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The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.
Brief Communication|Articles in Press

Left Ventricular Functional Improvement Appears to Contribute to Lower Rates of Device Thrombosis in Patients on Durable Mechanical Circulatory Support

  • Christos P. Kyriakopoulos
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA

    Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
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  • Benjamin D. Horne
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA

    Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA
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  • Konstantinos Sideris
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA
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  • Iosif Taleb
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA

    Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
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  • Rachel J. Griffin
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA

    Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
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  • Eric Sheffield
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA
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  • Rami Alharethi
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA
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  • Thomas C. Hanff
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA
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  • Josef Stehlik
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA
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  • Craig H. Selzman
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA

    Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
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  • Stavros G. Drakos
    Correspondence
    Corresponding author. Stavros G. Drakos, MD, PhD, FACC, Division of Cardiovascular Medicine & Nora Eccles Harrison Cardiovascular Research and Training Institute (CVRTI), University of Utah Health & School of Medicine, 30 North 1900 East, Room 4A150, Salt Lake City, UT, 84132. Tel.: (801) 585-2340; Fax: (801) 585-0701
    Affiliations
    Utah Transplantation Affiliated Hospitals (U.T.A.H.) Cardiac Transplant Program & Utah Cardiac Recovery (UCAR) Program (University of Utah Health & School of Medicine, Intermountain Medical Center, and George E. Wahlen Department of Veterans Affairs Medical Center), Salt Lake City, UT, USA

    Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, USA
    Search for articles by this author

      Abstract

      By unloading the failing heart, left ventricular (LV) assist devices (LVADs) provide a favorable environment for reversing adverse structural and functional cardiac changes. Prior reports have suggested that an improved native LV function might contribute to the development of LVAD thrombosis. We used the Interagency Registry for Mechanically Assisted Circulatory Support and found that LV functional improvement is associated with a lower risk for device thrombosis. The risk for cerebrovascular accident and transient ischemic attack was comparable across post-LVAD LV function subgroups, while the risk of hemolysis was lower in subgroups of patients with better LV function on LVAD support.

      Keywords

      Abbreviations:

      CVA (Cerebrovascular accident), HF (Heart failure), HR (Hazard ratio), Intermacs (Interagency Registry for Mechanically Assisted Circulatory Support), LV (Left ventricle/left ventricular), LVAD (Left ventricular assist device), LVEF (Left ventricular ejection fraction), TIA (Transient ischemic attack)
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