Ventricular thrombus and subarachnoid bleeding during support with ventricular assist devices

Gruber, Éva; Seitelberger, Rainald; Hiesmayr, Michael

doi:10.1016/s0003-4975(99)00120-4

Cited by 10 publications

(4 citation statements)

References 7 publications

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“…On account of the exposure of the patient's blood to foreign body surfaces and the potential for stasis in any of the components' cavities, anticoagulation to an INR of 2.5 to 3.5 and antiplatelet therapy is required which can increase the risk of bleeding. 4,7,10 In our cases, despite correction of anticoagulation, the support devices did not fail; similarly in other case studies and case reports, it is rare for the support devices to fail. 9 Specifically, it has in addition been shown that female gender, creatinine greater than 2.6 mg/dL, and need for dialysis are independent risk factors for ICH.…”

Section: Discussionsupporting

confidence: 87%

Intracranial Hemorrhage Surgery on Patients on Mechanical Circulatory Support

Factora¹,

Bustamante²,

Spiotta³

et al. 2011

Journal of Neurosurgical Anesthesiology

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The results of recent cardiothoracic surgery trials have led to an increase of surgical management instead of medical management in the treatment of heart failure. Although most agree with the immediate reversal of anticoagulation and antiplatelet therapy, there is no standard protocol for restarting anticoagulation or antiplatelet therapy after craniotomy in this population. The standard practices of resuscitation and ACLS including inotropes, vasopressors, and vasodilators (with the exception of chest compressions that can dislodge the devices), can be used as needed. The identification of cardiothoracic surgeons and perfusionists who are available for immediate assistance as and when required during the surgery and transportation is an important factor.

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Section: Discussionsupporting

confidence: 87%

Intracranial Hemorrhage Surgery on Patients on Mechanical Circulatory Support

Factora¹,

Bustamante²,

Spiotta³

et al. 2011

Journal of Neurosurgical Anesthesiology

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“…20 However, none of these factors except BSI seemed to affect the incidence of HCVA in our study. The rate of mortality from MCS dramatically increases from 61% to 92.3% when ICH develops, 23,24 as has been demonstrated in our study (100%).…”

Section: Discussionsupporting

confidence: 83%

Are Blood Stream Infections Associated With an Increased Risk of Hemorrhagic Stroke in Patients With a Left Ventricular Assist Device?

Aggarwal¹,

Gupta²,

Kumar³

et al. 2012

ASAIO Journal

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Blood stream infections (BSIs) are an important cause of morbidity and mortality in patients with left ventricular assist devices (LVADs). The aim of this study was to examine the correlation between hemorrhagic cerebrovascular accident (CVA) and BSI after implantation of LVAD for advanced heart failure (HF). This was a retrospective descriptive review of 87 patients with end-stage HF, who underwent implantation of HeartMate II continuous-flow LVAD over a 4 year period. Blood stream infections were diagnosed by serial blood cultures, and suspected neurological complications including CVAs were confirmed by neuroimaging. Extensive patient chart review was performed, and descriptive characteristics were analyzed using SPSS statistical software. The mean age of our study population was 62.3 ± 12.8 years, and the majority of our patients were males (n = 75, 86.2%). The baseline characteristics were comparable in the patients with and without CVAs. Patients with BSI had a much greater incidence of CVA compared to patients without BSI (n = 13, 43.3% vs. n = 5, 10.0%; p < 0.0001). There was an increased mortality in patients with BSI than those without (n = 57, 65.5% vs. n = 30, 34.5%; p = 0.003). The risk of all CVAs (hemorrhagic/ischemic) was eightfold (odds ratio [OR] = 7.9; 95% confidence interval [CI] = 2.4-25.5; p = 0.001] in patients with BSI. Patients with BSI had a >20-fold risk of hemorrhagic CVA (OR = 24; 95% CI = 2.8-201.1; p = 0.03). Advanced HF patients with LVAD support who developed BSI need urgent evaluation and close monitoring for suspected neurological complications, particularly hemorrhagic CVA.

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“…Other mechanisms of late AR include endocarditis [21], aortic dissection [22,23], and aortic leaflet prolapse or perforation.…”

Section: Aortic Valve Opening and Functionmentioning

confidence: 99%

Echocardiography and Hemodynamic Monitoring Tools for Clinical Assessment of Patients on Mechanical Circulatory Support

Scolletta¹,

Biagioli²,

Franchi³

et al. 2013

Recent Advances in the Field of Ventricular Assist Devices

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Ventricular thrombus and subarachnoid bleeding during support with ventricular assist devices

Cited by 10 publications

References 7 publications

Intracranial Hemorrhage Surgery on Patients on Mechanical Circulatory Support

Intracranial Hemorrhage Surgery on Patients on Mechanical Circulatory Support

Are Blood Stream Infections Associated With an Increased Risk of Hemorrhagic Stroke in Patients With a Left Ventricular Assist Device?

Echocardiography and Hemodynamic Monitoring Tools for Clinical Assessment of Patients on Mechanical Circulatory Support

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