Abnormal Pre-Operative Mixing Studies Identify VAD Patients at High Risk for Spontaneous Bleeding

Abstract

S245 pump thrombosis as he was deemed not a candidate for pump exchange or heart transplant. Bleeding during eptifibatide occurred in 8 events: 3 patients developed gastrointestinal hemorrhage, 2 had epistaxis, 1 had intracranial hemorrhage with modified Rankin score of 1 at last follow-up, and 2 developed other sources of bleeding. Only one patient required blood transfusion (1 unit) due to menorrhagia. Five (62.5%) of the bleeding events occurred in patients who received the maximum dose of eptifibatide. One patient developed an embolic cerebrovascular accident. No patient developed significant thrombocytopenia during therapy. Conclusion: In our single center experience, addition of eptifibatide to UFH in medical management of PT had a moderate efficacy (clinical resolution > 50%) with low risk of bleeding requiring transfusion. Further studies are needed to define the optimal dosing strategy and timing, as well as patient characteristics that predict a successful outcome with this therapy.