Carotid artery structure and hemodynamics and their association with adverse vascular events in left ventricular assist device patients

We examined the association of these measures with the composite outcome as well as individual subcomponents such as stroke. After adjusting for established risk factors, the composite adverse outcome was associated with pre-operative moderate-to-severe carotid plaque (OR 5.08, 95% CI 1.67 –15.52) as well as pre-operative internal carotid artery stenosis (OR 9.02, 95% CI 1.06–76.56). In contrast, altered hemodynamics during LVAD support were not associated with the composite outcome. Our findings suggest that pre-existing atherosclerosis possibly in combination with LVAD hemodynam ics may be an important contributor to adverse vascular events during mechanical support. This encourages greater awareness of carotid morphology pre-operatively and further study of the interaction between hemodynamics, pulsatility, and structural arterial disease during LVAD support.
Source: Journal of Artificial Organs - Category: Transplant Surgery Source Type: research