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J Thorac Cardiovasc Surg 2003;126:1636-1637
© 2003 The American Association for Thoracic Surgery

Brief communications

Resistance to aspirin after external ventricular assist device implantation

^a Department of Thoracic and Cardiovascular Surgery, Hôpital Henri Mondor, Créteil, France,
^b Department of Hematology, Hôpital Lariboisière, Paris, France

Received for publication February 28, 2003; accepted for publication April 22, 2003.

^* Address for reprints: Rémi Houël, MD, Department of Thoracic and Cardiovascular Surgery, Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil, France.

The first 20% of the full text of this article appears below.

Anticoagulation in patients implanted with ventricular assist devices is widely performed with aspirin, heparin, and anti–vitamin K therapy. Nonetheless, a variable antiplatelet effect of aspirin is well-known in healthy subjects. Moreover, the efficacy of aspirin may be reduced in the days after coronary artery bypass grafting surgery.¹ Its efficacy has not been reported during the chronic phase of mechanical support with an external ventricular assist device. We report a resistance to aspirin that did respond to an increased daily oral intake and that could be observed as long as 6 weeks after device implantation.

Methods

Patient selection
Fifteen patients were studied prospectively during 6 weeks after implantation of an external ventricular assist device (Thoratec Laboratories Corporation, Pleasanton, Calif). Two patients were female. Median age was 44.3 years, range was 16.6 to 58.6 years. Indications for emergent device implantation were persistent primary cardiogenic shock complicating acute myocardial infarction in 7 patients, acute myocarditis in 2 patients, and end-stage dilated cardiomyopathy in 6 patients. Seven patients were . . . [Full Text of this Article]

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