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Updated: May 26, 2026
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Asymmetric pattern of cerebrovascular lesions in patients after left ventricular assist device implantation
Tomoko S Kato1, Takeyoshi Ota, P Christian Schulze
1Columbia University Medical Center, Department of Medicine, Division of Cardiology, 622 West 168th St, New York, NY 10032, USA.
Insights
Stroke after left ventricular assist device (LVAD) surgery predominantly affects the right hemisphere. Postoperative infection is linked to a higher incidence of right-sided strokes in LVAD patients.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Medical Device Research
Background:
- Stroke is a significant complication following left ventricular assist device (LVAD) implantation.
- Understanding stroke patterns is crucial for improving patient outcomes after LVAD surgery.
Purpose of the Study:
- To investigate the hemispheric distribution of strokes in patients supported by LVADs.
- To identify potential factors associated with stroke location after LVAD implantation.
Main Methods:
- Retrospective review of 317 consecutive patients undergoing LVAD surgery.
- Analysis of stroke events occurring during LVAD support between November 2000 and July 2011.
Main Results:
- A total of 46 strokes were recorded postoperatively.
- Right hemispheric strokes (58.7%) were more frequent than left hemispheric strokes (28.2%).
- Right hemispheric stroke was significantly associated with postoperative infection.
Conclusions:
- Stroke following LVAD implantation exhibits a right hemispheric predominance.
- LVAD-related thrombus, particularly in the context of infection, and cannula anastomosis anatomy are implicated in stroke occurrence.
Background And Purpose:
Stroke is a major adverse event after left ventricular assist device (LVAD) surgery. The purpose of this study was to describe differences in hemispheric distribution of stroke in LVAD patients.
Methods:
We reviewed 317 consecutive patients who underwent LVAD surgery between November 2000 and July 2011. Stroke during LVAD support was analyzed.
Results:
In total, 46 strokes occurred at 76.0±96.8 days postoperatively. Among the 46 strokes, 27 events (58.7%) occurred in right hemisphere, 13 events (28.2%) in the left hemisphere, 3 events (8.7%) occurred bilaterally, and 2 events (4.3%) were vertebrobasilar lesions. The right hemispheric stroke was significantly more common in patients with postoperative infection compared with left hemispheric events.
Conclusions:
Stroke after LVAD implantation has a right hemispheric predominance. This finding suggests LVAD-related thrombus in the setting of infection and/or the anatomic configuration of LVAD outflow cannula-ascending aorta anastomosis to be highly associated with stroke after LVAD surgery.
