Comprehensive review of hemolysis in ventricular assist devices  

作　　者：Christos A Papanastasiou Konstantinos G Kyriakoulis Christina A Theochari Damianos G Kokkinidis Theodoros D Karamitsos Leonidas Palaiodimos 

机构地区：[1]1(st)Department of Cardiology,AHEPA Hospital,Aristotle University of Thessaloniki,Thessaloniki 54621,Greece [2]3(rd)Department of Medicine,Sotiria Hospital,National and Kapodistrian University of Athens,Athens 11527,Greece [3]Department of Internal Medicine,Messinia General Hospital,Kalamata 24100,Greece,Bronx,NY 10461,United States [4]Department of Medicine,Jacobi Medical Center,Albert Einstein College of Medicine [5]Department of Medicine,Montefiore Medical Center,Albert Einstein College of Medicine,NY 10461,United States

出　　处：《World Journal of Cardiology》2020年第7期334-341,共8页世界心脏病学杂志（英文版）（电子版）

摘　　要：Ventricular assist devices(VADs)have played an important role in altering the natural history of end-stage heart failure.Low-grade hemolysis has been traditionally described in patients with VADs,indicating effective device functionality.However,clinically significant hemolysis could be crucial in terms of prognosis,calling for prompt therapeutic actions.The absence of solid and widely approved diagnostic criteria for clinically significant hemolysis,render the utilization of hemolysis laboratory markers challenging.Hemolysis incidence varies(5%-18%)depending on definition and among different VAD generations,being slightly higher in continuous-flow devices than in pulsatile devices.Increased shear stress of red blood cells and underlying device thrombosis appear to be the main pathogenetic pathways.No certain algorithm is available for the management of hemolysis in patients with VADs,while close clinical and laboratory monitoring remains the cornerstone of management.Imaging examinations such as echocardiography ramp test or computed tomography scan could play a role in revealing the underlying cause.Treatment should be strictly personalized,including either pharmacological(antithrombotic treatment)or surgical interventions.

关 键 词：Ventricular assist device HEMOLYSIS THROMBOSIS 

分 类 号：R541.6[医药卫生—心血管疾病]