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ECMO VAD

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https://www.readbyqxmd.com/read/27933693/heart-transplantation-in-children-with-intellectual-disability-an-analysis-of-the-unos-database
#1
Alexander N Goel, Amit Iyengar, Kenneth Schowengerdt, Andrew C Fiore, Charles B Huddleston
Heart transplantation in children with intellectual disability (ID) is an issue of debate due to the shortage of available donor organs. We sought to perform the first large-scale retrospective cohort study describing the prevalence and outcomes of heart transplantation in this population. The United Network of Organ Sharing database was queried from 2008 to 2015 for pediatric patients (age <19 years) receiving first, isolated heart transplant. Recipients were divided into three subgroups: definite ID, probable ID, and no ID...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27861427/quality-of-life-and-mid-term-survival-of-patients-bridged-with-extracorporeal-membrane-oxygenation-to-left-ventricular-assist-device
#2
Shinya Unai, Kentaro Yamane, Daizo Tanaka, Gary Cook, Hitoshi Hirose, Nicholas C Cavarocchi, John W C Entwistle
Insertion of a left ventricular assist device (LVAD) improves survival and quality of life (QOL) in patients with class IV heart failure failing medical management. However, QOL and survival of patients bridged to LVAD with extracorporeal membrane oxygenation (ECMO) is unknown. Between July 2008 and June 2014, 213 patients underwent insertion of HeartMate II LVAD at 2 VAD centers without a bridge with a temporary VAD. ECMO was used as a bridge prior to LVAD insertion in 22 INTERMACS 1 patients (ECMO-VAD group)...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27821152/a-20-year-multicentre-outcome-analysis-of-salvage-mechanical-circulatory-support-for-refractory-cardiogenic-shock-after-cardiac-surgery
#3
Maziar Khorsandi, Scott Dougherty, Andrew Sinclair, Keith Buchan, Fiona MacLennan, Omar Bouamra, Philip Curry, Vipin Zamvar, Geoffrey Berg, Nawwar Al-Attar
BACKGROUND: Refractory post-cardiotomy cardiogenic shock (PCCS) is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS), namely extra-corporeal membrane oxygenation (ECMO) or ventricular assist devices (VAD). In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO) and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period...
November 8, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27818380/novel-minimally-invasive-surgical-approach-using-an-external-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-in-refractory-cardiogenic-shock
#4
Koji Takeda, Arthur R Garan, Veli K Topkara, Ajay J Kirtane, Dimitri Karmpaliotis, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Hiroo Takayama
OBJECTIVES: The use of short-term mechanical circulatory support (MCS) has increased in the treatment of refractory cardiogenic shock (RCS). Percutaneous short-term MCS technology has emerged rapidly; however, limitations in flow and durability remain. We therefore investigated a minimally invasive surgical approach using an external ventricular assist device (VAD) and extracorporeal membrane oxygenation (ECMO) in patients with RCS. METHODS: Twenty-five patients underwent minimally invasive external VAD insertion with a magnetically levitated centrifugal pump for various causes of cardiogenic shock between April 2010 and May 2016...
November 6, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27803956/improved-survival-while-waiting-and-risk-factors-for-death-in-pediatric-patients-listed-for-cardiac-transplantation
#5
Dala Zakaria, Elizabeth Frazier, Michiaki Imamura, Xiomara Garcia, Sherry Pye, Kenneth R Knecht, Parthak Prodhan, Jeffrey R Gossett, Christopher J Swearingen, W Robert Morrow
Our aim is to determine (a) the effect of changes in pre-transplant management and era of listing on survival of children listed for HTx and (b) risk factors for death while waiting. This retrospective study included all children listed between 1/1993 and 12/2009 at our center. Survival was determined using survival analysis and competing outcomes modeling. There were 254 listed patients of whom 144 (57%) had congenital heart disease, 208 (82%) were status 1, 52 used ECMO (20%), and 28 used ventricular assist device support (VAD) (11%) beginning in 2005...
November 1, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27774445/ecls-in-pediatric-cardiac-patients
#6
Matteo Di Nardo, Graeme MacLaren, Marco Marano, Corrado Cecchetti, Paola Bernaschi, Antonio Amodeo
Extracorporeal life support (ECLS) is an important device in the management of children with severe refractory cardiac and or pulmonary failure. Actually, two forms of ECLS are available for neonates and children: extracorporeal membrane oxygenation (ECMO) and use of a ventricular assist device (VAD). Both these techniques have their own advantages and disadvantages. The intra-aortic balloon pump is another ECLS device that has been successfully used in larger children, adolescents, and adults, but has found limited applicability in smaller children...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27601054/mechanical-circulatory-support-is-associated-with-loss-of-platelet-receptors-glycoprotein-ib%C3%AE-and-glycoprotein-vi
#7
P Lukito, A Wong, J Jing, J F Arthur, S F Marasco, D A Murphy, P J Bergin, J A Shaw, M Collecutt, R K Andrews, E E Gardiner, A K Davis
: Essentials Relationship of acquired von Willebrand disease (VWD) and platelet dysfunction is explored. Patients with ventricular assist devices and on extracorporeal membrane oxygenation are investigated. Acquired VWD and platelet receptor shedding is demonstrated in the majority of patients. Loss of platelet adhesion receptors glycoprotein (GP) Ibα and GPVI may increase bleeding risk. SUMMARY: Background Ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO) are associated with bleeding that is not fully explained by anticoagulant or antiplatelet use...
September 7, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27515989/survival-quality-of-life-and-impact-of-right-heart-failure-in-patients-with-acute-cardiogenic-shock-treated-with-ecmo
#8
Felix Schoenrath, Dennis Hoch, Francesco Maisano, Christoph T Starck, Burkhardt Seifert, Urs Wenger, Frank Ruschitzka, Markus J Wilhelm
BACKGROUND: Mechanical circulatory support is increasingly used in acute cardiogenic shock. OBJECTIVE: To assess treatment strategies for cardiogenic shock. METHODS: Data of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed.​ RESULTS: Overall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6...
September 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27497103/biventricular-unloading-in-patients-with-refractory-cardiogenic-shock
#9
Konstantinos Karatolios, Georgios Chatzis, Birgit Markus, Ulrich Luesebrink, Anette Richter, Bernhard Schieffer
BACKGROUND: Cardiogenic shock remains a clinical challenge with high mortality rate. Mechanical circulatory support (MCS) devices have become an integral component of the therapeutic armamentarium expanding the treatment options for refractory cardiogenic shock (RCS). METHODS: We included all consecutive patients with biventricular unloading with Impella-2.5 and VA-ECMO admitted for RCS between October 2013 and March 2015. Outcome data included survival to discharge, bridging to VAD and 28-day mortality...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27450699/novel-percutaneous-mechanical-circulatory-support-devices-and-their-expanding-applications
#10
John R Spratt, Ganesh Raveendran, Kenneth Liao, Ranjit John
Temporary mechanical circulatory support (MCS) is a common supportive therapy in cardiogenic shock and high-risk coronary intervention. The proliferation of new percutaneous MCS devices allows support to be instituted rapidly without surgical cutdown. The recent literature exploring the indications, benefits, and risks of each is reviewed. Areas discussed: Current applications of percutaneous MCS devices, including intra-aortic balloon pumps (IAPB), Impella, TandemHeart, and VA ECMO are discussed. Studies investigating each were identified through a combination of online database queries and direct extraction of single studies cited in previously-identified papers...
October 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27240450/novel-modifications-of-a-ventricular-assist-device-for-infants-and-children
#11
Michael C Mongé, Bradley T Kulat, Osama Eltayeb, Shyamasundar Balasubramanya, Anne E Sarwark, Neale R Zingle, Steven T Moss, Michael Alice Moga, Jeffrey G Gossett, Elfriede Pahl, John M Costello, Carl L Backer
BACKGROUND: A continuous-flow "adult" ventricular assist device (VAD) was modified to support infants and children waiting for heart transplantation. METHODS: A centrifugal VAD, designed to flow at 1.5 to 8 L/min, was used as a bridge to transplantation in pediatric patients. In smaller children and infants, a modified recirculation shunt permitted lower flow ranges. In hypoxic patients, an oxygenator was spliced into the circuit. RESULTS: From 2010 to 2015, the VAD was placed in 13 consecutive patients...
July 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27234777/heart-transplantation-under-mechanical-circulatory-support-for-acute-fulminant-myocarditis-with-cardiogenic-shock-10%C3%A2-years-experience-of-a-single-center
#12
M Ting, C-H Wang, C-I Tsao, S-C Huang, N-H Chi, N-K Chou, Y-S Chen, S-S Wang
BACKGROUND: Acute fulminant myocarditis with intractable cardiogenic shock is a fatal condition; its only therapeutic option is mechanical circulatory support. The use of mechanical circulatory support, either extracorporeal membrane oxygenation (ECMO) or a ventricular assist device (VAD), serves as a bridge to recovery or as a bridge to transplantation. OBJECTIVES: The aim of this research was to advance our understanding of the outcome of heart transplantation under mechanical support for acute myocarditis...
April 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27125829/decreased-maximum-clot-firmness-in-rotational-thromboelastometry-rotem%C3%A2-is-associated-with-bleeding-during-extracorporeal-mechanical-circulatory-support
#13
Antti Laine, Tomi Niemi, Raili Suojaranta-Ylinen, Peter Raivio, Leena Soininen, Karl Lemström, Pekka Hämmäinen, Alexey Schramko
BACKGROUND: We aimed to characterize the coagulation disturbances which may increase the risk of bleeding, thrombosis or death shortly after implantation of an extracorporeal membrane oxygenation (ECMO) or ventricular assist (VAD) device. METHODS: Antithrombotic treatment was started in 23 VAD and 24 ECMO patients according to the hospital protocol. Additionally, conventional laboratory testing, rotational thromboelastometry (ROTEM®) and platelet function analysis (Multiplate®) were performed at predetermined intervals...
April 28, 2016: Perfusion
https://www.readbyqxmd.com/read/27009673/outcomes-of-children-implanted-with-ventricular-assist-devices-in-the-united-states-first-analysis-of-the-pediatric-interagency-registry-for-mechanical-circulatory-support-pedimacs
#14
Elizabeth D Blume, David N Rosenthal, Joseph W Rossano, J Timothy Baldwin, Pirooz Eghtesady, David L S Morales, Ryan S Cantor, Jennifer Conway, Angela Lorts, Christopher S Almond, David C Naftel, James K Kirklin
BACKGROUND: Use of mechanical circulatory support in children has increased as more options have become available. A national account of the use of mechanical support in children and adolescents is essential to understanding outcomes, refining patient selection and improving quality of care. METHODS: The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a National Heart, Lung, and Blood Institute-supported nationwide registry for temporary and durable ventricular assist device (VAD) use in patients <19 years of age...
May 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27009672/supporting-pediatric-patients-with-short-term-continuous-flow-devices
#15
Jennifer Conway, Mohammed Al-Aklabi, Don Granoski, Sunjidatul Islam, Lyndsey Ryerson, Vijay Anand, Gonzalo Guerra, Andrew S Mackie, Ivan Rebeyka, Holger Buchholz
BACKGROUND: Short-term continuous-flow ventricular assist devices (STCF-VADs) are increasingly being used in the pediatric population. However, little is known about the outcomes in patients supported with these devices. METHODS: All pediatric patients supported with a STCF-VAD, including the Thoratec PediMag or CentriMag, or the Maquet RotaFlow, between January 2005 and May 2014, were included in this retrospective single-center study. RESULTS: Twenty-seven patients (15 girls [56%]) underwent 33 STCF-VAD runs in 28 separate hospital admissions...
May 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27005981/implanting-permanent-left-ventricular-assist-devices-in-patients-on-veno-arterial-extracorporeal-membrane-oxygenation-support-do-we-really-need-a-cardiopulmonary-bypass-machine
#16
Muhammad S K M Abdeen, Alexander Albert, Bujar Maxhera, Till Hoffmann, Georgi Petrov, Stephan Sixt, Elisabeth Roussel, Ralf Westenfeld, Artur Lichtenberg, Diyar Saeed
OBJECTIVES: Selected patients who failed to be weaned off temporary veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support may be considered for long-term left ventricular assist devices (LVADs). Activation of the systemic inflammatory response due to the cardiopulmonary bypass (CPB) machine and its associated deleterious effects on the coagulation system have been well documented. The aim of the study was to compare the outcome of patients receiving VAD on VA-ECMO with patients who were converted to CPB at the time of VAD implantation...
September 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27000519/proceedings-of-the-ast-heart-allocation-meeting-at-the-american-transplant-congress-philadelphia-pennsylvania-may-4-2015
#17
Jon Kobashigawa, Jeffrey Teuteberg, Monica Colvin, Leah Edwards, Tiffany Daun, Minh Luu, Jignesh Patel, John David Vega, Dan Meyer
Ensuring fair and equitable allocation of donor hearts in the US is the charge of the Organ Procurement and Transplantation Network (OPTN). However, the recent increase of candidates waiting without a corresponding increase in available donors, higher waitlist mortality rates in higher status patients, the presence of disadvantaged subgroups, and the changing management of heart failure patients with increased VAD usage, has necessitated review of allocation policy. Therefore, the Heart Subcommittee of the OPTN/UNOS Thoracic Committee is exploring a further-tiered allocation system, devising a "straw man" model as a starting point for modeling analyses and public discussion...
May 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/26912304/modern-outcomes-of-mechanical-circulatory-support-as-a-bridge-to-pediatric-heart-transplantation
#18
Brody Wehman, Kristen A Stafford, Gregory J Bittle, Zachary N Kon, Charles F Evans, Keshava Rajagopal, Nicholas Pietris, Sunjay Kaushal, Bartley P Griffith
BACKGROUND: Pediatric patients awaiting orthotopic heart transplantation frequently require bridge to transplantation (BTT) with mechanical circulatory support. Posttransplant survival outcomes and predictors of mortality have not been thoroughly described in the modern era using a large-scale analysis. METHODS: The United Network for Organ Sharing database was reviewed to identify pediatric heart transplant recipients from 2005 through 2012. Patients were stratified into three groups: extracorporeal membrane oxygenation (ECMO), ventricular assist device (VAD), and direct transplantation (DTXP)...
June 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26892226/advanced-mechanical-circulatory-support-for-post-cardiotomy-cardiogenic-shock-a-20-year-outcome-analysis-in-a-non-transplant-unit
#19
Maziar Khorsandi, Kasra Shaikhrezai, Sai Prasad, Renzo Pessotto, William Walker, Geoffrey Berg, Vipin Zamvar
BACKGROUND: Post-cardiotomy cardiogenic shock (PCCS) has an incidence of 2-6 % after routine adult cardiac surgery. 0.5-1.5 % are refractory to inotropic and intra-aortic balloon pump (IABP) support. Advanced mechanical circulatory support (AMCS) can be used to salvage carefully selected number of such patients. High costs and major complication rates have lead to centralization and limited funding for such devices in the UK. We have looked the outcomes of such devices in a non-transplant, intermediate-size adult cardiothoracic surgery unit...
2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/26833577/peripheral-veno-arterial-extracorporeal-membrane-oxygenation-as-a-bridge-to-decision-for-pediatric-fulminant-myocarditis
#20
Noritaka Okada, Hiroomi Murayama, Hiroki Hasegawa, Satoru Kawai, Hiromitsu Mori, Kazushi Yasuda
It is essential to establish an appropriate initial treatment strategy for pediatric fulminant myocarditis. We reviewed eight cases of pediatric fulminant myocarditis that required extracorporeal membrane oxygenation (ECMO) from 2012 to 2015. The median age was 8 years (range 3 months-13 years), and the median body surface area was 0.89 m(2) (range 0.35-1.34 m(2) ). Peripheral veno-arterial ECMO was initially applied, and we evaluated whether heart decompression was sufficient. If the pump flow was insufficient, central cannulation was performed via median sternotomy (central ECMO)...
August 2016: Artificial Organs
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