Aortic arch branching variations and risk of cerebrovascular accidents in patients with a left ventricular assist device.
J Cardiovasc Med (Hagerstown)
; 25(1): 44-50, 2024 01 01.
Article
em En
| MEDLINE
| ID: mdl-38079280
ABSTRACT
AIMS:
This retrospective study investigated the association between anatomical variations in the aortic arch branching and adverse events, including the risk of cerebrovascular accidents (CVAs), in patients with a left ventricular assist device (LVAD).METHODS:
Medical charts were reviewed for all patients with HeartMate 3 LVAD support at our center from 2016 to 2021. Computed tomography scans were evaluated to categorize the variations in the aortic arch branching based on seven different types, as described in the literature.RESULTS:
In total, 101 patients were included 86 (85.1%) with a normal branching pattern and 15 (14.9%) with an anatomical variation. The following variations were observed eight (7.9%) with a bovine arch and seven (6.9%) with a left vertebral arch. The median age was 57âyears, 77.2% were men, and the median follow-up was 25âmonths. No difference was found in the rate of early (< 30âdays) re-exploration due to bleeding after LVAD implantation. The rate of CVA and mortality did not differ significantly between patients with a normal arch or an anatomical variation during follow-up, with hazard ratios of 1.47 [95% confidence interval (CI) 0.48-4.48; Pâ=â0.495] and 0.69 (95% CI 0.24-1.98; Pâ=â0.489), respectively.CONCLUSION:
This preliminary study showed no differences in early and long-term adverse events, including CVA, when comparing patients with a variation in the aortic arch branching to patients with a normal aortic arch. However, knowledge of the variations in aortic arch branching could be meaningful during cardiac surgery for potential differences in surgical events in the perioperative period.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Coração Auxiliar
/
Acidente Vascular Cerebral
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article