A1. Recovery (stem cell) project (Specific Aim 1). Neuroscience Specific Aim 1: To determine whether intracoronary autologous bone marrow angioblasts given to LVAD patients with CHF will improve their neurocognitive function and reduce the incidence of ischemic neurological events. Neuroscience Hypothesis 1: Patients with CHF on LVAD who have increased ejection fraction as a result of stem cell therapy will have greater improvement in neurocognitive function and fewer clinical neurological events than patients on LVAD without stem cell therapy with no change in ejection fraction. A2. Coagulation project (Specific Aim 3b). Neuroscience Specific Aim 2. To determine whether inhibition of the intrinsic pathway (IP) of coagulation during cardiopulmonary bypass (CPB) and during the post-operative period after LVAD implantation reduces the incidence of stroke and cognitive dysfunction. Neuroscience Hypothesis 2: Administration of IP antagonists during CPB and during the postoperative period after destination LVAD implantation in patients with CHF will reduce the occurrence of hemorrhagic and ischemic stroke both during the acute and chronic periods.
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