Аcute renal failure in patients with implanted LVAD in the early postoperative period

Abstract

AKI is one of the major complications in the cardiac surgery group of patients in the world. In patients with LVAD in the short postoperative period, the situation with such a complication as AKI is associated with the state of hemodynamics and fluctuations in the parameters of the hemostasis system. The purpose of this scientific work is to analyze the state of the blood coagulation system and its response to therapy and complications in the early postoperative period in fifty patients with implanted devices for mechanical support of the left ventricle, left ventricle assist device, LVAD, in the Silesian Heart Disease, Poland. Patients were divided into two groups, a control group receiving classical anticoagulation targeted therapy (ATT), which included the most controlled monotherapy with heparin, after reaching the target values of APTT, the addition and transition to monotherapy with warfarin until reaching the target INR and ASA, and the main, research group, who received an alternative ATT consisting of the previous one with the addition of P2Y12-receptor blockers and Xa-factors. The results showed that the control group of patients with classical anticoagulant targeted therapy had greater mortality associated with AKI than the patients of the study group, and it was also demonstrated that the initially longer duration of surgery and intraoperative polyuria gave a greater percentage of AKI in the postoperative period. The work was carried out within the framework of a bilateral agreement on scientific cooperation between the Department of Anesthesiology & Intensive Care at the National Medical Academy of Post-Graduate Education Named After P.L. Shupyk and the Silesian Center for Heart Diseases (Poland). This article is part of the analysis of the work on the analysis of the blood coagulation system in patients after implantation of the left ventricular mechanical circulatory support system with the analysis of such postoperative complication as acute kidney failure.

Keywords

• left ventricle assist device (LVAD)
• anticoagulant targeted therapy (ATT)
• renal complications