Cerebrovascular disease in the era of left ventricular assist devices with continuous flow: risk factors, diagnosis, and treatment

J Heart Lung Transplant. 2014 Sep;33(9):878-87. doi: 10.1016/j.healun.2014.05.005. Epub 2014 Jun 2.

Abstract

Cerebral infarction and hemorrhage are among the principal sources of morbidity and mortality associated with mechanical circulatory support. There has been particular concern with the recently reported increased rate of device thrombosis in continuous-flow left ventricular assist devices. The neurologic management of stroke among these patients has limited data to inform current clinical practices. In this investigation we review the available literature on stroke in patients with continuous-flow left ventricular assist devices, with a focus on treatment algorithms in the acute setting and for secondary stroke prevention.

Keywords: acute stroke; epidemiology; intracerebral hemorrhage; ischemic stroke; left ventricular assist device; stroke prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Algorithms
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / epidemiology
  • Cerebral Hemorrhage / therapy
  • Cerebrovascular Disorders / diagnosis*
  • Cerebrovascular Disorders / epidemiology*
  • Cerebrovascular Disorders / therapy
  • Heart Failure / therapy*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Risk Factors
  • Secondary Prevention
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Stroke / therapy
  • Tomography, X-Ray Computed
  • Ventricular Dysfunction, Left / therapy*