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ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs

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https://www.readbyqxmd.com/read/28198716/incidence-of-cannula-associated-deep-vein-thrombosis-after-veno-venous-ecmo
#1
Jay Menaker, Ali Tabatabai, Raymond Rector, Katelyn Dolly, Joseph Kufera, Eugenia Lee, Zachary Kon, Pablo Sanchez, Si Pham, Daniel L Herr, Michael Mazzeffi, Ronald P Rabinowitz, James V OʼConnor, Deborah M Stein, Thomas M Scalea
Limited literature regarding the incidence of cannula associated deep vein thrombosis (CaDVT) following veno-venous extracorporeal membrane oxygenation (VV ECMO) exists. The purpose of this study was to identify the incidence of post decannulation CaDVT and identify any associated risk factors. Forty eight patients were admitted between August 2014 and January 2016 to the Lung Rescue Unit were included in the study. Protocolized anticoagulation levels (partial thromboplastin time 45-55 second) and routine post decannulation DVT screening were in place during the study period...
February 13, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28195885/eisenmenger-syndrome-and-pregnancy-novel-ecmo-configuration-as-a-bridge-to-delivery-and-recovery-utilizing-a-multidisciplinary-team
#2
Erika B Rosenzweig, Darryl Abrams, Mauer Biscotti, Diane Kerstein, Daphnie Drassinower, Daniel Brodie, Matthew Bacchetta
Pregnancy is typically contraindicated in Eisenmenger syndrome because of its association with excessively high maternal and fetal morbidity and mortality. We report on our novel approach to successfully managing a 29 year-old pregnant woman with an unrepaired patent ductus arteriosus (PDA) with Eisenmenger syndrome through delivery and recovery. Venovenous ECMO was utilized during induction of labor to stabilize maternal hemodynamics and optimize fetal oxygenation by creating an oxygenated right-to-left shunt through the PDA...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28195884/interventional-treatment-of-lvad-outflow-graft-stenosis-by-introduction-of-bare-metal-stents
#3
Dominik Wiedemann, Thomas Schlöglhofer, Thomas Haberl, Julia Riebandt, Kamen Dimitrov, Heinrich Schima, Johannes Kastner, Wolfgang Matzek, Günther Laufer, Daniel Zimpfer
LVAD outflow graft stenosis is a rare but life-threatening complication of MCS-therapy. Current treatment modalities (pump exchange or systemic thrombolytic therapy) are associated with significant mortality and morbidity.Implantation of bare metal stents within the stenosed outflow graft is an alternative. Herein we describe a series of 3-cases with successful stent placement. This seems to be safe and successful however correct and early diagnosis of outflow stenosis can be challenging. Information provided by the HeartWare HVAD logfiles are extremely helpful for diagnosis...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28195883/long-term-pediatric-ventricular-assist-device-therapy-a-case-report-of-2100-days-of-support
#4
Neha J Purkey, Aileen Lin, Jenna M Murray, Maryalice Gowen, Paul Shuttleworth, Katsuhide Maeda, Christopher S Almond, David N Rosenthal, Sharon Chen
Ventricular assist devices (VADs) have been placed as destination therapy in adults for over twenty years but have only recently been considered an option in a subset of pediatric patients. A 2016 report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) revealed only eight pediatric patients implanted as destination therapy. We report the case of an adolescent male with Becker Muscular Dystrophy (BMD) who underwent VAD placement in 2011 as bridge to candidacy. He subsequently decided to remain as destination therapy and so far has accrued over 2100 days on VAD support, the longest duration of pediatric VAD support reported in the literature to date...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28195882/the-in-hospital-cost-of-ventricular-assist-device-therapy-implications-for-patient-selection
#5
Amit Iyengar, Oh Jin Kwon, Msgana Tamrat, Anthony Salimbangon, Nancy Satou, Peyman Benharash, Abbas Ardehali, Richard J Shemin, Murray H Kwon
Ventricular Assist Device (VAD) therapy is increasingly utilized to support patients in end-stage heart failure. However, VAD programs are resource intensive and demand active monitoring in order to ensure long term sustainability. The purpose of this study was to analyze total cost trends of the VAD program at our academic medical center.Retrospective analysis of UCLA's VAD program between years 2013-2014 was performed. Total in-hospital costs from the date of VAD surgery admission were queried and normalized to a Z-score...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28187049/fiber-bundle-design-for-an-integrated-wearable-artificial-lung
#6
Shalv P Madhani, Brian J Frankowski, William J Federspiel
Mechanical ventilation and ECMO are the only viable treatment options for lung failure patients at the end stage, including ARDS and COPD. These treatments however are associated with high morbidity and mortality due to long wait times for lung transplant. Contemporary clinical literature has shown ambulation improves post-transplant outcomes in lung failure patients. Given this, we are developing the PAAL, a truly wearable artificial lung that allows for ambulation. In this study, we targeted 180 ml/min oxygenation and determined the form factor for a hollow fiber membrane (HFM) bundle for the PAAL...
February 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28187048/utility-of-cha2ds2-vasc-and-has-bled-scores-as-predictor-of-thromboembolism-and-bleeding-after-left-ventricular-assist-device-implantation
#7
Hatice S Kemal, Serkan Ertugay, Sanem Nalbantgil, Pelin Ozturk, Cagatay Engin, Tahir Yagdi, Mustafa Ozbaran
Ischemic and hemorrhagic events are the common causes of morbidity and mortality after continuous-flow left ventricular assist device implantation (CF-LVAD). CHA2DS2-VASc score predicts thromboembolic (TE) event risk and HAS-BLED score predicts bleeding risk in patients on anti-coagulant with atrial fibrillation. We aimed to evaluate if these scoring systems would be predictive of TE and bleeding complications following CF-LVAD implantation. From December 2010 to December 2014, 145 patients who underwent CF-LVAD implantation at a single center were included...
February 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28187047/is-extracorporeal-co2-removal-really-safe-and-less-invasive-observation-of-blood-injury-and-coagulation-impairment-during-ecco2r
#8
Johannes Kalbhenn, Nadine Neuffer, Barbara Zieger, Axel Schmutz
Extracorporeal CO2-Removal (ECCO2R) is promoted with attributes like "safe" and "less invasive" compared to (high-flow) veno-venous ECMO-Systems. With our experience in coagulation disorders during ECMO-therapy with this observational study we for the first time prospectively evaluate hemolysis and coagulation disorders during ECCO2R. Eight consecutive patients with predominant hypercapnic respiratory failure were treated with the Hemolung® Respiratory Assist System (RAS) (Alung-Technologies, Pittsburg, USA)...
February 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28187046/effect-of-hydroxyethyl-starch-priming-on-the-systemic-inflammatory-response-and-lung-edema-following-cardiopulmonary-bypass-in-a-rat-model
#9
Yutaka Fujii, Takayuki Tanabe, Tsubasa Yamashiro, Mikiyasu Shirai, Yoshiaki Takewa, Eisuke Tatsumi
Cardiopulmonary bypass (CPB) preserves patients' lives during open heart surgery by providing sufficient oxygen delivery and blood supply to vital organs. However, previous studies have suggested that the interaction of hemodilution and vascular hyperpermeability induces tissue edema and an inflammatory response during CPB. In this study, we hypothesized that suppression of the systemic inflammatory response and tissue edema during CPB by a plasma substitute (hydroxyethyl starch: HES).Rats (450-500 g) were divided into a SHAM group (n=5), a Ringer's acetate CPB group (n=7), and an HES CPB group (n=7)...
February 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28169848/efficacy-of-flow-monitoring-during-ecmo
#10
Aditya Badheka, Sara E Stucker, Joseph W Turek, Madhavan L Raghavan
The hypothesis that blood flow monitoring could serve as an effective early indicator of distal obstruction during ECMO was tested under controlled experimental conditions. The ECMO circuit typically includes (or could be easily modified to include) a shunt that bifurcates from the main line returning a small amount of blood back to the pump with access points for drug infusions. Distal circuit obstructions in the oxygenator and beyond will result in an increased diversion of flow from the distal line to the shunt...
February 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28169847/sedation-strategies-for-extracorporeal-membrane-oxygenation-support
#11
Kandis L Adkins
No abstract text is available yet for this article.
February 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28169846/re-myocardial-recovery-in-peripartum-cardiomyopathy-after-hyperprolactinemia-treatment-on-biventricular-assist-device
#12
Dominik Wiedemann, Thomas Schlöglhofer, Julia Riebandt, Markus Neuner, Edda Tschernko, Heinrich Schima, Daniel Zimpfer
No abstract text is available yet for this article.
February 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28169845/percutaneous-transcatheter-implantable-gadgets-for-de-novo-aortic-valve-regurgitation-after-left-ventricular-assist-device-implant-pushing-the-limits-or-a-feasible-bailout
#13
Kamen Dimitrov, Daniel Zimpfer
No abstract text is available yet for this article.
February 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28134659/assessment-of-bleeding-and-thrombosis-based-on-aspirin-responsiveness-after-continuous-flow-left-ventricular-assist-device-placement
#14
Catherine K Floroff, Krista L Rieger, Tara M Veasey, Sara E Strout, Walter F DeNino, Holly B Meadows, Martha R Stroud, John M Toole, Dawn P Heyward, Meredith A Brisco, Jennifer L Cook, John Lazarchick, Walter E Uber
Pump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding following LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial non-responders who were then titrated upward to achieve therapeutic response.Patients ≥ 18 years of age with initial placement of HeartMate II® (HMII) LVAD at our institution and at least one VerifyNow® Aspirin test performed during initial hospitalization were included...
January 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28134658/flow-rate-through-pigtail-catheter-used-for-left-heart-decompression-in-an-artificial-model-of-extracorporeal-membrane-oxygenation-circuit
#15
Won Ho Kim, Tae Hee Hong, Joung Hun Byun, Jong Woo Kim, Sung Hwan Kim, Sung Ho Moon, Hyun Oh Park, Jun Young Choi, Jun Ho Yang, In Seok Jang, Chung Eun Lee, Jeong Hee Yun
In refractory cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (ECMO) can be initiated. Although left heart decompression can be accomplished by insertion of a left atrial (LA) or LV cannula using a percutaneous pigtail catheter, the venting flow rate according to catheter size and ECMO flow rate is unknown. We developed an artificial ECMO circuit. 1L saline bag with its pressure set to 20 mmHg was connected to ECMO to mimic LV failure. A pigtail catheter was inserted into the 1 L saline bag to simulate LV unloading...
January 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28125467/near-infrared-spectroscopy-monitoring-for-early-detection-of-limb-ischemia-in-patients-on-veno-arterial-extracorporeal-membrane-oxygenation
#16
Dong Jung Kim, Young-Jae Cho, Sang Hon Park, Cheong Lim, Kay-Hyun Park, Sang-Hoon Jheon, Jun Sung Kim
This study aimed to investigate the effectiveness of near-infrared spectroscopy (NIRS) monitoring for the early detection of limb ischemia in patients who were placed on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via femoral artery. We prospectively used NIRS monitoring for the early detection of limb ischemia in 28 adult patients, who were supported with peripheral VA-ECMO between August 2013 and August 2014 (NIRS group). A decision to perform distal perfusion catheterization was made in accordance to the regional oxygen saturation (rSO2) values provided by the NIRS system...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28125466/comparison-of-hemodynamic-performance-and-clinical-results-with-evaheart-versus-heartmate-ii
#17
Yorihiko Matsumoto, Tomoyuki Fujita, Satsuki Fukushima, Hiroki Hata, Yusuke Shimahara, Yuta Kume, Kizuku Yamashita, Kensuke Kuroda, Seiko Nakajima, Takuma Sato, Osamu Seguchi, Masanobu Yanase, Norihide Fukushima, Hideyuki Shimizu, Junjiro Kobayashi
This study aimed to compare the hemodynamic performance and clinical results of the EVAHEART and HeartMate II left ventricular assist devices (LVADs). From 2007 to 2016, 14 patients received EVAHEART and 28 received HeartMate II at our center. Early survival, driveline infection and neurological events were evaluated. Hemodynamic performance was evaluated with transthoracic echocardiography and right heart catheterization. Mean follow-up was 35.5 ± 14.8 months for EVAHEART, and 29.8 ± 6.5 months for HeartMate II...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28125465/the-supraclavicular-approach-to-the-subclavian-vein-as-an-alternative-venous-access-site-for-ecmo-cannulae-a-retrospective-comparison
#18
Andja Bojic, Irene Steiner, Jutta Gamper, Peter Schellongowski, Wolfgang Lamm, Alexander Hermann, Katharina Riss, Oliver Robak, Thomas Staudinger
Venous reperfusion as well as double-lumen cannulae for extracorporeal gas exchange (ECMO) are usually inserted via the right internal jugular vein. The supraclavicular approach to the right or left subclavian vein could serve as a possible alternative. The aim of this analysis was to compare feasibility, complications, and performance of supraclavicular and jugular cannulation, respectively.We retrospectively analysed charts and registry data of patients undergoing veno-venous ECMO. Twenty-four patients underwent jugular cannulation and 11 patients underwent supraclavicular cannulation...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28125464/cardiac-output-assessment-in-patients-supported-with-left-ventricular-assist-device-discordance-between-thermodilution-and-indirect-fick-cardiac-output-measurements
#19
David M Tehrani, Jonathan Grinstein, Sara Kalantari, Gene Kim, Nitasha Sarswat, Sirtaz Adatya, Gabriel Sayer, Nir Uriel
Cardiac output (CO) assessed by thermodilution (TD) and indirect Fick (iFK) methods is commonly employed in Left Ventricular Assist Devices (LVAD) patients, however no study has assessed agreement. This study assess correlation between these methods, and association with hemodynamic/echocardiographic data in LVAD patients. Discordance was defined as a 20% difference between TD and iFK CO measurements. Bias and agreement were determined via the Bland-Altman technique in both the overall sample and iFK stratified tertiles...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28125463/percutaneous-driveline-fracture-following-implantation-of-the-heartmate-ii-left-ventricular-assist-device-how-durable-is-driveline-repair
#20
John M Stulak, Sarah Schettle, Nicholas Haglund, Shannon Dunlay, Jennifer Cowger, Palak Shah, Keith D Aaronson, Francis D Pagani, Simon Maltais
Durability of the percutaneous driveline is critical for the optimal long-term support of patients after left ventricular assist device (LVAD) implantation. There are no data specifically examining the durability of major repair for driveline fracture or its effect on patient outcomes.Between May 2004 and August 2014, 560 patients underwent implantation with the HeartMate II LVAD at our respective institutions. Median age at LVAD implantation was 59 years (range, 18-82 years) and 465 patients (83%) were male...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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