Fondaparinux as an Alternative Anticoagulant Treatment in Patients with Left Ventricular Assist Devices and Recurrent Gastrointestinal Bleeding: Case Series

Authors

Daniela Piani, Cardiothoracic Department, University Hospital, Udine, ItalyFollow
Andrea Lechiancole, Cardiothoracic Department, University Hospital, Udine, ItalyFollow
Massimo Maiani, Cardiothoracic Department, University Hospital, Udine, ItalyFollow
Igor Vendramin, Cardiothoracic Department, University Hospital, Udine, ItalyFollow
Sandro Sponga, Cardiothoracic Department, University Hospital, Udine, ItalyFollow
Elisabetta Auci, Department of Anesthesia and Intensive Care Medicine, University Hospital, Udine, ItalyFollow
Ugolino Livi, Cardiothoracic Department, University Hospital, Udine, ItalyFollow

Document Type

Case Report

Abstract

Gastrointestinal bleeding (GIB) can occur in patients after left ventricular assist device (LVAD) implantation. In cases of recurrent GIB, the management of anticoagulation treatment represents a challenging situation in which the risk of bleeding recurrence and the need for long-term anticoagulation must be balanced. This case series describes the successful management of anticoagulation in three patients with recurrent GIB using fondaparinux.

To our knowledge, these are the first reported cases of recurrent GIB in which a single dose of subcutaneous fondaparinux was used instead of oral anticoagulation. None of the patients presented with signs of pump thrombosis or arterial embolism.

If confirmed by larger studies, the substitution of oral anticoagulation with subcutaneous, single-dose fondaparinux could represent a safe alternative treatment in a select group of patients with recurrent GIB.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Recommended Citation

Piani, Daniela; Lechiancole, Andrea; Maiani, Massimo; Vendramin, Igor; Sponga, Sandro; Auci, Elisabetta; and Livi, Ugolino (2022) "Fondaparinux as an Alternative Anticoagulant Treatment in Patients with Left Ventricular Assist Devices and Recurrent Gastrointestinal Bleeding: Case Series," The VAD Journal: Vol. 8(1) :e2022813 DOI: https://doi.org/10.11589/vad/e2022814

Available at: https://digitalcommons.library.tmc.edu/vad/vol8/iss1/4

First Page

e2022813