Background: Neurologic complications are common complications encountered by patients with left ventricular assist devices (LVADs). This single-center retrospective study aims to identify the incidence and risk factors of neurologic complications and interventions in patients supported with LVADs and define the associated anticoagulation management.
Methods: Between August 2009 and August 2017, 244 patients underwent LVAD implantation. Twenty-one patients were excluded for having neurologic complications before LVAD placement or for having previously undergone heart transplantation.
Results: Fifty-six patients (25%) suffered 61 complications, and 11 (19.6%) died as a result. Gender, type of LVAD, or chronic medical comorbidities evaluated did not contribute to a difference in complication rate; in contrast, length of LVAD implantation was directly related to risk of neurologic complication. Eleven patients (19.6%) underwent 13 surgical interventions including 5 mechanical thrombectomies. Anticoagulation was reversed in 16 patients and held without complication. Anticoagulation was not held for ischemic complications, and no clinically significant hemorrhagic transformation occurred. Intravenous tissue plasminogen activator was also successfully administered to 3 patients without complication.
Conclusions: Neurologic complications were observed in 25% of patients supported with LVADs, of which 20% required neurosurgical intervention. Anticoagulation can be safely withheld in patients with hemorrhagic complications. Patients with ischemic complications can continue to be anticoagulated with no significant risk of hemorrhagic transformation. Length of LVAD implantation was directly related to the risk of neurologic complication. Finally, our study adds to existing literature that mechanical thrombectomy and even intravenous tissue plasminogen activator are options for LVAD patients with ischemic complications.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2020.04.064 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intermittent High-Degree AV Block, Rash, and Facial Droop with Negative Lyme PCR.
J Emerg Med
August 2024
Department of Emergency Medicine, University of Kentucky, Lexington, Kentucky.
Background: Lyme disease is the most common tick-borne illness in the United States, and cases of Lyme disease have nearly doubled since the early 2000s. Symptoms and presentation vary based on severity of illness, with more serious complications of disease consisting of neurologic and cardiac dysfunction. Testing is often unreliable, which can lead to delayed diagnosis and management.
View Article and Find Full Text PDFPrenatally diagnosed intracranial hemorrhage in the fetus is associated with a wide range of neonatal disorders, from completely uncomplicated physiological development to severe neurological impairment or death. The incidence is 0.6-1/1,000 births.
View Article and Find Full Text PDFEGFP/RFP-based FRET sensors for botulinum neurotoxin A biological activity detection and methodological validation.
Anal Chim Acta
February 2025
Joint Drug Development and Innovation Centre for Neurological Disorders of Lanzhou University-China National Biotec Group-Lanzhou Biotechnology Development Co., School of Pharmacy, Lanzhou University, Lanzhou, Gansu, 730000, PR China; MOE Frontiers Science Center for Rare Isotopes, Lanzhou University, Lanzhou, Gansu, 730000, PR China. Electronic address:
Background: Botulinum neurotoxin type A (BoNT/A) is the most potent and prevalent neurotoxin known to cause botulism, and is also widely used in medical and cosmetic applications. The detection of BoNT/A is of great significance for botulism diagnosis and drug potency determination. Currently, the mouse bioassay (MBA) has long been the gold standard method but has disadvantages of ethical concerns, long testing duration, and high costs.
View Article and Find Full Text PDFDietary supplementation and the role of phytochemicals against the Alzheimer's disease: Focus on polyphenolic compounds.
J Prev Alzheimers Dis
January 2025
Indian Scientific Education and Technology Foundation, Lucknow, 226002, India. Electronic address:
Alzheimer's disease is a complicated, multifaceted, neurodegenerative illness that places an increasing strain on healthcare systems. Due to increasing malfunction and death of nerve cells, the person suffering from Alzheimer's disease (AD) slowly and steadily loses their memories, cognitive functions and even their personality. Although medications may temporarily enhance memory, there are currently no permanent therapies that can halt or cure this irreversible neurodegenerative process.
View Article and Find Full Text PDFMarchiafava-Bignami disease post-bariatric surgery: A case report and review of similar cases.
Neurosciences (Riyadh)
January 2025
From the Neurology of Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Marchiafava-Bignami disease (MBD) is a rare neurological disorder typically occurring in alcoholic patients. The main disease mechanism is hypothesized to be vitamin B-complex deficiency due to malnutrition. In the literature, there have been few reported cases of the disease occurring in patients who have undergone bariatric surgery.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!