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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/30234504/conduction-abnormalities-associated-with-tricuspid-annuloplasty-in-cardiac-transplantation
#1
Geoffrey Rubin, Joseph Sanchez, Joseph Bayne, Uma Mahesh R Avula, Hiroo Takayama, Koji Takeda, Yoshifumi Naka, Hasan Garan, Maryjane A Farr, Elaine Y Wan
Prophylactic DeVega tricuspid annuloplasty (DVA) of the donor heart has been reported to improve tricuspid regurgitation (TR), renal dysfunction, and mortality in cardiac transplant recipients. This is the first study to investigate the electrical, as well as, hemodynamic effects of DVA during orthotopic heart transplantation (OHT). Electrocardiographic, echocardiographic, and hemodynamic data of 76 patients with DVA and 104 patients without DVA who underwent OHT between 2013 and 2017 at Columbia University Medical Center (New York, NY) were studied...
September 17, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30234503/bloodstream-infections-in-continuous-flow-left-ventricular-assist-device-recipients-diagnostic-and-clinical-implications
#2
Andreas Kyvernitakis, Orestis Pappas, Dimitrios Farmakiotis, Edward T Horn, Raymond L Benza, Stephen H Bailey, Richa Agarwal
Bloodstream infection (BSI) is a common complication of left ventricular assist device (LVAD) support and particularly difficult to treat. The presentation is often variable because of altered physiology and augmentation of cardiac output by the device. We studied LVAD recipients at a single institution. Multivariate logistic and Cox (with time-varying parameters) regression were implemented. Of 212 patients, 58% experienced infections. Driveline infection (DLI) affected 31%, with 60% of them having deep-tissue involvement...
September 17, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30234506/quality-over-quantity-standardization-of-pediatric-heartware-ventricular-assist-device-dressing-changes
#3
Leigh Ann Difusco, Stephanie M Helman
Pediatric patients are unique both in their diagnosis and clinical presentation before implantation of a ventricular assist device (VAD) and in their driveline site characteristics post-implant. There is limited evidence in scholarly literature that describes complications of pediatric VAD driveline sites or approaches by which to manage them. The Cardiac Center at The Children's Hospital of Philadelphia (CHOP) follows a standard of care for HeartWare VAD (HVAD) dressing changes in the inpatient setting with the goal of transitioning patients to weekly dressing changes by the time they are discharged to home...
September 12, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30234505/marked-practice-variation-in-antithrombotic-care-with-the-berlin-heart-excor-pediatric-ventricular-assist-device
#4
Lindsay J May, Angela Lorts, Christina VanderPluym, Jennifer Conway, M Patricia Massicotte, Morgan M Millar, Marie E Steiner, David N Rosenthal
Management of antithrombotic therapy (ATT) for pediatric ventricular assist devices is challenging, and the Berlin EXCOR remains the only FDA-approved option. Among those on the EXCOR, 28% have neurologic complications and major bleeding occurs in 50%. The Edmonton Protocol was developed to guide ATT, but the adverse event rate remains high, leading most centers to make modifications. The objective of this study is to characterize antithrombotic practice variation among North American pediatric ventricular assist device programs, in order to guide future research...
September 12, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30198911/impact-of-change-in-body-mass-index-on-outcomes-after-left-ventricular-assist-device-implantation-in-obese-patients
#5
Akiko Mano, Ahmet Kilic, Brent C Lampert, Sakima A Smith, Bryan Whitson, Ayesha K Hasan
Obesity could be a risk factor portending a poor prognosis after left ventricular assist device (LVAD) implantation. We sought to determine the impact of change in body mass index (BMI) on outcomes in obese patients supported by LVAD. Fifty-nine patients, who received LVAD between January 2010 and June 2015, with BMI ≥30 kg/m at the time of LVAD implantation, were retrospectively analyzed. Patients were divided into two groups based upon whether BMI after 6 months of device support decreased when compared with before...
September 5, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30161035/improved-6-minute-walk-distance-and-brain-type-natriuretic-peptide-after-continuous-flow-ventricular-assist-device-placement-in-children
#6
Jason F Goldberg, Robin S Schlosser, James G Walrath, Shaine A Morris, Barbara A Elias, Jack F Price, Antonio G Cabrera, Susan W Denfield, Wiliam J Dreyer, Yunfei Wang, Iki Adachi, Aamir Jeewa
Despite increasing continuous-flow ventricular assist device (CF-VAD) use in children, minimal data exist regarding the functional recovery and rehabilitation potential after device placement. We hypothesized that after CF-VAD implantation, children would demonstrate a time-limited improvement in 6 minute walk distance (6MWD) and brain-type natriuretic peptide (BNP). A retrospective cohort study of 27 patients was conducted, those <18 years of age at a tertiary-care center during the study period. Seventy-four percent were male; median age was 12...
August 29, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30153198/anticoagulation-reversal-and-risk-of-thromboembolic-events-among-heart-transplant-recipients-bridged-with-durable-mechanical-circulatory-support-devices
#7
Jeremy Moretz, Joann Lindenfeld, Ashish Shah, Mark Wigger, Kelly Schlendorf, Mary Keebler, Matthew Danter, Suzanne Brown-Sacks, Henry Ooi, Marshall Brinkley, Peter Hanna, Sandip Zalawadiya
Anticoagulation reversal agents (ARAs) can minimize bleeding complications associated with mechanical circulatory support devices (MCSDs) explantation at the time of heart transplantation (HT); data on thromboembolic (TE) risk associated with ARAs are limited in this patient population. In this single-center study, we retrospectively analyzed 118 consecutive adults who were supported with durable MCSDs and underwent HT between May 2013 and October 2016. Patients were categorized based on intraoperative use of ARAs (recombinant factor VIIa [n=23], 4-factor prothrombin complex concentrate [n=48], or factor IX complex [n=2]) at the time of HT; these agents were used at discretion of implanting surgeons for bleeding control...
August 25, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30153197/confirming-distal-perfusion-catheter-position-by-micro-bubbles-in-patients-on-peripheral-venoarterial-extracorporeal-membrane-oxygenation
#8
Shek-Yin Au, Ka-Man Fong, Wing-Yiu George Ng, Kit-Hung Anne Leung
Distal perfusion catheter (DPC) is commonly employed to prevent lower limb ischemia in patient put on peripheral venoarterial extracorporeal membrane oxygenation. Confirming its proper position is important but technically difficult by bedside ultrasound. We describe in this article a novel method to use micro-bubble ultrasound enhancing agents, which are commonly used for contrast echocardiography studies, to confirm DPC position at the bedside. The sequential appearance of the micro-bubbles in the popliteal artery and then popliteal vein by ultrasound after injection through the side port of the DPC confirms the proper DPC position...
August 25, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30153196/in-vivo-remodeling-of-an-extracellular-matrix-cardiac-patch-in-an-ovine-model
#9
R Scott Baker, Farhan Zafar, Naritaka Kimura, Timothy Knilans, Hanna Osinska, Jeffrey Robbins, Michael Taylor, David L S Morales
Lack of an ideal patch material for cardiac repairs continues to challenge congenital heart surgeons. The current materials are unable to grow and result in scarring, contraction, and arrhythmias. An acellular extracellular matrix (ECM) patch derived from porcine small intestinal submucosa has demonstrated remodeling potential when used to repair various tissues. This study investigated the in vivo electrophysiologic, mechanical, and histological properties of an ECM patch used to repair a right-ventricular (RV) wall defect in a growing ovine model...
August 25, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30153195/hemostasis-and-bone-regeneration-using-chitosan-gelatin-bcp-bi-layer-composite-material
#10
Andrew R Padalhin, Byong-Taek Lee
The aim of the study was to determine the hemostatic activity of a composite bi-layered topical hemostat composed of electrospun gelatin loaded with bi-phasic calcium phosphate and chitosan layer and its effect on bone formation. Morphology of the composite hemostat and its individual components were observed using scanning electron microscopy. In vitro biocompatibility of the topical hemostat tested using preosteoblasts cells (MC3t3-E1) showed no adverse toxicity. Confocal microscopy of seeded cells showed good cell adhesion while MTT assay indicated 15% increased cell proliferation at the end of 1 week culture period...
August 25, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30134259/virtual-fitting-and-hemodynamic-simulation-of-the-evaheart-2-left-ventricular-assist-device-and-double-cuff-tipless-inflow-cannula
#11
Simon Johannes Sonntag, Erin Zebrowski, Michael Neidlin, Kristin Hugenroth, Robert Benkowski, Tadashi Motomura, Tim Arne Simon Kaufmann
Inflow malposition during surgery, postoperative pump migration, inflow obstruction, and right ventricular compression are major contributors to low flow and adverse events in patients with ventricular assist devices (VADs). These position abnormalities can lead to adverse events including ischemic stroke. To address these problems, we conducted a virtual anatomical fitting study and hemodynamic simulation on iterative cannula designs, resulting in the EVAHEART 2 with the novel double-cuff tipless (DCT) inflow cannula and smaller pump design...
August 21, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30134258/preclinical-evaluation-of-the-evaheart-2-centrifugal-left-ventricular-assist-device-in-bovines
#12
Tadashi Motomura, Egemen Tuzun, Kenji Yamazaki, Eisuke Tatsumi, Robert Benkowski, Shunichi Yamazaki
The EVAHEART 1 left ventricular assist device was miniaturized to the EVAHEART 2, with a new inflow cannula designed to mitigate the risks of malposition. To evaluate the safety of the new double-cuff tipless inflow cannula, in vivo studies were performed in healthy bovines. Eight consecutive studies were done: five short-term studies of hematological adaptation and three long-term studies of tissue adaptation. Each inflow cannula was purposefully implanted in the worst-case setting with marked malposition...
August 16, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30074966/discontinuation-of-aspirin-in-heartmate-3-left-ventricular-assist-device
#13
Hoong Sern Lim, Aaron Ranasinghe, Jorge Mascaro, Neil Howell
No abstract text is available yet for this article.
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30074965/simulated-performance-of-the-cleveland-clinic-continuous-flow-total-artificial-heart-using-the-virtual-mock-loop
#14
Takuma Miyamoto, David J Horvath, Dennis W Horvath, Jamshid H Karimov, Nicole Byram, Barry D Kuban, Kiyotaka Fukamachi
Our new Virtual Mock Loop (VML) is a mathematical model designed to simulate the human cardiovascular system and gauge performance of mechanical circulatory support devices. We aimed to mimic the hemodynamic performance of Cleveland Clinic's self-regulating continuous-flow total artificial heart (CFTAH) via VML and evaluate VML's accuracy versus bench data from our standard mock circulatory loop. The VML reproduced 23 hemodynamic conditions. Systemic/pulmonary vascular resistances and pump rotational speed were set for VML from bench test data...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30074964/valvular-regurgitation-in-a-biventricular-mock-circulatory-loop
#15
Sajad Shehab, Sabine M Allida, Phillip J Newton, Desiree Robson, Peter S Macdonald, Patricia M Davidson, Paul C Jansz, Christopher S Hayward
Aortic regurgitation (AR), mitral regurgitation (MR), and tricuspid regurgitation (TR) after continuous-flow left ventricular assist device (LVAD) are common and may increase with prolonged LVAD support. The aim of this study was to simulate severe valvular regurgitation (AR, MR, and TR) within a 4-elemental pulsatile mock circulatory loop (MCL) and observe their impact on isolated LVAD and biventricular assist device (BiVAD) with HeartWare HVAD. Aortic regurgitation, MR, and TR were achieved via the removal of one leaflet from bileaflet mechanical valve from the appropriate valves of the left or right ventricles...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30074963/lvad-pulsatility-assesses-cardiac-contractility-in-vitro-model-utilizing-the-total-artificial-heart-and-mock-circulation
#16
Philemon Mikail, Jessica R Crosby, Marvin J Slepian, Richard Smith, Zain Khalpey
There is a need for a consistent, reproducible, and cost-effective method of determining cardiac recovery in patients who receive emerging novel therapeutics for advanced and end-stage heart failure (HF). With the increasing use of ventricular assist devices (VADs) in end-stage HF, objective device diagnostics are available for analysis. Pulsatility, one of the accessible diagnostic measures, is a variable gage of the differential between peak systolic and minimum diastolic flow during a single cardiac cycle...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30074962/long-term-continuous-flow-left-ventricular-assist-device-support-after-left-ventricular-outflow-tract-closure
#17
Chitaru Kurihara, William E Cohn, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Aortic valve insufficiency can be addressed during continuous-flow left ventricular assist device (CF-LVAD) implantation by performing aortic valve repair or replacement, or patch closure of the left ventricular outflow tract (LVOT). However, few studies have examined the safety of long-term CF-LVAD support after LVOT closure. From November 2003 through March 2016, 16 patients with advanced chronic heart failure underwent CF-LVAD implantation and concomitant LVOT closure for severe aortic insufficiency. We compared their long-term outcomes with those of 510 CF-LVAD recipients without concomitant LVOT closure...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30074498/impact-of-cannula-size-on-clinical-outcomes-in-peripheral-venoarterial-extracorporeal-membrane-oxygenation
#18
Juwon Kim, Yang Hyun Cho, Kiick Sung, Taek Kyu Park, Ga Yeon Lee, Joo Myung Lee, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Jeong Hoon Yang
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is an effective mechanical circulatory support for cardiopulmonary failure. Conventionally, an arterial cannula over 15 Fr is inserted for full circulatory support in peripheral VA ECMO. However, limited data are available regarding the impact of cannula size on clinical and procedural outcomes. Between January 2014 and April 2016, 165 patients underwent peripheral VA ECMO with femoral artery cannulation were enrolled in a single-center registry. We classified patients into two groups according to the arterial cannula's size: "small cannula group" (14-15 Fr, n = 87) and "large cannula group" (16-21 Fr, n = 78)...
July 25, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30074497/highlights-from-the-extracorporeal-life-support-organization-registry-2006-2017
#19
Viviane G Nasr, Lakshmi Raman, Ryan P Barbaro, Yigit Guner, Joseph Tonna, Kollengode Ramanathan, Pappalardo Federico, Ravi R Thiagarajan, Peta M A Alexander
Extracorporeal membrane oxygenation (ECMO) is a supportive therapy for patients with severe cardiovascular or respiratory failure refractory to conventional medical therapy. Improvements in ECMO technology, easy access to ECMO devices, and a greater understanding of care of ECMO patients have led to increased utilization of ECMO. The Extracorporeal Life Support Organization (ELSO) registry was established in 1984, to collect data on patients receiving ECMO support to help improve outcomes of these patients, and has grown to include over 400 contributing centers from 60 countries and contains data for more than 80,000 patients...
July 25, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30045051/a-versatile-hybrid-mock-circulation-for-hydraulic-investigations-of-active-and-passive-cardiovascular-implants
#20
Anastasios Petrou, Marcus Granegger, Mirko Meboldt, Marianne Schmid Daners
During the development process of active or passive cardiovascular implants, such as ventricular assist devices or vascular grafts, extensive in vitro testing is required. The aim of the study was to develop a versatile hybrid mock circulation (HMC) that can support the development of such implants that have a complex interaction with the circulation. The HMC operates based on the hardware-in-the-loop concept with a hydraulic interface of four pressure-controlled reservoirs allowing the interaction of the implant with a numerical model of the cardiovascular system...
July 23, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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