Abstract

Case Report

Acute ischemic stroke management in a patient with ventricular assist device

Çisil İrem Özgenç Biçer*, Işıl Kalyoncu Aslan, Irmak Salt and Eren Gözke

Published: 23 December, 2020 | Volume 5 - Issue 3 | Pages: 174-175

Ventricular assist device is a portable machine which is also called an artificial heart for the patients who have terminal heart failure. The device maintains the heart’s vital functions until the suitable donor is found for the heart transplantation. It can be applied to either ventricles or both (biventricular). Although the device provides independence for the patient, it also has life-threatening complications. Such as infection, stroke secondary to thromboembolism, hemorrhage depending on anticoagulant use, right heart failure… and most of the time it is really hard to manage those complications. We will present a case, who had ischemic stroke as a complication of VAD even though he has been using aspirin, warfarin and had effective INR value.

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References

  1. From R, Hasan D, Froehler M, Goerbig-Campbell J. Stroke and Left, Ventricular Assist Device (LVAD). Open J Anesthesiol. 2013; 3: 51-56.
  2. Yuan N, Arnaoutakis GJ, George TJ, Allen JG, Ju DG, et al. The spectrum of complications following, left ventricular assist device placement. J Card Surg. 2012; 27: 630–638. PubMed: https://pubmed.ncbi.nlm.nih.gov/22978843/
  3. Kirklin JK, Naftel DC, Kormos RL, Pagani FD, Myers SL, et al. Interagency Registry for Mechanically, Assisted Circulatory Support (INTERMACS) analysis of pump thrombosis in the, Heart Mate II left ventricular assist device. J Heart Lung Transplant. 2014; 33: 12–22. PubMed: https://pubmed.ncbi.nlm.nih.gov/24418730/
  4. Adams HP, Jr., del Zoppo G, Alberts MJ, et al. Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic, Peripheral Vascular Disease and Quality of Care Outcomes in Research, Interdisciplinary Working Groups. Circulation. 2007; 115: 478-534.
  5. Parikh NS, Cool J, Karas MG, Boehme AK, Kamel H. Stroke Risk and Mortality in Patients With Ventricular Assist Devices. Stroke. 2016; 47: 2702-2706. PubMed: https://pubmed.ncbi.nlm.nih.gov/27650070/
  6. Hassett C, Cho SM, Rice C, Uchino K. The Etiology of Left Ventricular Assist Device Associated Ischemic Stroke (P6.242). Neurology. 2018; https://n.neurology.org/content/90/15_Supplement/P6.242
  7. Bishawi M, Joseph J, Patel C, Schroder J, Daneshmand M, et al. Risk Factors for Stroke on Left Ventricular Assist Devices. J Cardiac Surg. 2018; 33: 348-352. PubMed: www.ncbi.nlm.nih.gov/pubmed/29774592
  8. Menon AK, Götzenich A, Sassmannshausen H, Haushofer M, Autschbach R, et al. Low stroke rate and few thrombo-embolic events after HeartMate II implantation under mild anticoagulation. Eur J Cardiothorac Surg. 2012; 42: 319-323. PubMed: https://pubmed.ncbi.nlm.nih.gov/22398471/
  9. DeVore AD, Stewart GC. The Risk of Stroke on Left Ventricular Assist Device Support. JACC Heart Failure. 2017; 5: 712-714. PubMed: https://pubmed.ncbi.nlm.nih.gov/28958346/
  10. Cho SM, Moazami N, Katz S, Bhimraj A, Shrestha KN, et al. Stroke Risk Following Infection in Patients with Continuous- Flow Left Ventricular Assist Device. Neurocrit Care. 2019; 31: 72-80. PubMed: www.ncbi.nlm.nih.gov/pubmed/30644037
  11. Patil CG, Long EF, Lansberg MG. Cost-effectiveness analysis of mechanical thrombectomy in acute ischemic stroke. J Neurosurg. 2009; 110: 508-513. PubMed: https://pubmed.ncbi.nlm.nih.gov/19025358/
  12. Morici N, Varrenti M, Brunelli D, Perna E, Cipriani M, et al. Antithrombotic therapy in ventricular assist device (VAD) management: From ancient beliefs to updated evidence. A narrative review. IJC Heart Vasculature. 2018; 20: 20-26. PubMed: https://pubmed.ncbi.nlm.nih.gov/30229131/
  13. Cao C, Martinelli A, Spoelhof B, Llinas R, Marsh E. In Potential Stroke Patients on Warfarin, the International Normalized Ratio Predicts Ischemia. Cerebrovasc Dis Extra. 2017; 7: 111-119. PubMed: https://pubmed.ncbi.nlm.nih.gov/28803231/

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