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Semin Neurol 2021; 41(04): 411-421
DOI: 10.1055/s-0041-1726328
Review Article

A Comprehensive Review of Risk Factor, Mechanism, and Management of Left Ventricular Assist Device–Associated Stroke

Sung-Min Cho    *
1   Division of Neurocritical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Pouya Tahsili-Fahadan   *
1   Division of Neurocritical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
2   Neuroscience Intensive Care Unit, Department of Medicine, Virginia Commonwealth University, Inova Fairfax Medical Campus, Falls Church, Virginia
3   Neuroscience Research, Neuroscience and Spine Institute, Inova Fairfax Medical Campus, Falls Church, Virginia
,
Ahmet Kilic
4   Department of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Chun Woo Choi
4   Department of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Randall C. Starling
5   Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
,
Ken Uchino
6   Neurological Institute, Cleveland Clinic, Cleveland, Ohio
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Abstract

The use of left ventricular assist devices (LVADs) has been increasing in the last decade, along with the number of patients with advanced heart failure refractory to medical therapy. Ischemic stroke and intracranial hemorrhage remain the leading causes of morbidity and mortality in LVAD patients. Despite the common occurrence and the significant outcome impact, underlying mechanisms and management strategies of stroke in LVAD patients are controversial. In this article, we review our current knowledge on pathophysiology and risk factors of LVAD-associated stroke, outline the diagnostic approach, and discuss treatment strategies.

Keywords

left ventricular assist device - ischemic stroke - intracranial hemorrhage - heart failure

Authors' Contribution

All authors participated in the literature review and drafting of the manuscript.


* S-M.C. and P.T-F. contributed equally as first authors.




Publication History

Article published online:
13 April 2021

© 2021. Thieme. All rights reserved.

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