Thromboembolic Complications During Weaning from Right Ventricular Assist Device Support

We report on two patients who experienced life-threatening thromboembolic complications during prolonged weaning from Levitronix ® CentriMag right ventricular assist device support. Right ventricular assist device flow in both patients was reduced below 2 L/min for a period of 72 or 36 h to closely monitor patients' hemodynamics and echocardiography because the extent of right ventricular recovery was difficult to assess. Thrombus formation occurred despite adjusting the heparin dosage to achieve partial prothrombin time values between 60 and 70 s. Periods of reduced flow during Levitronix ® CentriMag support must be kept short, and an additional bolus dose of heparin should be considered.