Internal bleeding higher with popular heart device than earlier model

June 11, 2011

The incidence of internal bleeding was higher in the most commonly implanted heart device than in an earlier model, according to two studies at Henry Ford Hospital in Detroit.

The HeartMate II, a (LVAD) is a continuous-flow mechanical pump connected to the patient's heart that takes over the pumping of the weakened heart's left ventricle.

"Although there were more instances of bleeding in the skull and gastrointestinal track with the HeartMate II, as opposed to the earlier model, there was no increase in ," says lead author Jeffrey A. Morgan, M.D., associate director of Mechanical Circulatory Support in the Edith and Benson Ford Heart &Vascular Institute at Henry Ford.

Dr. Morgan will present the studies on June 11 at the annual conference of the American Society of Artificial Internal Organs in Washington, D.C.

From March 2006 through May 2010, 64 patients with chronic underwent implantation of a HeartMate II LVAD as a bridge to transplant or a permanent therapy for those ineligible for transplants.

The incidence of gastrointestinal bleeding or adverse neurological events (ANE) was evaluated to determine their impact on survival and identify predictors of occurrence.

The overall incidence of gastrointestinal bleeding was nearly 22 percent, and the incidence of major ANEs was eight percent. Patients with an ANE were significantly older, with a higher incidence of chronic renal insufficiency. They also had higher International Normalized Ratios (INRs), a lab test that measures the time it takes for blood to clot, and compares it to an average, at the time of the event. The higher the INR, the longer it takes blood to clot.

No complications due to blood clots occurred in those with , but for patients with an ANE, there were four intracranial hemorrhages and one thromboembolic stroke.

There was no significant difference in gender, race, cause of heart failure, diabetes, or body mass index (BMI) between patients who had post-operative bleeding and those who did not.

Study co-author Robert J. Brewer, M.D., surgical director of the Program at Henry Ford, believes that as data accumulates on the relatively low incidence of thromboembolic events with the HeartMate II for patients on low-dose or no anticoagulation, it may be prudent to lower the goal INR, with the intent of lowering bleeding complications.

The HeartMate II is smaller, with fewer moving parts, than the previous model, the HeartMate I XVE, and requires less invasive surgery. Its size makes it available to a larger number of advanced-stage heart failure patients, and it has been predicted to greatly increase patients' quality of life. The device can cover the full output of a healthy heart. Studies have shown that continuous-flow pumps last much longer than pulsing pumps before they must be replaced.

Usage of LVADs has increased in the United States, where heart failure affects five million people, but there are less than 3,000 donor organs available annually worldwide. Last year, nearly 2500 patients were implanted with the device in the United States, which is used chiefly for those waiting for a heart transplant due to the chronic donor shortage. In other cases, it is used for long-term support in patients who are not candidates for a transplant.

Explore further: Non-cardiac surgery: Safe for patients with heart device

Related Stories

Non-cardiac surgery: Safe for patients with heart device

April 15, 2011
Non-cardiac surgery can be performed safely in patients with a heart device typically implanted into patients waiting for a transplant, according to a study at Henry Ford Hospital in Detroit.

New patient guidelines for heart devices

April 17, 2011
A series of new guidelines for cardiac specialists has been developed to determine when heart failure patients should receive a mechanical heart-pumping device.

Recommended for you

How Gata4 helps mend a broken heart

August 15, 2017
During a heart attack, blood stops flowing into the heart; starved for oxygen, part of the heart muscle dies. The heart muscle does not regenerate; instead it replaces dead tissue with scars made of cells called fibroblasts ...

Injectable tissue patch could help repair damaged organs

August 14, 2017
A team of U of T Engineering researchers is mending broken hearts with an expanding tissue bandage a little smaller than a postage stamp.

Air pollution linked to cardiovascular disease; air purifiers may lessen impact

August 14, 2017
Exposure to high levels of air pollution increased stress hormone levels and negative metabolic changes in otherwise healthy, young adults in a recent study conducted in China. Air purifiers appeared to lessen the negative ...

Study hints at experimental therapy for heart fibrosis

August 14, 2017
Researchers report encouraging preclinical results as they pursue elusive therapeutic strategies to repair scarred and poorly functioning heart tissues after cardiac injury—describing an experimental molecular treatment ...

Scientists identify mutations in venous valve disease

August 14, 2017
A team of scientists has discovered that mutations in the genes FOXC2 and GJC2 are associated with defects in venous valves, flaps within veins that help maintain proper blood flow.

Mechanism behind sudden cardiac deaths in sports uncovered

August 10, 2017
Researchers have worked out the mechanism behind sudden cardiac deaths that follow a hard blow to the chest.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.