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Stroke epidemiology and outcomes in the modern era of left ventricular assist devices

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Abstract

The care for the patients with end-stage heart failure has been revolutionized by the introduction of durable left ventricular assist devices, providing a substantial improvement in patient survival and quality of life and an alternative to heart transplantation. The newest devices have lower instances of mechanical dysfunction and associated pump thrombosis. Despite these improvements in complications, the use of continuous flow assist devices is still associated with high rates of thrombotic and hemorrhagic complications, most notably stroke in approximately 10% of continuous flow assist devices patients per year. With the newest HeartMate 3 devices, there have been lower observed rates of stroke, which has in part been achieved by both improvements in pump technology and knowledge of the risk factors for stroke and neurological complications. The therapeutic options available to clinicians to reduce the risk of stroke, including management of hypertension and antithrombotics, will be reviewed in this manuscript.

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Authors and Affiliations

  1. Department of Neurology, Columbia University Irving Medical Center, 710 West 168th street, Room 604, New York, NY, 10032, USA

    Chinwe Ibeh & Joshua Z. Willey

  2. Department of Neurology, New York University Medical Center, New York, NY, 10032, USA

    Kara R. Melmed

  3. Department of Cardiology, Columbia University Irving Medical Center, New York, NY, 10032, USA

    Melana Yuzefpolskaya & Paolo C. Colombo

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  1. Chinwe Ibeh
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  2. Kara R. Melmed
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  3. Melana Yuzefpolskaya
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  4. Paolo C. Colombo
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  5. Joshua Z. Willey
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Correspondence to Joshua Z. Willey.

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Ibeh, C., Melmed, K.R., Yuzefpolskaya, M. et al. Stroke epidemiology and outcomes in the modern era of left ventricular assist devices. Heart Fail Rev 27, 393–398 (2022). https://doi.org/10.1007/s10741-021-10201-x

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