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https://www.readbyqxmd.com/read/29762934/rescue-tavi-for-aortic-regurgitation-after-left-ventricular-assist-device-implantation-following-preoperative-impella%C3%A2-support
#1
Florian E M Herrmann, Petra Wellmann, Vera von Dossow, Steffen Massberg, Christian Hagl, René Schramm, Maximilian Pichlmaier
A patient presented with a decompensated cardiomyopathy requiring invasive hemodynamic support with an Impella® heart pump. Extracorporeal life support (ECLS) became necessary during the further course and the patient was bridged to left ventricular assist device (LVAD) implantation. Postoperatively, the patient did not improve as expected due to new aortic regurgitation (AR) that was most likely caused by the previously placed Impella. A SAPIEN 3 transcatheter aortic valve was implanted as a bail-out strategy; an additional valve-in-valve rescue was required due to paravalvular regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29754648/the-cvad-registry-for-percutaneous-temporary-hemodynamic-support-a-prospective-registry-of-impella-mechanical-circulatory-support-use-in-high-risk-pci-cardiogenic-shock-and-decompensated-heart-failure
#2
George W Vetrovec, Mark Anderson, Theodore Schreiber, Jeffrey Popma, William Lombardi, Brijeshwar Maini, Jacob Eifer Moller, Andreas Schäfer, Simon R Dixon, Shelley Hall, E Magnus Ohman, Catalin Mindrescu, Jeffrey Moses, William O'Neill
Management of patients requiring temporary, mechanical hemodynamic support during high- risk percutaneous coronary intervention (PCI) or in cardiogenic shock is rapidly evolving. With the availability of the Impella 2.5, CP, 5.0, LD, and RP percutaneous mechanical circulatory support devices, there is a need for continued surveillance of outcomes. Three factors underline the importance of a registry for these populations. First, large randomized trials of hemodynamic support, involving cardiogenic shock, are challenging to conduct...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29745979/trends-etiologies-and-predictors-of-90-day-readmission-after-percutaneous-ventricular-assist-device-implantation-a-national-population-based-cohort-study
#3
Hafeez Ul Hassan Virk, Byomesh Tripathi, Shuchita Gupta, Akanksha Agrawal, Sandeep Dayanand, Faisal Inayat, Chayakrit Krittanawong, Ali Raza Ghani, Mohammad Nour Zabad, Parasuram Melarcode Krishnamoorthy, Aman Amanullah, Gregg Pressman, Christian Witzke, Sean Janzer, Jon George, Sanjog Kalra, Vincent Figueredo
Percutaneous ventricular assist devices (pVADs) are indicated to provide hemodynamic support in high-risk percutaneous interventions and cardiogenic shock. However, there is a paucity of published data regarding the etiologies and predictors of 90-day readmissions following pVAD use. We studied the data from the US Nationwide Readmissions Database (NRD) for the years 2013 and 2014. Patients with a primary discharge diagnosis of pVAD use were collected by searching the database for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural code 37...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29739745/left-ventricular-mechanical-unloading-by-total-support-of-impella-in-myocardial-infarction-reduces-infarct-size-preserves-left-ventricular-function-and-prevents-subsequent-heart-failure-in-dogs
#4
Keita Saku, Takamori Kakino, Takahiro Arimura, Genya Sunagawa, Takuya Nishikawa, Takafumi Sakamoto, Takuya Kishi, Hiroyuki Tsutsui, Kenji Sunagawa
BACKGROUND: Acute myocardial infarction remains a leading cause of chronic heart failure. Excessive myocardial oxygen demand relative to supply is the fundamental mechanism of myocardial infarction. We thus hypothesized that left ventricular (LV) mechanical unloading by the total support of transvascular LV assist device Impella could minimize oxygen demand, thereby reducing infarct size and preventing subsequent heart failure. METHODS AND RESULTS: In 20 dogs, we ligated the left anterior descending coronary artery for 180 minutes and then reperfused...
May 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29736364/the-long-road-to-the-left-main-a-multidisciplinary-approach-to-the-revascularization-of-complex-left-main-coronary-artery-disease
#5
Scott Donald, Hilary Bews, Chantal Asselin, Basem Elbarouni, David Allen, Malek Kass, Siuchan Sookhoo, Davinder S Jassal
Severe aortic stenosis (AS) is considered a contraindication to the use of mechanical circulatory support (MCS) devices, including the Impella heart pump (Abiomed, Aachen, Germany). We describe a case in which a 72-year-old female with severe AS and peripheral vascular disease (PVD) presented with retractable ischemia in the setting of a non-ST elevation myocardial infarction (NSTEMI). Using a coordinated multidisciplinary approach, our case is the first to combine iliac angioplasty, balloon aortic valvuloplasty (BAV), and the insertion of an Impella CP device in the setting of severe AS to facilitate successful coronary artery revascularization in a non-surgical patient...
March 6, 2018: Curēus
https://www.readbyqxmd.com/read/29734259/ec-vad-combined-use-of-extracorporeal-membrane-oxygenation-and-percutaneous-microaxial-pump-left-ventricular-assist-device
#6
Olutosin J Akanni, Koji Takeda, Lauren K Truby, Paul A Kurlansky, Codruta Chiuzan, Jiho Han, Veli K Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Dimitrios Karmpaliotis, Jeffery W Moses, Yoshifumi Naka, A Reshad Garan, Ajay J Kirtane, Hiroo Takayama
Combination of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and a percutaneous microaxial left ventricular assist device (pLVAD), or "EC-VAD," has been reported in cases of left ventricular decompression with mixed results. We conducted a retrospective review of patients who received EC-VAD (n = 29) or isolated VA-ECMO therapy (ECMO-only; n = 196) for refractory cardiogenic shock between February 2011 and October 2014. Fourteen patients received VA-ECMO and then Impella pLVAD (E→EC-VAD), and 15 received the Impella pump then VA-ECMO (I→EC-VAD)...
April 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29713934/effects-of-percutaneous-lvad-support-on-right-ventricular-load-and-adaptation
#7
Jeffrey P Yourshaw, Prabodh Mishra, M Christopher Armstrong, Bhavadharini Ramu, Michael L Craig, Adrian B Van Bakel, Daniel H Steinberg, Thomas G DiSalvo, Ryan J Tedford, Brian A Houston
Both operative and hemodynamic mechanisms have been implicated in right heart failure (RHF) following surgical left ventricular assist device (LVAD) implantation. We investigated the effects of percutaneous LVAD (pLVAD; Impella®, Abiomed) support on right ventricular (RV) load and adaptation. We reviewed all patients receiving a pLVAD for cardiogenic shock at our institution between July 2014 and April 2017, including only those with pre- and post-pLVAD invasive hemodynamic measurements. Hemodynamic data was recorded immediately prior to pLVAD implantation and up to 96 h post-implantation...
April 30, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29703655/techniques-of-impella-removal-while-preserving-arterial-access
#8
REVIEW
Jad Omran, Ryan Reeves
Preservation of the arterial access site after removal of large caliber mechanical circulatory devices (MCD) can be challenging. In this paper, we describe two novel techniques and review the current literature focusing on the maintenance of arterial access after Impella removal.
April 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#9
Jean E Cibula, Daniel S Demos, Brenda G Fahy
BACKGROUND: A challenge in ICU EEG interpretation is identifying subclinical status epilepticus versus patterns on the ictal-interictal continuum versus other repetitive patterns. In the electrically noisy intensive care unit, identifying and eliminating interference and artifact allow accurate diagnoses from the EEG, avoiding unnecessary treatment or sedation. METHODS: We present a case during Impella (Abiomed Inc, Danvers, MA) continuous flow left ventricular assist device use where the EEG artifact was initially misinterpreted as seizure by the resident and treated as status epilepticus because of the "focal" sharply contoured repetitive pattern...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29643128/effects-of-impella-on-coronary-perfusion-in-patients-with-critical-coronary-artery-stenosis
#10
Mohammad Alqarqaz, Mir Basir, Khaldoon Alaswad, William O'Neill
BACKGROUND: Mechanical circulatory support devices are used to maintain hemodynamic stability during high-risk percutaneous coronary interventions. Little is known on the effects of such devices on coronary hemodynamics in patients with significant coronary stenosis. We sought to investigate whether mechanical circulatory support in the form of Impella (Abiomed Inc, Danvers, MA) can improve coronary hemodynamics in the presence of a critical coronary stenosis. METHODS AND RESULTS: We examined coronary perfusion pressures and coronary pressure distal to a critical stenosis using a coronary pressure wire in 11 patients (12 coronary lesions) undergoing high-risk percutaneous coronary interventions with the use of mechanical circulatory support...
April 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29642690/impella-protected-pci-the-clinical-results-achieved-so-far
#11
Gabriele Pesarini, Andrea Gratta, Giulia Dolci, Mattia Lunardi, Flavio L Ribichini
The ability of interventional cardiologists to identify high-risk percutaneous coronary interventions (PCI) patients, requires the integration of different features belonging to medical history, organ damage, coronary anatomy and the nature of the acute event. The selection of a subgroup of patients that could benefit from mechanical support during interventions is a key feature to success. The introduction of the Impella percutaneous axial pump have added an easy to set-up, less-invasive and time consuming active-support device to the interventional toolbox...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29628145/percutaneous-biventricular-impella-support-in-therapy-refractory-cardiogenic-shock
#12
Cheng-Ying Chiu, Robert Hättasch, Damaris Praeger, Fabian Knebel, Karl Stangl, Ivan Diaz Ramirez, Henryk Dreger
INTRODUCTION: Percutaneous mechanical circulatory support systems have increasingly been adopted as a bail out strategy in patients with cardiogenic shock. Since studies showed mostly mixed results, however, the use of support systems remains a case by case decision. CASE: Here, we report on a case of therapy-refractory cardiogenic shock due to acute myocardial infarction treated with percutaneous right and left ventricular assist devices (Impella RP and CP). CONCLUSION: Due to myocardial stunning, even patients with fulminant cardiogenic shock have the potential for full recovery...
April 5, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29600725/overview-of-impella-and-mechanical-devices-in-cardiogenic-shock
#13
Hymie Habib Chera, Menachem Nagar, Nai-Lun Chang, Carlos Morales-Mangual, George Dous, Jonathan D Marmur, Muhammad Ihsan, Paul Madaj, Yitzhak Rosen
Cardiogenic shock (CS) is a life-threatening condition associated with significant morbidity and mortality. The Impella (Abiomed Inc.) is an axial flow pump on a pigtail catheter that is placed across the aortic valve to unload the left ventricle by delivering non-pulsatile blood flow to the ascending aorta. It is used for high-risk percutaneous coronary intervention and CS. Areas covered: Percutaneous mechanical support devices are placed in a minimally invasive manner and provide life-saving assistance. We review Impella and other percutaneous devices such as intra-aortic balloon pump, TandemHeart, and extracorporeal membrane oxygenation (ECMO) and the evidence supporting their use in the setting of CS...
April 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29580794/intra-arterial-fibrinous-sheath-development-as-a-potential-complication-of-the-impella-ventricular-assist-device
#14
Enrique Pantin, Alexander Kahan, Chiricolo Antonio, Levin Danielle, George Batsides, Denes Papp
No abstract text is available yet for this article.
February 26, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29527866/percutaneous-coronary-intervention-in-patients-refused-from-surgery-a-different-entity
#15
Rocco A Montone, Giampaolo Niccoli
Patients with left main or multivessel coronary artery disease (CAD) and depressed left ventricular function undergoing coronary artery by-pass grafting (CABG) have a markedly worse prognosis compared with general population, making surgical treatment of CAD unattractive especially when features such as poor distal targets, severe comorbidities, reoperation, advanced age, or impaired renal function are present. At the same time, evidence for improved clinical outcome in this high-risk subset of patients using mini-invasive surgical techniques (i...
March 8, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29527864/left-ventricular-support-during-complex-transradial-percutaneous-coronary-intervention-for-complete-revascularization
#16
Annamaria Dachille, Amelia Focaccio, Lucio Selvetella, Giovanni Napolitano, Carlo Briguori
Although there is not uniform definition of high-risk percutaneous coronary intervention (PCI), patients with severe three-vessel disease, left main disease, single remaining patent vessel and/or depressed left ventricular ejection fraction are considered a high-risk population. In this setting, periprocedural hemodynamic instability represents a serious issue. Percutaneous mechanical circulatory support (MCS) devices may improve both safety and efficacy of high risk PCI. Indeed, MCS help to maintain coronary perfusion pressure and reduce myocardial workload, providing the operator sufficient time to reach the target of complete revascularization...
March 8, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29520699/indication-and-short-term-clinical-outcomes-of-high-risk-percutaneous-coronary-intervention-with-microaxial-impella%C3%A2-pump-results-from-the-german-impella%C3%A2-registry
#17
Stefan Baumann, Nikos Werner, Karim Ibrahim, Ralf Westenfeld, Fadi Al-Rashid, Jan-Malte Sinning, Dirk Westermann, Andreas Schäfer, Konstantinos Karatolios, Timm Bauer, Tobias Becher, Ibrahim Akin
BACKGROUND: Percutaneous coronary intervention (PCI) is an alternative strategy to coronary artery bypass grafting (CABG) in patients with high perioperative risk. The microaxial Impella® pump (Abiomed, Danvers, MA, USA), used as prophylactic and temporary support, is currently the most common device for "protected high-risk PCI" to ensure hemodynamic stability during complex coronary intervention. METHODS: The study is an observational, retrospective multi-center registry...
March 8, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29514403/mechanical-circulatory-support-for-acute-right-ventricular-failure-in-the-setting-of-pulmonary-embolism
#18
Mahir Elder, Nimrod Blank, Amir Kaki, M Chadi Alraies, Cindy L Grines, Marvin Kajy, Reema Hasan, Tamam Mohamad, Theodore Schreiber
BACKGROUND: Right ventricular (RV) failure due to pulmonary embolism (PE) increases morbidity and mortality and contributes to prolonged hospital length of stay and higher costs of care. RV mechanical circulatory support (MCS) including Impella RP devices have been increasingly used in hemodynamically compromised PE patients who are refractory to intravascular volume expansion and inotropic therapy. However, effectiveness and safety of Impella RP, in hemodynamically unstable PE patients is unknown...
March 7, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29506964/minimizing-the-risk-of-contrast-induced-nephropathy-and-hemodynamic-collapse-during-chronic-total-occlusion-percutaneous-coronary-intervention-with-a-percutaneous-left-ventricular-assist-device
#19
REVIEW
Damiano Regazzoli, Daisuke Hachinohe, Ozan M Demir, Mauro Carlino, Julien Lemoine, Satoru Mitomo, Enrico Poletti, Max Amor, Antonio Colombo, Lorenzo Azzalini
Candidates for percutaneous coronary revascularization are becoming progressively older and more complex. A combination of factors related to the patient, lesion, and/or hemodynamic conditions may increase the risk of adverse events. Therefore, when a high-risk procedure is identified, it is crucial to provide the patient with adequate support in order to safely perform percutaneous coronary intervention (PCI). We report the case of a 77-year-old man with moderate left ventricular dysfunction and stage IV chronic kidney disease who underwent successful recanalization of a chronically occluded left anterior descending artery...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29506838/safety-of-long-distance-transfers-of-patients-on-acute-mechanical-circulatory-support
#20
Tae Soo Kang, Byung Soo Ko, Stavros G Drakos, Josef Stehlik, Steven I Bott, Antigone Koliopoulou, Joseph E Tonna, Megan E Bowen, Kathleen Stoddard, Craig H Selzman, Stephen H McKellar
BACKGROUND: Acute mechanical circulatory support (aMCS) can be a lifesaving therapy for patients with refractory cardiogenic shock. As device safety and technology improve, so will the ability to extend aMCS to patients at remote hospitals. The Intermountain West is unique because of the large geographical area, making transport of critically ill patients a logistical challenge. METHODS: We reviewed our experience of transporting patients in cardiogenic shock over long distances who had already been placed on aMCS: Impella and extracorporeal membrane oxygenator devices...
April 2018: Journal of Surgical Research
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