Abstract WP228: Stroke Risk Quantification For Patients With A Left Ventricular Assist Device Conference Proceeding uri icon



  • ; Introduction:; Stroke is a leading cause of death and disability and a significant complication for heart failure patients on Left Ventricular Assist Device (LVAD) support. Most of these stroke cases are embolic in nature. Yet, specifics of embolus transport to the brain by the flow driven by an LVAD are poorly understood; precluding a clear understanding of post-implant stroke risks in these patients. Here we demonstrate an innovative stroke risk descriptor using in silico embolus transport analysis.; ; ; Methods:; Cardiac gated CTA images with LVAD graft were obtained for 6 patients. 3 patients reported post-LVAD stroke and the other 3 did not. 3D computer models of the LVAD graft, aortic arch, and branch vessels to the head were created using SimVascular. Blood flow from LVAD was computed for each model using LVAD flow rate and mean blood pressure as inputs. A custom fluid-particle interaction model for embolus transport was used to obtain the distribution of emboli entering the arch from the LVAD. A combination of normalized embolus distribution was used to create a stroke risk descriptor and compared across the stroke and non-stroke cases. Two sets of descriptors were defined using: (a) embolus distribution to the head; and (b) distribution to the head as well as accumulation at aortic root near the dysfunctional aortic valve.; ; ; Results:; We present results from 5,000 different embolism scenarios using representative thromboembolic particles of 1 mm diameter. For descriptor category (a) defined in Methods, the computed average for post-LVAD stroke cases was 0.35 as compared to 0.24 for those without post-LVAD stroke. For risk of embolic events in the brain including embolus accumulation in aortic root (i.e. descriptor category (b) in Methods) the reported averages were 0.38 and 0.27 for stroke vs no-stroke cases.; ; ; Conclusions:; The results indicate that our descriptor is a good surrogate for identifying stroke risks post-LVAD implantation, with stroke cases correlated with high values of the descriptor. The results also indicate that emboli traveling from LVAD graft into the arch, as well as emboli accumulating in regions of stasis at the aortic root may both contribute to stroke risks in patients with an LVAD. Continued investigations with bigger patient cohorts are needed.;

publication date

  • February 1, 2023

has restriction

  • closed

Date in CU Experts

  • January 31, 2024 11:14 AM

Full Author List

  • Sahni A; McIntyre EE; Pal JD; Mukherjee D

author count

  • 4

published in

Other Profiles

International Standard Serial Number (ISSN)

  • 0039-2499

Electronic International Standard Serial Number (EISSN)

  • 1524-4628

Additional Document Info


  • 54


  • Suppl_1