Application of Different Anticoagulant Techniques in VA-ECMO Supportive Therapy for Patients Undergoing Heart Transplantation
WANG Lei
CAO Dandan
WANG Menghao
LIU Chao
WANG Shupeng
MENG Shuping
Abstract：Objective To explore the application effects of different anticoagulation techniques in veno-artery extracorporeal membrane oxygenation(VA-ECMO)supportive treatment for patients undergoing heart transplantation.Methods A retrospective analysis was conducted to collect data from 13 patients who received VA-ECMO support therapy after heart transplantation in Fuwai Central China Cardiovascular Hospital from November 2022 to April 2024.Patients who received heparin(Hep)anticoagulation were included in group A(4 cases),those who received bivalirudin anticoagulation were included in group B(4 cases),and those who received agatroban anticoagulation were included in group C(5 cases).The coagulation indexes,the incidence of thrombosis and bleeding events,and ECMO support treatment indexes were compared among the three groups.Results The time points,inter group,and interaction effects of the three groups of activated partial thrombin time(APTT)values were statistically significant(P＜0.05).At 24 hours of treatment,fibrinogen(Fib)in group A increased and platelet count(PLT)decreased compared to before treatment.Fib levels in group B and C were lower than those in group A and PLT levels were higher than those in group A(P＜0.05).However,there were no significant differences between groups and within groups before and after treatment in group B and C(P＞0.05).There was no significant difference in the incidence of thrombosis and bleeding among the three groups(P＞0.05).The ECMO assisted time and intensive care unit(ICU)stay time in groups B and C were lower than those in group A(P＜0.05).All the patients in the three groups survived.Conclusion Compared with regular Hep anticoagulation,the use of bivalirudin and agatroban in VA-ECMO supportive treatment for heart transplant patients is more conducive to APTT stability and has less effect on other coagulation factors,which is beneficial for reducing the occurrence of thrombosis and bleeding events,improving ECMO assistance time,and reducing ICU stay time.
Keywords：heart transplantationveno-artery extracorporeal membrane oxygenationheparinbivalirudinagatrobanantico-agulation
Publication Date：2025-05-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 1629-1632 )