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CHA2DS2VASc Score as a Predictor for Thromboembolic Stroke in Patients with Cardiac Aneurysm
Background: Patients with atrial fibrillation (AF) are at an increased risk of stroke due to increased propensity for thrombus formation in the left atrium secondary to sluggish blood flow. CHA2DS2VASc score is used to predict the risk of stroke in these patients, and treat them accordingly. Similarly, there is poor flow in cardiac aneurysms (CA) which increase thrombus formation and risk for thromboembolic stroke. Data on CHA2DS2VASc score as a predictor of thromboembolic stroke in CA is limited.
Source: Journal of Cardiac Failure - August 1, 2017 Category: Cardiology Authors: Siva Sagar Taduru, Shubha Deep Roy, Madhuri Ramakrishnan, Dushyant Ramakrishnan, Alankrita Taneja, Paramdeep Baweja Source Type: research

Apixaban Use in LVAD Patient with Recurrent GI Bleeding and Recent Embolic Stroke
Background: Left ventricular assist devices (LVAD) have been shown to improve quality of life and decrease mortality in patients with advanced heart failure. GI bleeding and pump thrombosis are major complications associated with LVAD therapy. Warfarin is the mainstay of anticoagulation for these patients. However, warfarin therapy can be challenging due to a narrow therapeutic window, drug/food interactions and need for frequent monitoring. The direct oral anticoagulants (DOACs) have been shown to be non-inferior or superior to warfarin for preventing stroke and reducing the risk of bleeding in patients with AF.
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Lisa Curran, Ali Cosgrove, Amy Clegg, Molly Reece, Bryan Bartle, Peter Van Trigt, Dalton McLean, Daniel Bensimhon Source Type: research

A Rare Case of Myocarditis, Intracardiac Thrombus And Embolic Stroke Caused By Mycoplasma Pneumoniae
We describe a rare case of mycoplasma pneumoniae myocarditis complicated by acute systolic heart failure, left ventricular thrombus and embolic stroke.
Source: Journal of Cardiac Failure - September 30, 2020 Category: Cardiology Authors: Raksha Kulkarni, Mansi Oberoi, Tony Oliver Tags: 176 Source Type: research

Heart Failure With Sinus Rhythm: Does Anticoagulation Reduce Stroke at All?
Heart failure (HF) carries substantial risk of thromboembolism with or without concomitant atrial fibrillation (AF).1 –3 Patients with recent HF are almost twice likely to develop ischemic stroke compared with matched controls in a large cohort without AF (incidence of 2.23 per 100 person-years vs 1.17 per 100 person-years).2 The prothrombotic state in HF could be explained by the elements fulfilling Virchow tria d in HF population: decreased cardiac output, abnormal haemostasias and platelet function, and endothelial dysfunction.
Source: Journal of Cardiac Failure - August 1, 2021 Category: Cardiology Authors: Juqian Zhang, Eduard Shantsila, Gregory Y.H. Lip Tags: Editorial Source Type: research

Thrombolytic Therapy for Thrombosis of Continuous Flow Ventricular Assist Devices
Conclusions: In the setting of LVAD thrombosis, thrombolytic therapy is an alternate treatment strategy in a subset of patients. Candidacy for this alternate procedure must carefully weigh the risks of complications, including hemorrhage and thromboembolism.
Source: Journal of Cardiac Failure - December 19, 2013 Category: Cardiology Authors: Kelly Schlendorf, Chetan B. Patel, Thomas Gehrig, Todd L. Kiefer, G. Michael Felker, Adrian F. Hernandez, Laura J. Blue, Carmelo A. Milano, Joseph G. Rogers Tags: Clinical Investigations Source Type: research

Increased Risk of LVAD Thrombosis in Patients With a Previous History Thromboembolic Event
Heart failure is a clinical syndrome that affects more than 5.1 million Americans and over 23 million individuals worldwide. With the likely substantial growth in the incidence and prevalence of heart failure patients over the next 20-40 years, there will also likely be a corresponding increasein the need for left ventricular assist devices (LVADs). Complications occur and consist primarily of infection, stroke or other thromboembolic event, device malfunction, bleeding, and pump thrombosis. Since LVAD thrombosis can have devastating consequences, including central or peripheral thromboembolism, LVAD malfunction or failure...
Source: Journal of Cardiac Failure - July 31, 2015 Category: Cardiology Authors: Scott Lundgren Tags: Clinical Care I Source Type: research

Clinical Journey of Severe Heart Failure Patients after Left Ventricular Assistance Device Implant
This study aims to model the post-operative care pathway of patients after LVAD implementation using INTERMACS data.
Source: Journal of Cardiac Failure - August 1, 2017 Category: Cardiology Authors: Faezeh Movahedi, Lisa Lohmueller, Yiye Zhang, Rema Padman, James Antaki Source Type: research

Increased Risk of Thromboembolic Events Following Gastrointestinal Bleeds among Left Ventricular Assist Device Patients
Introduction: Patients with left ventricular assist devices (LVADs) are typically treated with warfarin and aspirin to prevent pump thrombosis and ischemic stroke. It has been observed that LVAD patients have a high incidence of bleeding complications, most commonly from the gastrointestinal tract. Patients who experience gastrointestinal bleeds (GIB) requiring hospitalization typically undergo a reduction in their anticoagulation and/or antiplatelet regimen. Few studies have examined the relationship between GIB and thromboembolic (TE) events in this population.
Source: Journal of Cardiac Failure - August 1, 2017 Category: Cardiology Authors: Eric W. Rudofker, Saadia Sherazi, John D. Rice, Brent A. Johnson, Jeffrey D. Alexis Source Type: research

The Hemodynamic Profile of GI Bleeding in Continuous-Flow LVADs: Is it All About the Right Ventricle?
The last decade has seen LVADs emerge as an effective and durable means to support select patients with advanced heart failure. Despite improvements in heart failure morbidity and mortality with mechanical support, device-related complications remain a challenge. While rates of pump thrombosis, driveline infection and stroke have declined with improvements in pump design and patient care strategies, the risk of gastrointestinal (GI) bleeding has remained constant.1 GI bleeding remains the leading cause of hospital readmission following device implant, occurring in 30% of patients with continuous-flow LVADs and negatively i...
Source: Journal of Cardiac Failure - August 2, 2018 Category: Cardiology Authors: Christopher T. Sparrow, Joel D. Schilling Source Type: research

Diffuse Connective Tissue Diseases and Left-Ventricular Assist Devices: Insights from the National Inpatient Sample
Durable left-ventricular assist devices (LVAD) have become an increasingly frequent treatment strategy for end-stage heart failure (HF) but their use remains limited by complications including bleeding, thrombosis, and stroke. The impact of LVAD therapy on outcomes in HF patients with postulated higher risk comorbid conditions, such as diffuse connective tissue diseases (DCTD), has not been well studied to date. Given that these patients have an inherently higher risk of hematological complications than the general population, we aimed to investigate demographic characteristics and outcomes after LVAD implantation in this ...
Source: Journal of Cardiac Failure - August 1, 2018 Category: Cardiology Authors: Ann Gage, Vanessa Blumer, Miguel Ortiz, Emer Joyce Tags: 323 Source Type: research

Bridging the Gap to LVAD Recovery and Explantation
Left ventricular assist device (LVAD) implantation continues to occur at an exceedingly high rate due to the donor and supply mismatch when it comes to heart transplantation. LVADs however do not come without risk and have high rates of significant bleeding, stroke, pump thrombosis and infection. Most of the clinical and research efforts thus far have been focused on LVAD insertion with the goal of destination therapy or as a bridge to transplant. The goal of bridge to recovery has often been underestimated despite multiple studies showing reverse remodeling of the myocardium.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Karlee K. Hoffman, Manreet Kanwar Tags: 361 Source Type: research

Mechanical Circulatory Support Driveline Infection Reduction through Nursing Quality Improvement
Infection in patients with left ventricular assist device is a leading cause of morbidity and mortality resulting in increased risk for additional complications such as bleeding, thrombosis and stroke. The purpose of this quality improvement project was to reduce driveline infections through implementation of an evidence-based bundled dressing kit and education to nursing staff.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Tania V. Randell, Tim Madeira, Noelle V. Pavlovic, Martha Abshire Tags: 335 Source Type: research

Role of Gallium-SPECT-CT in the Management of Patients with Ventricular Assist Device-Specific Percutaneous Driveline Infection
Implantable left ventricular assist device (LVAD) has dramatically improved the prognosis of patients with advanced heart failure.1 With ongoing technological innovation, patient survival and quality of life are further improving,2,3 and major complications related to LVAD such as pump thrombosis and stroke have decreased3; however, these complications have not been completely overcome. Infection remains a major complication in up to 60% of VAD patients and worsens prognosis and quality of life.
Source: Journal of Cardiac Failure - August 23, 2019 Category: Cardiology Authors: Yuki Kimura, Osamu Seguchi, Hiroki Mochizuki, Keiichiro Iwasaki, Koichi Toda, Yuto Kumai, Kensuke Kuroda, Seiko Nakajima, Emi Tateishi, Takuya Watanabe, Yorihiko Matsumoto, Satsuki Fukushima, Keisuke Kiso, Masanobu Yanase, Tomoyuki Fujita, Junjiro Kobayas Source Type: research

Increased Aortic Stiffness is Associated with Higher Rates of Stroke, GI-bleeding and Pump Thrombosis in CF-LVAD Patients
In the general population, increased aortic stiffness is associated with an increased risk of cardiovascular events. Previous studies have demonstrated an increase in aortic stiffness in continuous-flow left ventricular assist device (CF-LVAD) patients. However, the association between aortic stiffness and common adverse events  is unknown.
Source: Journal of Cardiac Failure - February 23, 2021 Category: Cardiology Authors: Hannah Rosenblum, Alberto Pinsino, Amelia Zuver, Azka Javaid, Giulio Mondellini, Ruiping Ji, John R. Cockcroft, Melana Yuzefpolskaya, A. Reshad Garan, Sofia Shames, Veli K. Topkara, Hiroo Takayama, Koji Takeda, Yoshifumi Naka, Barry J. McDonnell, Joshua Z Tags: Brief Report Source Type: research

Increased Aortic Stiffness Is Associated With Higher Rates of Stroke, Gastrointestinal Bleeding and Pump Thrombosis in Patients With a Continuous Flow Left Ventricular Assist Device
In the general population, increased aortic stiffness is associated with an increased risk of cardiovascular events. Previous studies have demonstrated an increase in aortic stiffness in patients with a continuous flow left ventricular assist device (CF-LVAD). However, the association between aortic stiffness and common adverse events  is unknown.
Source: Journal of Cardiac Failure - February 23, 2021 Category: Cardiology Authors: Hannah Rosenblum, Alberto Pinsino, Amelia Zuver, Azka Javaid, Giulio Mondellini, Ruiping Ji, John R. Cockcroft, Melana Yuzefpolskaya, A. Reshad Garan, Sofia Shames, Veli K. Topkara, Hiroo Takayama, Koji Takeda, Yoshifumi Naka, Barry J. Mcdonnell, Joshua Z Tags: Brief Report Source Type: research

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