Impact of anatomical position of the inflow cannula on stroke in patients with left ventricular assist devices. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Takada, Takuma; Nishinaka, Tomohiro; Ichihara, Yuki; Saito, Satoshi; Imamura, Yasutaka; Kikuchi, Noriko; Hattori, Hidetoshi; Suzuki, Atsushi; Ashihara, Kyomi; Shiga, Tsuyoshi; Nunoda, Shinichi; Hagiwara, Nobuhisa; Niinami, Hiroshi
• Is Part Of: International journal of artificial organs. Volume 45:Issue 1(2022)
• Page Start: 27
• Page End: 34
• Publication Date: 2022-01
• Subjects: Left ventricular assist device -- echocardiography -- stroke -- heart failure -- inflow cannula; Artificial organs -- Periodicals; 617.956
• DOI: 10.1177/0391398820988297
• Languages: English
• ISSNs: 0391-3988

Abstract

Objectives: Stroke is a substantial complication of left ventricular assist device (LVAD) implantation. The relationship between stroke and the anatomical position of the inflow cannula of patients who underwent LVAD implantation was investigated. Methods: We enrolled 15 patients with advanced-stage heart failure who underwent implantation of continuous-flow-LVAD. Data of patients who suffered a stroke within 6 months after LVAD implantation were retrospectively compared to those who remained free of stroke. The distance between the inflow duct and left ventricular (LV) septum (duct-sep distance) and its ratio to LV diastolic diameter (LVDd) were measured from echocardiography at 1 month after LVAD implantation. Receiver operating characteristic curves for the endpoint of stroke using the duct-sep distance to LVDd ratio was created and the cut-off value was calculated. The incidence of stroke during the 6 months after LVAD implantation according to this ratio was estimated using the Kaplan-Meier method. Results: At 1 month after LVAD implantation, there were no significant differences in baseline characteristics and echocardiography parameters between the stroke and stroke-free groups. Receiver operating characteristic curve analysis for the endpoint of stroke using the duct-sep distance to LVDd ratio revealed 0.217 as a cut-off value (sensitivity: 80%, specificity: 80%, area under the curve: 0.72). Stroke was more frequent in patients with a duct-sep distance to LVDd ratio ⩾0.217 at 1 month than in those with a lower ratio. Conclusion: The duct-sep distance to LVDd ratio was associated with the occurrence of stroke, suggesting that inflow cannula position influences the incidence of stroke.