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Titolo:
CEREBRAL AND SYSTEMIC EMBOLIZATION DURING LEFT-VENTRICULAR SUPPORT WITH THE NOVACOR N100 DEVICE
Autore:
SCHMID C; WEYAND M; NABAVI DG; HAMMEL D; DENG MC; RINGELSTEIN EB; SCHELD HH;
Indirizzi:
UNIV MUNSTER,DEPT CARDIOTHORAC SURG,ALBERT SCHWEITZER STR 33 D-48149 MUNSTER GERMANY UNIV MUNSTER,DEPT NEUROL D-48149 MUNSTER GERMANY
Titolo Testata:
The Annals of thoracic surgery
fascicolo: 6, volume: 65, anno: 1998,
pagine: 1703 - 1710
SICI:
0003-4975(1998)65:6<1703:CASEDL>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
MECHANICAL CIRCULATORY SUPPORT; ASSIST DEVICE; TRANSPLANTATION; EXPERIENCE; BRIDGE; HEART; REGISTRY; TIME;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
20
Recensione:
Indirizzi per estratti:
Citazione:
C. Schmid et al., "CEREBRAL AND SYSTEMIC EMBOLIZATION DURING LEFT-VENTRICULAR SUPPORT WITH THE NOVACOR N100 DEVICE", The Annals of thoracic surgery, 65(6), 1998, pp. 1703-1710

Abstract

Background. Patients undergoing implantation of left ventricular assist systems (LVAS) are prone to thromboembolic complications. We analyzed the incidence, clinical findings, and outcome of neurologic and systemic thromboembolic events (TE) in patients with the Novacor N100 LVAS. In a subset of patients, transcranial Doppler sonography was used to detect microembolic signals. Methods. Thirty-six patients underwent implantation of a Novacor N100 LVAS for various reasons. The surgical procedure was elective in 18 patients and scheduled on an urgent or emergency basis in another 18 patients. The assist period lasted from 17to 336 days (109 +/- 88 days); 22 patients were forwarded to heart transplantation after being supported for 140 +/- 87 days. Results. Clinical cerebral embolism was evident in 17 patients (47%). Thromboembolic events were singular in 8 and multiple in 9 patients; in the latter up to 10 TE occurred (mean +/- SD, 1.4 +/- 2 TE). Leading neurologic symptoms were unilateral hemiplegia in 11, as well as ocular symptoms and aphasia in 12 patients each. Non-cerebral TE were detected in 4 patients, 2 of whom underwent an emergency operation for intestinal and iliac artery occlusion. The incidence of TE did not correlate strongly with the interval of LVAS support. Cerebral computed tomography confirmed lesions in 58% of patients. Transcranial Doppler sonography detected microembolic signals on 67% of all recordings, with the microembolic signals being more frequent on days with clinically manifest TE. Theoutcomes were good, as only 2 patients suffer from neurologic sequelae. Conclusions. Thromboembolism is still a major threat for patients with LVAS implantation. Neurologic sequelae are frequent but have a favorable prognosis, and systemic complications occur considerably less often. Patient selection, adequate anticoagulation, and transcranial Doppler sonography may help to reduce the incidence of TE. (C) 1998 by The Society of Thoracic Surgeons.

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Documento generato il 18/01/21 alle ore 16:17:57