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Heart transplantation provides considerable survival benefits for patients with end-stage heart failure, but it is available for only a small fraction of these patients due to donor shortage. Especially in Japan, domestic legal issues had severely limited the number of heart transplantation until the Revised Organ Transplant Law was launched in 2010. The mean waiting period of Japanese heart transplant candidates after left ventricular assist device (LVAD) surgery had exceeded 2 years and occasionally reached 4 years until recently (Sasaoka T et al., 2010). The long-term LVAD support can result in serious complications such as cerebrovascular accident (CVA), the most common cause of death following LVAD surgery (Rose EA et al., 2001; Holman WL, 2009; Saito S, et al. 2010). CVA is the leading cause of death and the primary reason for elimination from transplant eligibility. In addition, transplant recipients with a history of CVA face tremendous difficulties in being reintegrated into society, often for years after transplant (Nakajima I et al., 2011). Therefore, we investigated factors associated with CVA after LVAD surgery in Japanese patients, as well as we reviewed our treatment strategies for CVA and the outcome of these patients after developing CVA.

Risk Factor Analysis and Management of Cerebrovascular Accidents in Japanese Patients Supported by Left Ventricular Assist Device