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Risk of stroke early after implantation of a left ventricular assist device

Takaaki Samura1, Daisuke Yoshioka1, Koichi Toda1

  • 1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

The Journal of Thoracic and Cardiovascular Surgery
|August 1, 2018
PubMed

Insights

Low cardiac output and high lactate dehydrogenase levels are key risk factors for stroke after left ventricular assist device implantation. Maintaining sufficient device flow may prevent acute stroke events.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Stroke is a significant complication following left ventricular assist device (LVAD) implantation.
  • The risk of stroke is elevated in the acute phase and chronic periods post-implantation.
  • Risk factors for acute-phase stroke after LVAD remain understudied.

Purpose of the Study:

  • To investigate the risk factors for symptomatic stroke in the acute phase (within 90 days) after LVAD implantation.
  • To identify specific clinical and biochemical markers associated with acute stroke risk.

Main Methods:

  • A retrospective analysis of 158 consecutive patients undergoing continuous-flow LVAD implantation.
  • Patients were monitored for symptomatic stroke within 90 days post-implantation.
  • Multivariate analysis was used to identify independent risk factors for acute stroke.

Main Results:

  • Stroke occurred in 28 patients during the acute phase.
  • Low cardiac output between 12-24 hours postoperatively was the sole independent risk factor for acute stroke (OR, 0.25; P=.024).
  • Patients experiencing stroke had higher serum lactate dehydrogenase (LDH) levels postoperatively.

Conclusions:

  • Perioperative low cardiac output and elevated LDH levels are associated with acute stroke after LVAD implantation.
  • Maintaining adequate LVAD flow is crucial for preventing acute stroke.
  • The findings suggest a potential link between pump performance, thrombosis, and stroke risk.
Abstract

Keywords:
left ventricular assist devicelow cardiac outputpump thrombosisstroke

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