must have a comprehensive evaluation for underlying coagulopathies. During the perioperative period, all measures must be taken to prevent excessive bleeding and maintain hemostasis. Postoperative bleeding and thromboembolic episodes must be minimized to prevent significant complications of ventricular assist device therapy. Bleeding and thromboembolism are an impediment to a patient's quality of life as they can result in multiple hospitalizations, along with serious consequences such as death and permanent disability.
左心室辅助装置（LVAD）是治疗终末期心力衰竭的一种挽救生命的疗法，但它会引发诸如出血和血栓形成等重大并发症。抗凝是LVAD治疗的重要组成部分；需要精心管理和监测以预防血栓栓塞和出血事件。搏动性和非搏动性装置的血栓预防建议各不相同，并且需要多种药物来实现充分的抗凝。预期要接受LVAD植入的患者必须对潜在的凝血病进行全面评估。在围手术期，必须采取一切措施预防过度出血并维持止血。术后出血和血栓栓塞事件必须降至最低，以防止心室辅助装置治疗出现重大并发症。出血和血栓栓塞会妨碍患者的生活质量，因为它们可能导致多次住院，以及诸如死亡和永久性残疾等严重后果。
