PedsCrit Ventricular Assist Devices with Dr. Tanya Perry --- Part 2: Stroke Prevention and the ACTION Learning Network
Jun 15, 2026
Tanya Perry, cardiac intensivist and VAD program director specializing in pediatric mechanical circulatory support. She discusses device selection by size and diagnosis. She explains anticoagulation differences across devices and how networks harmonized protocols. She walks through stroke types on VADs, monitoring challenges, inflammatory contributors, and the ACTION network’s ABCs for stroke prevention.
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Adjust Impella Strategy Around Purge Fluid Composition
- Manage Impella anticoagulation by knowing the purge fluid composition and systemic anticoagulant choice.
- Use heparin-based purge plus heparin infusion or bicarbonate purge with bivalirudin to avoid heparin exposure.
Prefer Bivalirudin And Aspirin For Paracorporeal VADs
- For Berlin Heart and many paracorporeal devices, prefer bivalirudin plus aspirin to reduce thrombotic events.
- Transitioning from varied historical regimens to bivalirudin dropped stroke rates from ~30% to ~11%.
CentriMag Risk Reflects Device And Patient Selection
- CentriMag patients show higher stroke rates partly because they're used for sicker, higher-risk patients and flow/titration needs.
- Studies suggest 20–29% stroke risk, reflecting both device and patient selection factors.