Related Experiment Video

Updated: Dec 5, 2025

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

3.9K

Management of Stroke in Patients with Left Ventricular Assist Devices

Antje Giede-Jeppe1, Sebastian S Roeder1, Kosmas Macha1

  • 1Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 17, 2020
PubMed

Insights

Patients with left ventricular assist devices (LVAD) experiencing stroke often have acceptable outcomes, particularly with ischemic strokes. Further research is needed to enhance stroke care and prevention in this growing population.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Left ventricular assist device (LVAD) use is increasing globally.
  • Cerebrovascular events are a significant complication in LVAD patients.
  • Limited data exists on stroke in LVAD patients regarding etiology, management, and outcomes.

Purpose of the Study:

  • To investigate the characteristics, causes, management, and functional outcomes of stroke in patients with LVADs.
  • To report on cerebrovascular events occurring in a cohort of LVAD patients.

Main Methods:

  • Retrospective analysis of consecutive LVAD patients with ischemic or hemorrhagic stroke (2010-2018).
  • Inclusion in an institutional registry at a university stroke center.
  • Data collection on clinical characteristics, stroke etiology, management, and functional outcome (modified Rankin Scale 0-3).

Main Results:

  • 30 strokes occurred in 20 LVAD patients (77% ischemic, 23% hemorrhagic).
  • 87% of strokes occurred with non-pulsatile LVADs, with a median time of 9 months post-implantation.
  • International normalized ratio (INR) values were frequently outside the therapeutic range (39% ischemic, 57% hemorrhagic).
  • Ischemic strokes were primarily cardioembolic (92%) and mild-to-moderate in severity (median NIHSS 6).
  • 61% of ischemic stroke patients achieved acceptable functional outcomes at 3 months.

Conclusions:

  • The majority of LVAD patients with ischemic stroke achieve acceptable functional outcomes within three months.
  • Therapeutic strategies for acute stroke care and prevention in LVAD patients require further investigation.
  • Optimizing anticoagulation management is crucial for reducing stroke complications in LVAD recipients.
Abstract

Keywords:
Functional outcomeIntracerebral hemorrhageIschemic strokeLeft ventricular assist devices

More Related Videos

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

3.5K
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.4K

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
173
Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

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...
175
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

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.
136
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
146
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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...
119
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
210