Anticoagulation strategies for left ventricular assist devices

Recommendations for thromboprophylaxis in patients with LVADs are scarce. The International Society for Heart and Lung Transplantation has put together minimum criteria for perioperative anticoagulation; however, this is on the basis of poor level of evidence (observational studies and expert opinion). Ultimately, clinicians will need to individualize the intensity and timing of anticoagulation following LVAD implantation to ensure adequate thromboprophylaxis while simultaneously minimizing bleeding.