التفاصيل البيبلوغرافية
| العنوان: |
Stroke outcomes following durable left ventricular assist device implant in patients bridged with micro‐axial flow pump: Insights from a large registry. |
| المؤلفون: |
Gallone, Guglielmo, Lewin, Daniel, Rojas Hernandez, Sebastian, Bernhardt, Alexander, Billion, Michael, Meyer, Anna, Netuka, Ivan, Kooij, J‐J, Pieri, Marina, Szymanski, Mariusz K., Moeller, Christian H., Akhyari, Payam, Jawad, Khalil, Krasivskyi, Ihor, Schmack, Bastian, Färber, Gloria, Medina, Marta, Haneya, Assad, Zimpfer, Daniel, Nersesian, Gaik |
| المصدر: |
Artificial Organs; Oct2024, Vol. 48 Issue 10, p1168-1179, 12p |
| مصطلحات موضوعية: |
HEMORRHAGIC stroke, ISCHEMIC stroke, ARTIFICIAL blood circulation, STROKE, HEART assist devices, INTRA-aortic balloon counterpulsation, HEMOLYSIS & hemolysins |
| مستخلص: |
Background: Stroke after durable left ventricular assist device (d‐LVAD) implantation portends high mortality. The incidence of ischemic and hemorrhagic stroke and the impact on stroke outcomes of temporary mechanical circulatory support (tMCS) management among patients requiring bridge to d‐LVAD with micro‐axial flow‐pump (mAFP, Abiomed) is unsettled. Methods: Consecutive patients, who underwent d‐LVAD implantation after being bridged with mAFP at 19 institutions, were retrospectively included. The incidence of early ischemic and hemorrhagic stroke after d‐LVAD implantation (<60 days) and association of pre‐d‐LVAD characteristics and peri‐procedural management with a specific focus on tMCS strategies were studied. Results: Among 341 patients, who underwent d‐LVAD implantation after mAFP implantation (male gender 83.6%, age 58 [48–65] years, mAFP 5.0/5.5 72.4%), the early ischemic stroke incidence was 10.8% and early hemorrhagic stroke 2.9%. The tMCS characteristics (type of mAFP device and access, support duration, upgrade from intra‐aortic balloon pump, ECMELLA, ECMELLA at d‐LVAD implantation, hemolysis, and bleeding) were not associated with ischemic stroke after d‐LVAD implant. Conversely, the device model (mAFP 2.5/CP vs. mAFP 5.0/5.5: HR 5.6, 95%CI 1.4–22.7, p = 0.015), hemolysis on mAFP support (HR 10.5, 95% CI 1.3–85.3, p = 0.028) and ECMELLA at d‐LVAD implantation (HR 5.0, 95% CI 1.4–18.7, p = 0.016) were associated with increased risk of hemorrhagic stroke after d‐LVAD implantation. Both early ischemic (HR 2.7, 95% CI 1.9–4.5, p < 0.001) and hemorrhagic (HR 3.43, 95% CI 1.49–7.88, p = 0.004) stroke were associated with increased 1‐year mortality. Conclusions: Among patients undergoing d‐LVAD implantation following mAFP support, tMCS characteristics do not impact ischemic stroke occurrence, while several factors are associated with hemorrhagic stroke suggesting a proactive treatment target to reduce this complication. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |