New anticoagulant coatings and hemostasis assessment tools to avoid complications with pediatric left ventricular assist devices

Abstract Although there is a great need for left ventricular assist devices for treatment of heart failure in children, only a single device has received FDA approval as a bridge to transplant in the pediatric population. As smaller devices, better tuned to the patients' smaller weight and blood volume have entered clinical trials, complication rates due to thrombosis, thromboembolism and bleeding remain stubbornly high. We therefore believe the focus should now shift to developing improved surface coatings for these devices that prevent thrombosis, as well as creation of better tools to assess and augment anticoagulation and antiplatelet function in real-time in the clinic. The solution to this ongoing clinical challenge potentially lies in new antithrombotic coating technologies and better antithrombotic management through development of new drugs and hemostasis monitors.