Monitoring of platelet function in pediatric patients receiving antiplatelet therapy supported by the Berlin Heart device

Introduction The management of ventricular assistance devices in pediatric patients presents significant hemostatic challenges, characterized by an increased susceptibility to both bleeding and thrombotic events. Antithrombotic therapy remains a key component in reducing the risk of major cerebrovascular complications. Method We retrospectively analyzed the results of light transmission aggregometry (LTA) and thromboelastography (TEG, Haemonetics) performed over a 7-month period in six pediatric patients receiving antithrombotic therapy and supported with a Berlin Heart device between November 2024 and June 2025. Patients’ characteristics are summarized in [ Fig. 1 ]. Fig. 1 Patients’ characteristics are summarized in Table 1. Results For each patient, aggregation percentages obtained from LTA and inhibition percentages derived from TEG were analyzed. Statistical significance was observed only in three patients for ADP. Conversely, focusing on the results related to arachidonic acid, the corresponding data are presented in [ Fig. 2 ]. Across the six pediatric patients, the number of aggregometry tests ranged from 3 to 10, with mean aggregation values between 6% and 20.2%. TEG assessments ranged from 3 to 12 per patient, showing mean inhibition values between 29.2% and 88.8%. Lower aggregation values tended to correspond with higher TEG inhibition rates. TEG results demonstrated greater variability in platelet response to activators compared with LTA. Accordingly, modifications to antithrombotic therapy were implemented based on clinical indications, relying predominantly on LTA findings for therapeutic guidance. Fig. 2 Corresponding data of the arachidonic acid results are presented in Figure 1. Conclusion Within such a complex population of pediatric patients, light transmission aggregometry remains the gold standard for platelet function testing. However, a multimodal approach incorporating thromboelastography may still provide valuable guidance in tailoring antiplatelet therapy, despite its limited comparability with the reference method [ 1 ] [ 2 ]. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany