{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T04:45:06Z","timestamp":1789879506516,"version":"4.0.1"},"reference-count":32,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T00:00:00Z","timestamp":1525996800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Artif Organs"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Mechanical circulatory support for pediatric heart failure patients with the Berlin Heart EXCOR ventricular assist system is the only approved and established bridging strategy for recovery or heart transplantation. In recent years, the burden of thromboembolic events has led to modifications of the recommended antithrombotic therapy. Therefore, we aimed to assess modifications of antithrombotic practice among the European EXCOR Pediatric Investigator Group members.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We sent a questionnaire assessing seven aspects of antithrombotic therapy to 18 European hospitals using the EXCOR device for children. Returned questionnaires were analyzed and identified antithrombotic strategies were descriptively compared to \u201cEdmonton protocol\u201d recommendations developed for the US EXCOR pediatric approval study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Analysis of 18 received surveys revealed substantial deviations from the Edmonton protocol, including earlier start of heparin therapy at 6\u201312\u2009h postoperatively and in 50% of surveyed centers, monitoring of heparin effectiveness with aPTT assay, administering vitamin K antagonists before 12\u2009months of age. About 39% of centers use higher international normalized ratio targets, and platelet inhibition is changed in 56% including the use of clopidogrel instead of dipyridamole. Significant inter-center variability with multiple deviations from the Edmonton protocol was discovered with only one center following the Edmonton protocol completely.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Current antithrombotic practice among European EXCOR users representing the treatment of more than 600 pediatric patients has changed over time with a trend toward a more aggressive therapy. There is a need for systematic evidence-based evaluation and harmonization of developmentally adjusted antithrombotic management practices in prospective studies toward revised recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0391398818773040","type":"journal-article","created":{"date-parts":[[2018,5,11]],"date-time":"2018-05-11T05:58:55Z","timestamp":1526018335000},"page":"385-392","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Antithrombotic therapy in pediatric ventricular assist devices: Multicenter survey of the European EXCOR Pediatric Investigator Group"],"prefix":"10.1177","volume":"41","author":[{"given":"Oliver","family":"Miera","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease\u2014Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina L","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease\u2014Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Akintuerk","sequence":"additional","affiliation":[{"name":"Pediatric Heart Center, University Hospital Giessen, Justus Liebig University, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angele","family":"Boet","sequence":"additional","affiliation":[{"name":"Cardiac ICU, \u201cMarie Lannelongue\u201d Surgical Center, South Paris University Hospitals, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Cesnjevar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Chila","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Freeman Hospital, Newcastle Upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Fleck","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Center Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranny","family":"Goldwasser","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology\/Congenital Heart Disease, Heidelberg University Hospital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis G","family":"Guereta","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, University Hospital La Paz, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Heineking","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Hoerer","sequence":"additional","affiliation":[{"name":"Cardiac ICU, \u201cMarie Lannelongue\u201d Surgical Center, South Paris University Hospitals, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Horke","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tain Y","family":"Hsia","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Huebler","sequence":"additional","affiliation":[{"name":"Department of Congenital Pediatric Surgery, Zurich Children\u2019s Hospital, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Kansy","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Children\u2019s Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Karimova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohdan","family":"Maruszewski","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Children\u2019s Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constancio","family":"Medrano","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Division, Hospital Materno Infantil, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Szymon","family":"Pawlak","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zdenka","family":"Reinhardt","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Freeman Hospital, Newcastle Upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Romlin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesia and Intensive Care, Queen Silvia Children\u2019s Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugen","family":"Sandica","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Defects, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Schramm","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Schweiger","sequence":"additional","affiliation":[{"name":"Department of Congenital Pediatric Surgery, Zurich Children\u2019s Hospital, Zurich, 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