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Stroke after implantation of continuous flow left ventricular assist devices
ConclusionThe occurrence of stroke significantly increases morbidity and mortality after LVAD implantation. Despite an adverse impact on survival and quality of life, several patients who suffered stroke still received a heart transplant. Furthermore, none of our patients had recurrence of a neurological event. Strict implementation of anticoagulation protocols is likely the mainstay of preventing this devastating complication.
Source: Journal of Cardiac Surgery - May 20, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Athanasios Tsiouris, Ioannis Heliopoulos, Dimitrios Mikroulis, Panayiotis D. Mitsias Tags: ORIGINAL ARTICLE Source Type: research

A review of the complex landscape of stroke in left ventricular assist device trials.
CONCLUSIONS: Based on this review, we propose that future clinical trials: 1) utilize standardized stroke definitions and define stroke subtypes, 2) ensure that neurologists are integrated in study design and event adjudication, 3) include more thorough evaluations of stroke etiology using multimodality techniques, and 4) adopt the National Institutes of Health Stroke Scale to define stroke severity. PMID: 32289297 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - April 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Mai X, Reyentovich A, Norcliffe-Kaufmann L, Moazami N, Frontera JA Tags: Ann Thorac Surg Source Type: research

Stroke After Left Ventricular Assist Device Implantation: Outcomes in the Continuous-Flow Era.
CONCLUSIONS: Stroke while on CF-LVAD support was associated with significant mortality. To reduce the risk of stroke, it is essential to further elucidate risk factors, to optimize anticoagulation, and to further understand the impact of LVAD-related infections. PMID: 26070599 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - June 9, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Harvey L, Holley C, Roy SS, Eckman P, Cogswell R, Liao K, John R Tags: Ann Thorac Surg Source Type: research

Stroke After Left Ventricular Assist Device Implantation: Outcomes in the Continuous-Flow Era
Conclusions Stroke while on CF-LVAD support was associated with significant mortality. To reduce the risk of stroke, it is essential to further elucidate risk factors, to optimize anticoagulation, and to further understand the impact of LVAD-related infections.
Source: The Annals of Thoracic Surgery - June 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Thromboembolic stroke in patients with a HeartMate-II left ventricular assist device – the role of anticoagulation
Conclusion: In our experience anticoagulation within predefined targets is not associated with a reduced thromboembolic stroke risk in patients with a HeartMate-II LVAD on antiplatelet therapy. However, no firm statement about the effect of either anticoagulant or antiaggregant therapy can be made based on our study. A larger randomized study is needed to support the hypothesis that there may be no additional benefit of coumarin or heparin therapy compared with antiplatelet therapy alone.
Source: Journal of Cardiothoracic Surgery - October 15, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Walter van den BerghAnnemieke Lansink-HartgringAbram van DuijnAnnemarie EngströmJaap LahporArjen Slooter Source Type: research

Minimally invasive mitral valve surgery without aortic cross-clamping and with femoral cannulation is not associated with increased risk of stroke compared with traditional mitral valve surgery: a propensity score-matched analysis ADULT CARDIAC
CONCLUSIONS A minimally invasive approach for mitral valve surgery on a fibrillating heart was not associated with a greater incidence of stroke/TIA than was median sternotomy. When performed by highly experienced surgeons, the minimally invasive approach with fibrillatory arrest did not increase the risk of perioperative stroke.
Source: European Journal of Cardio-Thoracic Surgery - November 17, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Ad, N., Holmes, S. D., Shuman, D. J., Pritchard, G., Massimiano, P. S. Tags: Transplantation - heart, Basic research vascular ADULT CARDIAC Source Type: research

Stroke risk following implantation of current generation centrifugal flow left ventricular assist devices
ConclusionsDifferent LVAD models appear to be associated with significantly different stroke risks.
Source: Journal of Cardiac Surgery - December 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Yuting P. Chiang, Daniel Cox, Jacob N. Schroder, Mani A. Daneshmand, Laura J. Blue, Chetan B. Patel, Adam D. DeVore, Muath Bishawi, Carmelo A. Milano Tags: ORIGINAL ARTICLE Source Type: research

A modified Glenn shunt reduces right ventricular stroke work during left ventricular assist device therapy TRANSPLANTATION AND MECHANICAL CIRCULATORY SUPPORT
CONCLUSIONS A modified Glenn shunt reduced RV volumes, RV stroke work and RA pressure during LVAD therapy in an experimental model of heart failure in pigs.
Source: European Journal of Cardio-Thoracic Surgery - February 6, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Schiller, P., Vikholm, P., Hellgren, L. Tags: Coronary disease, Myocardial protection, Peripheral vascular TRANSPLANTATION AND MECHANICAL CIRCULATORY SUPPORT Source Type: research

Lower body surface area is highly related to mortality due to stroke or systemic bleeding in patients receiving an axial flow blood pump as a left ventricular assist device TRANSPLANTATION AND MECHANICAL CIRCULATORY SUPPORT
CONCLUSIONS The lower BSA is an independent risk factor for mortality due to stroke or systemic bleeding during the VAD support.
Source: European Journal of Cardio-Thoracic Surgery - April 8, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Komoda, T., Drews, T., Hetzer, R., Lehmkuhl, H. B. Tags: TRANSPLANTATION AND MECHANICAL CIRCULATORY SUPPORT Source Type: research

Percutaneous PFO closure for paradoxical stroke in 8‐kg twins
We present two cases of PFO closures in identical 8 kg twin boys with Hurler’s syndrome who had central lines for planned bone marrow transplants, with embolic stroke in one. We discuss the treatment options as well as the special challenges based on the patients’ age, size, and diagnoses. We also discuss the technical aspects and safety of percutaneous PFO closure. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - September 1, 2013 Category: Cardiovascular & Thoracic Surgery Authors: James Hill, Tamar Preminger Tags: Case Report Source Type: research

Results of surgical aortic valve replacement and transapical transcatheter aortic valve replacement in patients with previous coronary artery bypass grafting
CONCLUSIONS Reported differences in mortality and morbidity after TaTAVR and RAVR reflect differences in baseline risk profiles. Given the lower trend for renal complications, patients at higher perioperative renal risk might be better served by TaTAVR.
Source: Interactive CardioVascular and Thoracic Surgery - May 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F., D'Onofrio, A., Biancari, F., Salizzoni, S., De Feo, M., Agrifoglio, M., Mariscalco, G., Lucchetti, V., Messina, A., Musumeci, F., Santarpino, G., Esposito, G., Santini, F., Magagna, P., Beghi, C., Aiello, M., Ratta, E. D., Savini, C., Troise, Tags: Molecular biology, Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

Outcomes of Heart Transplantation in Small Children Bridged With Ventricular Assist Devices.
CONCLUSIONS: Small children bridged to HTx with a VAD have early survival rates that are comparable to nonbridged children; however, this is achieved at the expense of a higher rate of stroke. Identifying the risk factors for early death and stroke in small children bridged to HTx with VADs is prudent as more experience with this patient population accumulates. PMID: 23972933 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - August 21, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Kilic A, Nelson K, Scheel J, Ravekes W, Cameron DE, Vricella LA Tags: Ann Thorac Surg Source Type: research

Clinical Differences Between Continuous Flow Ventricular Assist Devices: A Comparison Between HeartMate II and HeartWare HVAD
ConclusionWhile device complications were comparable, patients with HVAD experienced a significantly higher incidence of stroke and GI bleeding and therefore refinement in patients' management may decrease incidence of these complications.
Source: Journal of Cardiac Surgery - July 11, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Spencer D. Lalonde, Ana C. Alba, Alanna Rigobon, Heather J. Ross, Diego H. Delgado, Filio Billia, Michael McDonald, Robert J. Cusimano, Terrence M. Yau, Vivek Rao Tags: Original Article Source Type: research

Impact of concurrent surgical valve procedures in patients receiving continuous-flow devices
Conclusions: Patients frequently require concurrent VPs at the time of LVAD placement; these patients are sicker and have higher early mortality. Furthermore, right ventricular dysfunction is increased in these patients. Further studies to develop selection criteria for concurrent valve interventions are important to further improve clinical outcomes.
Source: The Journal of Thoracic and Cardiovascular Surgery - January 14, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Ranjit John, Yoshifumi Naka, Soon J. Park, Chittoor Sai-Sudhakar, Christopher Salerno, Kartik S. Sundareswaran, David J. Farrar, Carmelo A. Milano Tags: Acquired Cardiovascular Disease Source Type: research

Use of EuroSCORE as a predictor of morbidity after cardiac surgery
Conclusion: EuroSCORE proved to be a good predictor of major postoperative morbidity in cardiac surgery: respiratory and dialysis-dependent renal failure.
Source: Revista Brasileira de Cirurgia Cardiovascular - June 3, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

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