Anticoagulation and antiplatelet management in the PREVENtion of HeartMate II Pump Thrombosis study
| •Within 48 h of device implantation and once bleeding has stopped, begin bridging with unfractionated heparin or low-molecular-weight heparin |
| o Goal PTT 40-45 s in first 48 h, followed by increase to PTT 50-60 s by 96 h |
| • Initiate warfarin within 48 h to obtain goal INR of 2.0-2.5 by postoperative day 5-7 |
| • Discontinue heparin when INR is >2.0 |
| • Initiate aspirin therapy (81-325 mg) 2-5 d postimplantation (if no bleeding) |
| • Maintain INR 2.0-2.5 and aspirin as long-term VAD support antithrombotic therapy |
| •Within 48 h of device implantation and once bleeding has stopped, begin bridging with unfractionated heparin or low-molecular-weight heparin |
| o Goal PTT 40-45 s in first 48 h, followed by increase to PTT 50-60 s by 96 h |
| • Initiate warfarin within 48 h to obtain goal INR of 2.0-2.5 by postoperative day 5-7 |
| • Discontinue heparin when INR is >2.0 |
| • Initiate aspirin therapy (81-325 mg) 2-5 d postimplantation (if no bleeding) |
| • Maintain INR 2.0-2.5 and aspirin as long-term VAD support antithrombotic therapy |
Adapted from Maltais et al.13 PTT, partial thromboplastin time.