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Updated: Mar 21, 2026

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

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Outcomes after stroke complicating left ventricular assist device

Joshua Z Willey1, Michael V Gavalas2, Pauline N Trinh3

  • 1Departments of Neurology.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|May 11, 2016
PubMed

Insights

Stroke is a major complication for continuous flow-left ventricular assist device (CF-LVAD) patients. Ischemic strokes (IS) have better outcomes and transplant eligibility compared to intracerebral hemorrhages (ICH) after CF-LVAD support.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Stroke is a significant complication in patients with continuous flow-left ventricular assist devices (CF-LVAD).
  • While risk factors are known, treatment strategies and outcomes for stroke in CF-LVAD patients require further investigation.
  • This study examines stroke subtypes, severity, and outcomes in a large cohort of CF-LVAD patients.

Purpose of the Study:

  • To analyze stroke outcomes in CF-LVAD patients.
  • To compare outcomes between different stroke subtypes: intracerebral hemorrhage (ICH) and ischemic stroke (IS).
  • To evaluate transplant eligibility based on stroke type and severity in CF-LVAD patients.

Main Methods:

  • A retrospective analysis of 301 CF-LVAD patients (HeartMate II and HeartWare) from January 2008 to April 2015.
  • Stroke defined by focal neurologic deficit and abnormal neuroimaging; ICH excluded subdural hematoma and hemorrhagic conversion.
  • Stroke severity assessed by NIH Stroke Scale (NIHSS); outcomes included in-hospital mortality and transplant status.

Main Results:

  • Forty patients experienced stroke (8 ICH, 32 IS).
  • ICH patients had 50% in-hospital mortality (NIHSS 18.8 ± 13.7) versus survivors (NIHSS 1.8 ± 1.7).
  • IS patients had 28% in-hospital mortality (NIHSS 16.2 ± 10.8) versus survivors (NIHSS 7.0 ± 7.6); 12 IS patients received transplants, while no ICH patients did.

Conclusions:

  • Initial neurologic impairment significantly impacts in-hospital mortality post-stroke in CF-LVAD patients.
  • Ischemic stroke (IS) patients demonstrate better outcomes and higher transplant eligibility.
  • Prompt in-hospital treatment may improve recovery and transplant potential for IS patients.
Abstract

Keywords:
continuous flowintracerebral hemorrhageischemic strokeleft ventricular assist devicestroketransplant eligibility

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