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https://www.readbyqxmd.com/read/29905854/comparison-of-temporary-ventricular-assist-devices-and-extracorporeal-life-support-in-post-cardiotomy-cardiogenic-shock
#1
Prashant N Mohite, Anton Sabashnikov, Achim Koch, Raj Binu, Ashok Padukone, Sundip Kaul, Olaf Maunz, Diana García-Sáez, Bartlomiej Zych, Mubassher Husain, Fabio De Robertis, Aron-Frederik Popov, André R Simon
OBJECTIVES: Post-cardiotomy cardiogenic shock (PCCS) results in substantial morbidity and mortality, whereas refractory cases require mechanical circulatory support (MCS). The aim of the study was to compare extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VADs) utilized in the management of PCCS. METHODS: In total, 56 consecutive patients who developed PCCS from 2005 to 2014 required MCS as a bridge to decision-24 were supported with a VAD and 32 with an ECMO...
June 13, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29847341/nutritional-support-in-patients-with-extracorporeal-life-support-and-ventricular-assist-devices
#2
Christian Stoppe, Ekaterina Nesterova, Gunnar Elke
PURPOSE OF REVIEW: Extracorporeal life support (ECLS) including venovenous and venoarterial extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VAD) provide mechanical pulmonary and circulatory support, respectively, in patients with acute pulmonary or cardiovascular failure. This review discusses recently published data regarding specific topics of nutritional support in patients with ECLS and VAD. RECENT FINDINGS: ECLS may aggravate loss of endogenous and exogenous micronutrients and macronutrients...
May 29, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29780004/mechanical-circulatory-support-costs-in-children-bridged-to-heart-transplantation-analysis-of-a-linked-database
#3
Justin Godown, Andrew H Smith, Cary Thurm, Matt Hall, Debra A Dodd, Jonathan H Soslow, Bret A Mettler, David W Bearl, Brian Feingold
BACKGROUND: Pediatric mechanical circulatory support (MCS) has evolved considerably over the past decade. Though marked improvements in waitlist survival have been realized, costs have not been reassessed. This project aimed to assess contemporary MCS costs in children bridged to heart transplant (HT). METHODS: All pediatric HT recipients (2002-2016) were identified from a unique, linked PHIS/SRTR dataset. Costs were calculated from hospital charges, inflated to 2016 Dollars and adjusted for patient-specific characteristics using generalized linear mixed-effects models...
April 6, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29757910/ishlt-primary-graft-dysfunction-incidence-risk-factors-and-outcome-a-uk-national-study
#4
Sanjeet Singh Avtaar Singh, Nicholas R Banner, Sally Rushton, Andre R Simon, Colin Berry, Nawwar Al-Attar
BACKGROUND: Heart transplantation (HTx) remains the most effective long-term treatment for advanced heart failure. Primary graft dysfunction (PGD) continues to be a potentially life-threatening early complication. In 2014, a consensus statement released by ISHLT established diagnostic criteria for PGD. We studied the incidence of PGD across the UK. METHODS: We analysed the medical records of all adult patients who underwent heart transplantation between October 2012-October 2015 in the 6 UK heart transplant centers Preoperative donor and recipient characteristics, intraoperative details and posttransplant complications were compared between the PGD and non PGD groups using the ISHLT definition...
May 1, 2018: Transplantation
https://www.readbyqxmd.com/read/29757498/clinical-determinants-of-successful-weaning-from-extracorporeal-membrane-oxygenation-in-patients-with-fulminant-myocarditis
#5
Manabu Matsumoto, Yasuhide Asaumi, Yuichi Nakamura, Takeshi Nakatani, Toshiyuki Nagai, Tomoaki Kanaya, Shoji Kawakami, Satoshi Honda, Yu Kataoka, Seiko Nakajima, Osamu Seguchi, Masanobu Yanase, Kunihiro Nishimura, Yoshihiro Miyamoto, Kengo Kusano, Toshihisa Anzai, Teruo Noguchi, Tomoyuki Fujita, Junjiro Kobayashi, Hatsue Ishibashi-Ueda, Hiroaki Shimokawa, Satoshi Yasuda
AIMS: Patients with fulminant myocarditis (FM) often present with cardiogenic shock and require mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO) and ventricular assist device (VAD) implantation. This study sought to clarify the determinants of successful weaning from ECMO in FM patients. METHODS AND RESULTS: We studied 37 consecutive FM patients supported by ECMO as the initial form of mechanical circulatory support between January 1995 and December 2014 in our hospital...
May 14, 2018: ESC Heart Failure
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/29677081/changes-in-pediatric-heart-transplant-hospitalization-costs-over-time
#7
Justin Godown, Cary Thurm, Matt Hall, Jonathan H Soslow, Brian Feingold, Bret A Mettler, Andrew H Smith, David W Bearl, Debra A Dodd
BACKGROUND: Despite significant changes in the past decade for children undergoing heart-transplantation, including the evolution of mechanical circulatory support and increasing patient complexity, costs and resource utilization have not been reassessed. We sought to utilize a novel linkage of clinical-registry and administrative data to examine changes in hospitalization costs over time in this population. METHODS: We identified all pediatric heart transplant recipients in a unique linked PHIS/SRTR dataset (2002-2016)...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29552945/predictors-of-poor-outcomes-in-pediatric-venoarterial-extracorporeal-membrane-oxygenation
#8
Maanasi S Mistry, Sara M Trucco, Timothy Maul, Mahesh S Sharma, Li Wang, Shawn West
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides respiratory and hemodynamic support to pediatric patients in severe cardiac failure. We aim to identify risk factors associated with poorer outcomes in this population. METHODS: A retrospective chart review was conducted of pediatric patients requiring VA-ECMO support for cardiac indications at our institution from 2004 to 2015. Data were collected on demographics, indication, markers of cardiac output, ventricular assist device (VAD) insertion, heart transplantation, or left atrial (LA) decompression...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29492386/role-of-paediatric-assist-device-in-bridge-to-transplant
#9
Roland Hetzer, Mariano Francisco Del Maria Javier, Eva Maria Delmo Walter
Background: While heart transplantation has gained recognition as the gold standard therapy for advanced heart failure, the scarcity of donor organs has become an important concern. The evolution of surgical alternatives such as ventricular assist devices (VADs), allow for recovery of the myocardium and ensure patient survival until heart transplantation becomes possible. This report elaborates the role of VADs as a bridge to heart transplantation in infants and children (≤18 years old) with end-stage heart failure...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29236180/diagnosis-medical-treatment-and-stepwise-mechanical-circulatory-support-for-fulminat-myocarditis
#10
Shunsuke Saito, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Daisuke Yoshioka, Keitaro Domae, Yasumasa Tsukamoto, Yasushi Sakata, Yoshiki Sawa
Fulminant myocarditis is one of the most challenging diseases. We sought to examine the outcomes of our multidisciplinary treatment strategy for fulminant myocarditis. A retrospective review of consecutive 30 patients with fulminant myocarditis was conducted. Of the 30 patients, 25 required mechanical circulatory support (MCS). Percutaneous extracorporeal membrane oxygenation (ECMO) was the first-line therapy to rescue the patients and inserted in 23 of them. The other 2 were implanted with temporary ventricular assist device (t-VAD) with extracorporeal centrifugal pump(s)...
December 13, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29222320/anticoagulation-with-vads-and-ecmo-walking-the-tightrope
#11
REVIEW
Leslie Raffini
The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, resulting in device failure or embolic stroke...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29075482/fluid-resuscitation-practices-in-cardiac-surgery-patients-in-the-usa-a-survey-of-health-care-providers
#12
Solomon Aronson, Paul Nisbet, Martin Bunke
BACKGROUND: Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. METHODS: We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV) fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1) patients undergoing cardiopulmonary bypass (CPB) without bleeding, (2) patients undergoing CPB with bleeding, (3) patients undergoing acute normovolemic hemodilution (ANH), (4) patients requiring extracorporeal membrane oxygenation (ECMO) or use of a ventricular assist device (VAD), and (5) patients undergoing either off-pump coronary artery bypass graft (OPCABG) surgery or transcatheter aortic valve replacement (TAVR)...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29059075/extracorporeal-membrane-oxygenation-berlin-and-ventricular-assist-devices-a-primer-for-the-cardiologist
#13
Charlotte S Van Dorn, Devon O Aganga, Jonathan N Johnson
PURPOSE OF REVIEW: Mechanical circulatory support (MCS) has become an indispensable tool in the management of children with impending respiratory and cardiac failure. Though extracorporeal membrane oxygenation (ECMO) was classically the only form of support available to pediatric patients, considerable advances have allowed ventricular assist devices (VADs) to become increasingly utilized in children. This review provides an update of recent advances in ECMO and VAD management in children...
January 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28979045/left-ventricular-unloading-during-peripheral-extracorporeal-membrane-oxygenator-support-a-bridge-to-life-in-profound-cardiogenic-shock
#14
Paolo Centofanti, Matteo Attisani, Michele La Torre, Davide Ricci, Massimo Boffini, Andrea Baronetto, Erika Simonato, Alberto Clerici, Mauro Rinaldi
A limit of peripheral veno-arterial Extracorporeal Membrane Oxigenator (VA-ECMO) is the inadequate unloading of the left ventricle. The increase of end-diastolic pressure reduces the possibility of a recovery and may cause severe pulmonary edema. In this study, we evaluate our results after implantation of VA-ECMO and Transapical Left Ventricular Vent (TLVV) as a bridge to recovery, heart transplantation or long-term left ventricular assit devices (LVAD). From 2011 to 2014, 24 consecutive patients with profound cardiogenic shock were supported by peripheral VA-ECMO as bridge to decision...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28944511/cost-utility-analysis-of-direct-ventricular-assist-device-vs-double-bridges-to-heart-transplantation-in-patients-with-refractory-heart-failure
#15
Hsiao-Huang Chang, Po-Lin Chen, I-Ming Chen, Tzu-Ting Kuo, Zen-Chung Weng, Pei-Jung Huang, Nai-Yuan Wu, Ching-Li Cheng
OBJECT: This study compared the cost-utility of direct ventricular assist device (VAD) vs double bridges, extracorporeal membrane oxygenation (ECMO) before VAD, to heart transplantation in patients with refractory heart failure. MATERIALS AND METHODS: From a health payer perspective, a Markov model was developed. The cycle length was 1 month, and the time horizon was a lifetime. Probabilities and direct cost data were calculated from a nationwide claim database...
December 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28938306/different-clinical-course-and-complications-in-interagency-registry-for-mechanically-assisted-circulatory-support-1-intermacs-patients-managed-with-or-without-extracorporeal-membrane-oxygenation
#16
Jason J Han, Jennifer Chung, Carol W Chen, Ann C Gaffey, Alex Sotolongo, Christyna Justice, Alyse E Ameer, J Eduardo Rame, Christian Bermudez, Michael A Acker, Pavan Atluri
Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts...
May 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28567581/temporary-biventricular-support-with-extracorporeal-membrane-oxygenation-a-feasible-therapeutic-approach-for-cardiogenic-shock-with-multiple-organ-failure
#17
Osamu Seguchi, Tomoyuki Fujita, Takuya Watanabe, Kensuke Kuroda, Eriko Hisamatsu, Seiko Nakajima, Takuma Sato, Haruki Sunami, Masanobu Yanase, Hiroki Hata, Junjiro Kobayashi, Takeshi Nakatani, Norihide Fukushima
Various strategies using a ventricular assist device (VAD) are applied to rescue Interagency Registry for Mechanically Assisted Circulatory Support profile 1 (Profile-1) patients. However, the optimal use of VAD in Profile-1 patients has not been completely elucidated. We retrospectively reviewed 23 Profile-1 patients [mean age 36.9 ± 16.6 years, 14 males; 11 with non-ischemic cardiomyopathy (NICM), 9 with fulminant myocarditis (FM), 2 with ischemic cardiomyopathy (ICM), and 1 with peripartum cardiomyopathy (PPCM); 18 with pre-operative percutaneous extracorporeal membrane oxygenation (p-ECMO) support] who underwent VAD implantation from 2011 to 2015 at our institution...
September 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28457386/first-world-report-of-internal-power-cable-repair-in-left-ventricular-assist-device-jarvik-2000-case-report
#18
C G Sassi, M Cameli, A Dokollari, F Diciolla, S Scolletta, C Ricci, P Lucatelli, S Mondillo, M Maccherini
BACKGROUND: There are limited clinical reports concerning internal power cable fixing in left ventricular assist device (L-VAD) patients. Actually there are no reports in the literature about Jarvik 2000 internal cable repair. We show the first description of a technique for surgical reparation of such a fatal complication. PATIENT HISTORY: The patient was a 62-year-old woman who had L-VAD implantation (Jarvik 2000) with outflow graft apposition in descending thoracic aorta through left thoracotomy access, in 2009...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28319524/combined-therapy-of-ventricular-assist-device-and-membrane-oxygenator-for-profound-acute-cardiopulmonary-failure
#19
Kevin Fujita, Koji Takeda, Boyangzi Li, Christine Mauro, Paul Kurlansky, Sowmyashree Sreekanth, Jiho Han, Lauren K Truby, A Reshad Garan, Veli Topkara, Melana Yuzefpolskaya, Paolo Colombo, Yoshifumi Naka, Hiroo Takayama
Short-term ventricular assist devices (ST-VADs) have been effective in treating the patients with refractory cardiogenic shock. Membrane oxygenators (MOs) can be added to the circuit for concomitant, profound refractory hypoxia. This study reports the outcomes of combined therapy in this portion of patients. This is a retrospective review of 166 patients who received an ST-biventricular assist device (BiVAD) or right ventricular assist device (RVAD) for cardiogenic shock between November 2007 and November 2014...
November 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#20
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
June 2017: Journal of Heart and Lung Transplantation
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