Pump thrombosis
Pump thrombosis is a serious complication associated with the use of ventricular assist devices (VADs), which are mechanical pumps used to support heart function and blood flow in individuals with weakened hearts. This condition involves the formation of a blood clot within the pump, which can lead to device malfunction and serious clinical consequences.
Pathophysiology[edit | edit source]
Pump thrombosis occurs when a thrombus forms within the ventricular assist device. This can obstruct blood flow, leading to increased pump power consumption and potential device failure. The formation of a thrombus is influenced by several factors, including blood flow dynamics, shear stress, and the coagulation cascade.
Risk Factors[edit | edit source]
Several risk factors contribute to the development of pump thrombosis:
- Hypercoagulability: Conditions that increase the tendency of blood to clot can predispose patients to pump thrombosis.
- Device-related factors: The design and material of the VAD can influence thrombosis risk. Some devices have higher thrombosis rates due to their design.
- Suboptimal anticoagulation: Inadequate anticoagulation therapy can lead to thrombus formation.
- Patient-related factors: Individual patient characteristics, such as genetic predisposition and comorbidities, can affect thrombosis risk.
Clinical Presentation[edit | edit source]
Patients with pump thrombosis may present with:
- Dyspnea
- Fatigue
- Signs of heart failure
- Hemolysis, indicated by elevated lactate dehydrogenase (LDH) levels
- Device alarms indicating increased power consumption
Diagnosis[edit | edit source]
The diagnosis of pump thrombosis involves a combination of clinical assessment and diagnostic tests:
- Echocardiography: Used to assess heart function and detect thrombus formation.
- Blood tests: Elevated LDH and plasma-free hemoglobin levels can indicate hemolysis due to pump thrombosis.
- Device interrogation: Analyzing device parameters such as power consumption and flow rates can help identify thrombosis.
Management[edit | edit source]
Management of pump thrombosis includes:
- Anticoagulation therapy: Intensifying anticoagulation to prevent further thrombus formation.
- Thrombolysis: Use of thrombolytic agents to dissolve the thrombus.
- Device replacement: In severe cases, surgical replacement of the VAD may be necessary.
Prognosis[edit | edit source]
The prognosis of pump thrombosis depends on the timeliness and effectiveness of treatment. Prompt intervention can prevent serious complications such as stroke and heart failure.
Prevention[edit | edit source]
Preventive strategies include:
- Optimizing anticoagulation therapy to maintain therapeutic levels.
- Regular monitoring of device function and patient status.
- Use of devices with lower thrombosis risk profiles.
See Also[edit | edit source]
Cardiovascular disease A-Z
Most common cardiac diseases
- Cardiac arrhythmia
- Cardiogenetic disorders
- Cardiomegaly
- Cardiomyopathy
- Cardiopulmonary resuscitation
- Chronic rheumatic heart diseases
- Congenital heart defects
- Heart neoplasia
- Ischemic heart diseases
- Pericardial disorders
- Syndromes affecting the heart
- Valvular heart disease
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A[edit source]
- Accelerated idioventricular rhythm
- Acute decompensated heart failure
- Arteriosclerotic heart disease
- Athletic heart syndrome
- Atrial flutter
- Atrioventricular fistula
- Cardiovascular disease in Australia
- Autoimmune heart disease
B[edit source]
C[edit source]
- Ebb Cade
- Cardiac allograft vasculopathy
- Cardiac amyloidosis
- Cardiac asthma
- Cardiac tamponade
- Cardiogenic shock
- Cardiogeriatrics
- Cardiorenal syndrome
- Cardiotoxicity
- Carditis
- Coronary artery aneurysm
- Coronary artery anomaly
- Coronary artery disease
- Spontaneous coronary artery dissection
- Coronary artery ectasia
- Coronary occlusion
- Coronary steal
- Coronary thrombosis
- Coronary vasospasm
- Cœur en sabot
- Coxsackievirus-induced cardiomyopathy
D[edit source]
E[edit source]
H[edit source]
- Heart attack
- Heart failure
- Heart failure with preserved ejection fraction
- Heart to Heart (1949 film)
- High-output heart failure
- Hyperdynamic precordium
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
I[edit source]
- Idiopathic giant-cell myocarditis
- Interventricular dyssynchrony
- Intraventricular dyssynchrony
- Isolated atrial amyloidosis
K[edit source]
L[edit source]
M[edit source]
- Mydicar
- Myocardial bridge
- Myocardial disarray
- Myocardial rupture
- Myocardial scarring
- Myocardial stunning
- Myocarditis
N[edit source]
O[edit source]
P[edit source]
- Papillary fibroelastoma
- Pathophysiology of heart failure
- Postpericardiotomy syndrome
- Pulmonary vein stenosis
R[edit source]
S[edit source]
- Saturated fat and cardiovascular disease
- SCAR-Fc
- Shone's syndrome
- Strain pattern
- Subacute bacterial endocarditis
- Sudden cardiac death of athletes
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
T[edit source]
V[edit source]
W[edit source]
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Contributors: Prab R. Tumpati, MD
