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Correction to: The use of enoxaparin as bridge to therapeutic INR after LVAD implantation

Authors :
Sagar Ranka
Travis Abicht
Zubair Shah
Ioannis Mastoris
Aniket S Rali
Giorgio Zanotti
Moghni Mohammed
Farhad Sami
Christopher T. Salerno
A. Ravichandran
Savahanna Wagner
Andrew J. Sauer
Prakash Acharya
Nicholas Haglund
Source :
Journal of Cardiothoracic Surgery, Vol 16, Iss 1, Pp 1-1 (2021), Journal of Cardiothoracic Surgery
Publication Year :
2021
Publisher :
Springer Science and Business Media LLC, 2021.

Abstract

Left ventricular assist devices (LVAD) have been increasingly used in the treatment of end-stage heart failure. While warfarin has been uniformly recommended in the long-term as anticoagulation strategy, no clear recommendation exists for the post-operative period. We sought to evaluate the feasibility of enoxaparin in the immediate and early postoperative period after LVAD implantation.This is a two-center, retrospective analysis of 250 consecutive patients undergoing LVAD implantation between January 2017 and December 2018. Patients were bridged postoperatively to therapeutic INR by either receiving unfractionated heparin (UFH) or low molecular weight heparin (LMWH). Patients were followed while inpatient and for 3 months after LVAD implantation. The efficacy outcome was occurrence of first and subsequent cerebrovascular accident while safety outcome was the occurrence of bleeding events. Length of stay (LOS) was also assessed.Two hundred fifty and 246 patients were analyzed for index admission and 3-month follow up respectively. No statistically significant differences were found between the two groups in CVA (OR = 0.67; CI = 0.07-6.39, P = 0.73) or bleeding events (OR = 0.91; CI = 0.27-3.04, P = 0.88) during index admission. Similarly, there were no differences at 3 months in either CVAs or bleeding events (OR = 0.85; 0.31-2.34; p = 0.76). No fatal events occurred during the study follow-up period. Median LOS was significantly lower (4 days; p = 0.03) in the LMWH group.LMWH in the immediate and early postoperative period after LVAD implantation appears to be a concurrently safe and efficacious option allowing earlier postoperative discharge and avoidance of recurrent hospitalizations due to sub-therapeutic INR.

Details

ISSN :
17498090
Volume :
16
Database :
OpenAIRE
Journal :
Journal of Cardiothoracic Surgery
Accession number :
edsair.doi.dedup.....6fc08deeb2bf1d34d1e4fd93ccab3c98