Analysis of Neurological Complications and Related Risk Factors After Left Ventricular Assist Device Implantation
10.3969/j.issn.1000-3614.2025.04.007
- VernacularTitle:左心室辅助装置植入术后神经系统并发症及相关因素分析
- Author:
Haotian ZHANG
1
;
Xingtong ZHOU
1
;
Zelin YIN
1
;
Juan DU
1
;
Fengqing ZHANG
1
;
Haibo CHEN
1
;
Ping QING
1
;
Xiaohu WANG
1
;
Ze ZHANG
1
;
Liang ZOU
1
;
Yi CHEN
1
;
Yan JIN
1
;
Xianqiang WANG
1
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 心外科,北京 100037
- Publication Type:Journal Article
- Keywords:
left ventricular assist device;
neurological complication;
artificial heart;
mechanical circulatory support;
end-stage heart failure
- From:
Chinese Circulation Journal
2025;40(4):359-366
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To evaluate the incidence of neurological complications following left ventricular assist device(LVAD)implantation and to investigate related risk factors.Methods:A retrospective analysis was conducted on 151 patients who underwent LVAD implantation at Fuwai Hospital between June 2017 and September 2024.Clinical characteristics and postoperative survival outcomes were compared between patients with and without neurological complications.Results:Neurological complications occurred in 21 patients(13.9%)postoperatively,15 cases were ischemic strokes,5 cases were symptomatic intracranial hemorrhages or subarachnoid hemorrhages,and 1 case was transient ischemic attack(TIA).The total incidence of neurological complications was 0.08 events per person-year(EPPY),ischemic stroke was 0.06 EPPY and hemorrhagic stroke was 0.02 EPPY.Compared with patients without neurological complications,patients with neurological complications had a higher proportion of preoperative aortic regurgitation and tricuspid regurgitation,lower triglyceride levels,a lower rate of concurrent left atrial appendage resection and a higher rate of concurrent aortic valve replacement surgery.Multivariate cox regression analysis revealed that higher preoperative triglyceride levels(HR=0.21,95%CI:0.08-0.56,P=0.002)were associated with neurological complications.The median follow-up time was 508.0(186.5,931.5)days,12 out of 15 cases of ischemic stroke experienced no long-term sequelae,while 3 patients had varying degrees of residual deficits.All 5 patients with hemorrhagic stroke died,with 2 deaths directly attributed to hemorrhage.Kaplan-Meier survival curve analysis indicated that patients with neurological complications had a significantly lower survival rate(log-rank P=0.005).Conclusions:Neurological complications after LVAD implantation are predominantly ischemic strokes.Although less frequent,hemorrhagic strokes are associated with worse outcomes.Higher preoperative triglyceride levels is associated with neurological complications.
