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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Schlöglhofer, T; Aigner, P; Migas, M; Beitzke, D; Dimitrov, K; Wittmann, F; Riebandt, J; Granegger, M; Wiedemann, D; Laufer, G; Moscato, F; Schima, H; Zimpfer, D.
Inflow cannula position as risk factor for stroke in patients with HeartMate 3 left ventricular assist devices.
Artif Organs. 2022;
Doi: 10.1111/aor.14165
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Web of Science
PubMed
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- Co-authors Med Uni Graz
- Beitzke Dietrich
- Zimpfer Daniel
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- Abstract:
- BACKGROUND: A relation between the left ventricular assist device inflow cannula (IC) malposition and pump thrombus has been reported. This study aimed to investigate if the pump position, derived from chest X-rays in HeartMate 3 (HM3) patients, correlates with neurological dysfunction (ND), ischemic stroke (IS), hemorrhagic stroke (HS) and survival. METHODS: This analysis was performed on routinely acquired X-rays of 42 patients implanted with a HM3 between 2014 and 2017. Device position was quantified in patients with and without ND from frontal and lateral X-rays characterizing the IC and pump in relation to spine, diaphragm or horizontal line. The primary end-point was freedom from stroke and survival one-year after HM3 implantation stratified by pump position. RESULTS: The analysis of X-rays, 33.5 (41.0) days postoperative, revealed a significant smaller IC angle of HM3 patients with ND versus no ND (0.1° ± 14.0° vs. 12.9° ± 10.1°, p = 0.005). Additionally, the IC angle in the frontal view, IS: 4.1 (20.9)° versus no IS: 13.8 (7.5)°, p = 0.004 was significantly smaller for HM3 patients with IS. Using receiver operating characteristics derived cut-off, IC angle <10° provided 75% sensitivity and 100% specificity (C-statistic = 0.85) for predicting IS. Stratified by IC angle, freedom from IS at 12 months was 100% (>10°) and 60% (<10°) respectively (p = 0.002). No significant differences were found in any end-point between patients with and without HS. One-year survival was significantly higher in patients with IC angle >10° versus <10° (100% vs. 71.8%, p = 0.012). CONCLUSIONS: IC malposition derived from standard chest X-rays serves as a risk factor for ND, IS and worse survival in HM3 patients.
- Find related publications in this database (Keywords)
- inflow cannula position
- mechanical circulatory support
- neurological dysfunction
- predictor
- ventricular assist device