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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
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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
Summary
This summary is machine-generated.

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.

Keywords:
continuous flowintracerebral hemorrhageischemic strokeleft ventricular assist devicestroketransplant eligibility

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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.