Anticoagulation for Cardiac Prosthetic Devices: Prosthetic Heart Valves, Left Ventricular Assist Devices, and Septal Closure Devices

摘要: From the development of open heart surgery in 1950s, dramatic technological advances have facilitated progressively complex cardiac procedures with approaches ranging from or minimally invasive surgical to percutaneous endovascular. Treatments that involve securing prosthetic material in, communication with, are employed a variety pathologies, including valvular disease, cardiomyopathy, and undesired communications between chambers. These devices carry them risk thromboembolic complications mitigated by use antithrombotic therapies. In this chapter, we review features associated thrombosis, indications for device use, their hematologic complications, evidence guiding current recommendations management these devices. Cardiac discussed include valves (mechanical, bioprosthetic, transcatheter aortic valves), valve repair (surgical, MitraClip, endovascular plugs paravalvular leak), left ventricular assist (LVADs), temporary mechanical circulatory support, septal closure devices, atrial appendage (LAA) occlusion