PMID: 15227332Mar 1, 1987Paper

Stroke and the total artificial heart: neurologic considerations

Texas Heart Institute Journal
R G Hart, D G Sherman

Abstract

Neurologic complications, particularly brain infarction (ischemic stroke), are frequent and serious sequelae of total artificial heart (TAH) implantation. Most strokes that occur in TAH patients are due to embolism of thrombotic fragments originating on prosthetic surfaces. The emboli tend to lodge in the middle cerebral artery or its cortical branches and cause cortical syndromes. Cardioembolic strokes are characteristically heralded by the abrupt onset of a maximal neurologic deficit in an awake, often active patient. Cardioembolic strokes have a tendency to undergo hemorrhagic transformation. Anticoagulation is a major issue in stroke management: In anticoagulated patients, hemorrhagic transformation often results in major neurologic worsening; therefore, this risk must be weighed against the danger of recurrent embolism in the absence of anticoagulation. We recommend avoiding anticoagulation during the initial 24 to 48 hours after a stroke, especially in patients with large cardioembolic infarcts. Because of the many invasive procedures producing bacteremia in TAH patients, combined with the large area of prosthetic surfaces, infective endocarditis is a potential concern. Weighing the risks and benefits of anticoagulation i...Continue Reading

Related Feeds

Acute Stroke

A stroke occurs when blood supply to the brain is interrupted depriving the brain of oxygen and nutrients. This feed focuses cerebrovascular accidents including ischemic and paralytic stroke.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Related Papers

Southern Medical Journal
Roger E Kelley, Alireza Minagar
Current Treatment Options in Neurology
K Vahedi, Pierre Amarenco
Clinical Neurology and Neurosurgery
B Krijne-KubatP J van der Lugt
© 2022 Meta ULC. All rights reserved