Antiplatelet and Anticoagulant Strategies Following Left Ventricular Assist Device (LVAD) Explantation or Decommissioning: A Scoping Review of the Literature

Biocompatibility of an apical ring plug for left ventricular assist device explantation: Results of a feasibility pre‐clinical study

“…The major open question regards the ability of these plugs to favor the development of scar or endothelial tissues on their intra‐cavitary side and prevent potential thrombi formation. In order to avoid such events, anticoagulation therapy is advised but it is still unclear which are the best INR targets and therapy duration 24 …”

“…Consequently, anticoagulant therapy would be only necessary for an early postoperative stage up to 3 months after plug implantation, leading to a reduction of potential bleeding risks in the long term. Literature shows that so far no clear guidelines are available regarding antiplatelet and anticoagulant strategies after LVAD explantation or decommissioning 24 . Most studies maintain patients on a vitamin K antagonist for at least 3 months following device explant or decommissioning with or without antiplatelet therapy with low‐dose aspirin 24 .…”

“…24 However, anticoagulation strategy post-device explantation are influenced by the technique of explantation and the presence of retained closure device components. 24 The only available case report until now, presenting the explantation of an apical ring metal plug in an LVAD patient, describes extensive presence of tissue covering the plug as early as at 4 months after implantation. 11 In this case no smooth muscle cells, no endothelium and no neovascularization of the membrane were observed.…”

“…Literature shows that so far no clear guidelines are available regarding antiplatelet and anticoagulant strategies after LVAD explantation or decommissioning 24 . Most studies maintain patients on a vitamin K antagonist for at least 3 months following device explant or decommissioning with or without antiplatelet therapy with low‐dose aspirin 24 . However, anticoagulation strategy post‐device explantation are influenced by the technique of explantation and the presence of retained closure device components 24 .…”

“…Most studies maintain patients on a vitamin K antagonist for at least 3 months following device explant or decommissioning with or without antiplatelet therapy with low‐dose aspirin 24 . However, anticoagulation strategy post‐device explantation are influenced by the technique of explantation and the presence of retained closure device components 24 . The only available case report until now, presenting the explantation of an apical ring metal plug in an LVAD patient, describes extensive presence of tissue covering the plug as early as at 4 months after implantation 11 .…”