Asymmetric pattern of cerebrovascular lesions in patients after left ventricular assist device implantation.

Authors :: Kato TS
Ota T
Schulze PC
Farr M
Jorde U
Takayama H
Naka Y
Yamashita T
Mancini DM
Source :: Stroke [Stroke] 2012 Mar; Vol. 43 (3), pp. 872-4. Date of Electronic Publication: 2011 Dec 29.
Publication Year :: 2012
Abstract: 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.<br />Methods: We reviewed 317 consecutive patients who underwent LVAD surgery between November 2000 and July 2011. Stroke during LVAD support was analyzed.<br />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.<br />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.

Full Text Access

Tools