{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:14:39Z","timestamp":1777727679371,"version":"3.51.4"},"reference-count":7,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>The gold standard therapy for end-stage heart failure is cardiac transplantation. However, in the face of a donor shortage, a mechanical assist device such as the left ventricular assist device HeartMate 3 (Abbott Laboratories, Abbott Park, IL, USA) serves as bridging therapy to transplantation and\/or destination therapy. Current guidelines recommend anticoagulation with a vitamin K antagonist in combination with low-dose aspirin. We herein report a challenging anticoagulation regimen in a patient with a HeartMate 3 in whom systemic anticoagulation with warfarin was not feasible for 4 years because of low compatibility and a rare X-factor deficiency. This is a rare hematological disorder, estimated to affect approximately 1 in every 500,000 to 1,000,000 people in the general population. The patient finally received a modified anticoagulation regimen involving the combination of rivaroxaban and clopidogrel without warfarin. Under this regimen, the patient remained free of thromboembolic complications for 4 years with in situ placement of the left ventricular assist device. This case illustrates that under specific circumstances, long-term absence of warfarin therapy is feasible in patients with a HeartMate 3.<\/jats:p>","DOI":"10.1177\/03000605241258474","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T20:12:56Z","timestamp":1718914376000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term discontinuation of warfarin in a patient with HeartMate 3 left ventricular assist device without thromboembolic events"],"prefix":"10.1177","volume":"52","author":[{"given":"Yoganiranjana","family":"Dharuman","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Helios Clinic Siegburg, Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Doss","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Helios Clinic Siegburg, Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petar","family":"Risteski","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Zurich Clinic of Cardiovascular Surgery, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4226-3004","authenticated-orcid":false,"given":"Aron Frederik","family":"Popov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Helios Clinic Siegburg, Siegburg, Germany"},{"name":"Department of Cardiothoracic Surgery and Transplant Surgery, Medical High School Hannover, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"key":"bibr1-03000605241258474","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.16197"},{"key":"bibr2-03000605241258474","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.03.002"},{"key":"bibr3-03000605241258474","doi-asserted-by":"publisher","DOI":"10.1111\/head.12246"},{"key":"bibr4-03000605241258474","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2211"},{"key":"bibr5-03000605241258474","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14565"},{"key":"bibr6-03000605241258474","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14352"},{"key":"bibr7-03000605241258474","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-4849"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605241258474","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605241258474","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605241258474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:50:03Z","timestamp":1777459803000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605241258474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":7,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1177\/03000605241258474"],"URL":"https:\/\/doi.org\/10.1177\/03000605241258474","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6]]},"article-number":"03000605241258474"}}