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Stroke After LVAD: Does Age Matter? A Sex-based Analysis
The risk of stroke in women with left ventricular assist devices (LVADs) appears to be higher than men. Some authors suggested that variances in hormonal influences occurring with age might contribute to the increased thrombotic profile potentially acquired by some women.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: V. Blumer, G.A. Hernandez, M. Ortiz, V. Mehta, S. Chaparro Source Type: research

Quantifying the Devastation From Stroke During Support With Continuous Flow Pumps: An Intermacs Analysis
Strokes (S) during continuous flow (CF) left ventricular assist device (LVAD) support are a major barrier to extension of the therapy to less ill ambulatory heart failure (HF) patients. We analyzed the incidence, outcome, and impact of major S in the INTERMACS database.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.K. Kirklin, D.C. Naftel, S.L. Myers, F.D. Pagani, L.W. Stevenson, R.L. Kormos, P.C. Colombo Source Type: research

Blood Pressure Management Ameliorates the Severity of Neurological Events
The ENDURANCE Supplemental trial was designed to assess the effectiveness of an enhanced blood pressure (BP) management protocol in reducing the occurrence of neurological events in patients ineligible for cardiac transplantation receiving the Medtronic HeartWareTM HVADTM System. The trial demonstrated that enhanced BP management significantly reduced the mean arterial pressure (MAP) and the incidence of hemorrhagic strokes compared to the original ENDURANCE trial. This subsequent analysis sought to understand the effects of BP management on stroke severity and recovery.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.J. Teuteberg, J.G. Rogers, C.A. Milano, M.S. Kiernan, G.S. Couper, S.W. Boyce, C. Mahr, N.A. Mokadam, T.A. Vassiliades, F.D. Pagani Source Type: research

Blood Pressure Control as a Risk Factor for Stroke in LVAD Patients- Single Center Experience
The ENDURANCE trial suggested an increased stroke (CVA) risk in Heartware HVAD compared to Heartmate 2 (HM2); a risk that could be mitigated with improved blood pressure control as demonstrated in the ENDURANCE 2 supplemental study. We hypothesized that better blood pressure control reduced the stroke risk in all LVAD supported patients.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: N.S. Clarke, R. Vela, J. Pruszynski, M. Drazner, L.C. Huffman, M. Peltz Source Type: research

Systolic Blood Pressure and Outcomes in Patients on Continuous Flow LVAD Support: An INTERMACS Analysis
High mean arterial pressures in continuous flow (cf) LVAD patients are associated with increased stroke and pump thrombosis risks. Optimal thresholds for systolic blood pressure are unknown.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.A. Cowger, T. Chamogeorgakis, J. Borgi, G. Grafton, Y. Selektor, H. Nemeh, C. Williams, C. Tita, D. Lanfear Source Type: research

Early Elevated Plasma Free Hemoglobin Predicts Occurrence of Thromboembolic Stroke during Venoarterial Extracorporeal Membrane Oxygenation Support
Hemolysis creates a prothrombotic state by platelet activation; however, its impact on thromboembolic (TE) stroke during venoarterial extracorporeal membrane oxygenation (VA ECMO) support is unknown.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: O. Saeed, W. Jackobleff, T. Chinnadurai, S. Forest, S. Rangasamy, S. Madan, M. Aljoudi, Y. Xia, S.R. Patel, S. Vukelic, D.B. Sims, J. Shin, H.H. Billett, D.J. Goldstein, U.P. Jorde Source Type: research

Clinical Profile of Patients with Late Stroke after Left Ventricular Assist Device Implantation
Despite advances in left ventricular assist device (LVAD) therapy, stroke remains a relatively frequent complication and is associated with significant morbidity and mortality. In the early postoperative period, stroke may be related to patient demographics, operative factors and comorbid conditions. Less is known about strokes that occur greater than six months after LVAD implantation. The aim of this study was to describe the clinical profile of patients with late strokes.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J. Nnanabu, D. Rodgers, N. Sarswat, J. Raikhelkar, G. Kim, S. Kalantari, T. Ota, T. Song, C. Juricek, V. Jeevanandam, G. Sayer, N. Uriel Source Type: research

Time Spent Out of Mean Arterial Blood Pressure (MAP) Goal Correlates With Adverse Events in Patients on Left Ventricular Assist Device
High mean arterial blood pressure (MAP> 85 mmHg) correlates with increased adverse events, notably stroke, in patients with left ventricular assist device (LVAD). Little is known about MAP variations and success of blood pressure control in ambulatory patients.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: A. Khan, E. Sultanik, M. Racherla, E. Sorensen, H. Voorhees, L. Dees, E. Feller, D. Kaczorowski, Z. Kon, V. Ton Source Type: research

4D Flow MRI in 3D Printed Models of Aorta Grafted With a Ventricular Assist Device Allows Detailed Embolic Trajectory Analysis
Embolic stroke remains an important source of morbidity and mortality in heart failure patients treated with Ventricular Assist Devices (VADs). Decreasing the probability of cranial versus descending aortic embolic trajectory by optimizing the VAD outflow graft position and terminal curvature angle could reduce embolic stroke risk. The goal of this study is to investigate particle trajectories released by a VAD into the aorta, and the effect changes in outflow graft insertion site and terminal curve have on those trajectories.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: O. Amili, F. Coletti, R. MacIver Source Type: research

Increased Pump Speed is Associated with Reduced Rates of Stroke on HeartMate II LVAD Support
Higher pump speeds have recently been associated with reduced rates of pump thrombosis in the HeartMate II LVAD population. Whether pump speed is associated with stroke has not been well established. In this analysis we use a single center cohort to determine the association with discharge speed and all-cause stroke.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.N. Schultz, R. Cogswell, M. Prtizker, E. Missov, K. Liao, J. Misialek, R. John Source Type: research

Highly Accurate Continuous Blood Pressure Measurement in LVAD Patients with a Non-Invasive, Non-Oscillometric Wearable Device: A Pilot Study
This study aimed to assess the accuracy of a novel, non-invasive wearable device that provides a continuous measurement of systolic and diastolic BP (Figure 1A).
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: G. Sayer, G.H. Kim, D. Rodgers, B. Chung, A. Nguyen, N. Narang, J. Raikhelkar, S. Kalantari, N. Sarswat, V. Jeevanandam, N. Uriel Source Type: research

Evaluation of the CHADS2, CHA2DS2-VASc, and R2CHADS2 Risk Assessment Scores in Continuous Flow LVADs
We describe the overall experience of cerebrovascular accidents in CF-LVAD patients at a large volume center and compare the utility of CHADS2, CHA2DS2-VASc, and R2CHADS2 scores.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: A. Santiago, H. Lamba, A. Alnajar, F.H. Cheema, J. Hyak, R. Conyer, M. Kim, B. Chou, A. Nair, S. Oberton, R.K. Ghanta, J. George, Z.A. Taimeh, A. Civatello, O. Frazier, J. Morgan Source Type: research

Stroke Volume Response to Exercise is Dependent on Disease Severity in Pulmonary Arterial Hypertension
This study aimed to describe changes in stroke volume (SV) during exercise in patients with pulmonary arterial hypertension (PAH) to allow for exercise-based risk stratification.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: C. G öransson, N. Vejlstrup, J. Carlsen Source Type: research

Flow Performance of the CorWave LVAD Membrane Wave Pump
Implantable long-term blood pumps currently available or in development employ high speed rotary impellers. Use of these devices is currently limited due to relatively high rates of stroke, bleeding complications and infection. A new blood pump technology is under development inspired by the swimming motion of a fish. High frequency, low amplitude linear actuation creates a wave motion on a polymer membrane, gently pushing the blood through the pump. This approach offers a less damaging method for pumping blood, provides full physiologic pulsatility and can operate efficiently over a wide range of operating conditions.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: C.N. Botterbusch, P. Monticone, L. Polverelli Source Type: research

Novel Rat Lung Transplant Model of Primary Graft Dysfunction by Histone Administration
It has been known that intranuclear histones are released into systemic circulation in various medical conditions caused by massive tissue damage, such as stroke or trauma. We hypothesized that a histone-associated lung injury caused in the process of brain deaths of donors is one of risk factors of primary graft dysfunction (PGD) after lung transplantation.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: K. Nakao, M. Anraku, T. Murayama, M. Kawashima, A. Hosoi, J. Nakajima Source Type: research

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