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Mechanical circulatory support device

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https://www.readbyqxmd.com/read/28448170/mechanical-circulatory-support-devices-methods-to-optimize-hemodynamics-during-use
#1
Ben Bow Chung, Gabriel Sayer, Nir Uriel
Introduction Mechanical circulatory support (MCS) is an increasingly utilized mode of therapy in the management of advanced heart failure, both as bridge to heart transplantation and destination therapy. As MCS becomes more prevalent, it is ever more important to understand the complex hemodynamics of these devices, as well as the strategies for hemodynamic optimization. Areas Covered This review provides an overview of hemodynamics in the normal human heart and the failing heart. We discuss the various short-term mechanical circulatory support devices and their hemodynamic consequences...
April 27, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28441642/first-in-man-percutaneous-transaxillary-artery-placement-and-removal-of-the-impella-5-0-mechanical-circulatory-support-device
#2
Kenta Nakamura, Sandeep Krishnan, Claudius Mahr, James M McCabe
We report on the fully percutaneous insertion and removal of the Impella 5.0 microaxial flow device via the axillary artery in a patient with cardiogenic shock and peripheral artery disease. Due to inadequate iliofemoral vasculature and desire for mobility, the axillary artery was felt to be the most appropriate access approach for temporary mechanical circulatory support. The procedure was well tolerated and the patient was supported for 17 days, at which time the device was safely removed in a fully percutaneous manner at the time of permanent left ventricular assist device placement...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28433665/advancing-the-science-of-myocardial-recovery-with-mechanical-circulatory-support-a-working-group-of-the-national-heart-lung-and-blood-institute
#3
Stavros G Drakos, Francis D Pagani, Martha S Lundberg, J Timothy Baldwin
The medical burden of heart failure (HF) has spurred interest in clinicians and scientists to develop therapies to restore the function of a failing heart. To advance this agenda, the National Heart Lung Blood Institute (NHLBI) convened a Working Group of experts on June 2-3, 2016 in Bethesda Maryland to develop recommendations for the NHLBI aimed at advancing the science of cardiac recovery in the setting of mechanical circulatory support (MCS). MSC devices effectively reduce volume and pressure overload that drives the cycle of progressive myocardial dysfunction, thereby triggering structural and functional reverse remodeling...
April 19, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#4
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28396040/risk-assessment-and-comparative-effectiveness-of-left-ventricular-assist-device-and-medical-management-in-ambulatory-heart-failure-patients-the-roadmap-study-2-year-results
#5
Randall C Starling, Jerry D Estep, Douglas A Horstmanshof, Carmelo A Milano, Josef Stehlik, Keyur B Shah, Brian A Bruckner, Sangjin Lee, James W Long, Craig H Selzman, Vigneshwar Kasirajan, Donald C Haas, Andrew J Boyle, Joyce Chuang, David J Farrar, Joseph G Rogers
OBJECTIVES: The authors sought to provide the pre-specified primary endpoint of the ROADMAP (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients) trial at 2 years. BACKGROUND: The ROADMAP trial was a prospective nonrandomized observational study of 200 patients (97 with a left ventricular assist device [LVAD], 103 on optimal medical management [OMM]) that showed that survival with improved functional status at 1 year was better with LVADs compared with OMM in a patient population of ambulatory New York Heart Association functional class IIIb/IV patients...
March 30, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#6
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28387838/temporary-mechanical-circulatory-support-after-orthotopic-heart-transplantation-a-single-centre-experience
#7
Vakhtang Tchantchaleishvili, Katherine L Wood, Laura A Carlson, Bryan Barrus, Michael F Swartz, Himabindu Vidula, Juan M Lehoux, H Todd Massey, Leway Chen
OBJECTIVES: There are various strategies in the use of temporary mechanical circulatory support following orthotopic heart transplant (OHT). We sought to examine the outcomes following different temporary mechanical circulatory support strategies for acute graft failure. METHODS: Patients who received an OHT between 2001 and 2015 at a single institution were retrospectively reviewed. Patients were divided into 2 groups based on the need for temporary mechanical circulatory support (TMCS)...
April 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28385314/management-of-ventricular-arrhythmias-in%C3%A2-patients-with-advanced-heart-failure
#8
REVIEW
Pasquale Santangeli, J Eduardo Rame, Edo Y Birati, Francis E Marchlinski
Advanced heart failure (A-HF) is characterized by progressive symptoms of heart failure despite optimal therapy. In patients with A-HF, ventricular arrhythmias (VAs) are common. Clinical studies evaluating different therapies to prevent VAs had very limited representation of patients with A-HF. Among antiarrhythmic drugs, only amiodarone reduces VAs, although its use may be associated with increased mortality. Catheter ablation with substrate modification is effective to achieve VA suppression in patients with A-HF, including those with left ventricular assist devices...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28377296/mechanical-chest-compressions-improve-rate-of-return-of-spontaneous-circulation-and-allow-for-initiation-of-percutaneous-circulatory-support-during-cardiac-arrest-in-the-cardiac-catheterization-laboratory
#9
Joseph M Venturini, Elizabeth Retzer, J Raider Estrada, Janet Friant, David Beiser, Dana Edelson, Jonathan Paul, John Blair, Sandeep Nathan, Atman P Shah
BACKGROUND: Performing advanced cardiac life support (ACLS) in the cardiac catheterization laboratory (CCL) is challenging. Mechanical chest compression (MCC) devices deliver compressions in a small space, allowing for simultaneous percutaneous coronary intervention and reduced radiation exposure to rescuers. In refractory cases, MCC devices allow rescuers to initiate percutaneous mechanical circulatory support (MCS) and extracorporeal life support (ECLS) during resuscitation. This study sought to assess the efficacy and safety of MCC when compared to manual compressions in the CCL...
April 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28365175/outcomes-following-implantation-of-mechanical-circulatory-support-in-adults-with-congenital-heart-disease-an-analysis-of-the-interagency-registry-for-mechanically-assisted-circulatory-support-intermacs
#10
Christina J VanderPluym, Ari Cedars, Pirooz Eghtesady, Bryan G Maxwell, Jill M Gelow, Luke J Burchill, Simon Maltais, Devin A Koehl, Ryan S Cantor, Elizabeth D Blume
BACKGROUND: Adults with congenital heart disease represent an expanding and unique population of patients with heart failure (HF) in whom the use of mechanical circulatory support (MCS) has not been characterized. We sought to describe overall use, patient characteristics, and outcomes of MCS in adult congenital heart disease (ACHD). METHODS: All patients entered into the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) between June 23, 2006, and December 31, 2015, were included...
March 7, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28357450/an-alternative-strategy-for-bridge-to-transplant-recovery-in-small-children-with-dilated-cardiomyopathy
#11
REVIEW
Gilles Mets, Joseph Panzer, Daniël De Wolf, Thierry Bové
Dilated cardiomyopathy in children still has a poor prognosis with high rates of mortality and cardiac transplantation (resp. around 20 and 25%). Awaiting transplantation or possible recovery, these pediatric patients are mechanically supported with extracorporeal membrane oxygenation or a paracorporeal ventricular assist device, both resulting in higher survival rates but also entailing considerable risks of infection, thrombosis, or bleeding. A new indication for an old technique, i.e., pulmonary artery banding, presents itself as an interesting alternative to mechanical circulatory support in selected infants and small children with dilated LV cardiomyopathy and preserved RV function...
March 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28351172/current-status-of-mechanical-circulatory-support-for-treatment-of-advanced-end-stage-heart-failure-successes-shortcomings-and-needs
#12
Gengo Sunagawa, Marijan Koprivanac, Jamshid H Karimov, Nader Moazami, Kiyotaka Fukamachi
Heart failure (HF) remains a major global burden in terms of morbidity and mortality. Despite advances in pharmacological and resynchronization device therapy, many patients worsen to end-stage HF. Although the gold-standard treatment for such patients is heart transplantation, there will always be a shortage of donor hearts. Areas covered: A left ventricular assist device (LVAD) is a valuable option for these patients as a bridge measure (to recovery, to candidacy for transplant, or to transplant itself) or as destination therapy...
May 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28343276/an-updated-review-of-cardiac-devices-in-heart-failure
#13
REVIEW
C Murphy, H Zafar, F Sharif
BACKGROUND: Heart failure has the highest rates of adult hospitalisations, the highest mortality rates and significant costs associated with its care. The cost of heart failure is expected continue to grow on a global scale, with $108 billion spent on heart failure in 2012. Mortality rates are high, with incident cases of heart failure resulting in 30% 1-year mortality, and in hospital mortality of acute heart failure, 28%. METHODS AND RESULTS: This article reviews the devices currently in use for the treatment of heart failure, as well as those that are under investigation...
March 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28340840/short-term-results-of-heartmate-3-ventricular-assist-device-implantation-for-end-stage-heart-failure
#14
P Ozturk, S Ertugay, C Sahutoglu, C Engin, S Nalbantgil, T Yagdi, M Ozbaran
OBJECTIVE: To report our initial experience with Heartmate 3 ventricular assist device (HM3) in cases with end-stage heart failure (ESHF). METHODS: Charts of 8 ESHF patients who underwent HM3 implantation in our clinic from January to June 2016 (group 1) and 16 patients who underwent HM2 implantation during 2015 (group 2) were reviewed retrospectively. Demographics as well as pre- and early postoperative medical data were noted and statistically analyzed between the 2 groups...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28329060/first-series-of-left-ventricular-assist-device-exchanges-to-heartmate-3
#15
Jasmin S Hanke, Sebastian V Rojas, Günes Dogan, Christina Feldmann, Erik Beckmann, Ezin Deniz, Bettina Wiegmann, Jana-Elena Michaelis, L Christian Napp, Dominik Berliner, Malakh Shrestha, Johann Bauersachs, Axel Haverich, Jan D Schmitto
OBJECTIVES: Left ventricular assist device (LVAD) exchange is becoming a standard surgical procedure. The exchange procedure is an opportunity to upgrade patients to a new generation pump that offers advanced reduction of adverse events or longer battery hours. METHODS: We performed an analysis of 6 consecutive patients who underwent LVAD exchange to HeartMate 3 either from a HeartWare or HeartMate (HM) II device. Minimally invasive operations were performed through a lateral thoracotomy...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28321882/optical-dynamic-analysis-of-thrombus-inside-a-centrifugal-blood-pump-during-extracorporeal-mechanical-circulatory-support-in-a-porcine-model
#16
Tatsuki Fujiwara, Daisuke Sakota, Katsuhiro Ohuchi, Shu Endo, Tomoki Tahara, Tomotaka Murashige, Ryo Kosaka, Keiji Oi, Tomohiro Mizuno, Osamu Maruyama, Hirokuni Arai
Complications due to pump thrombus remain the weak point of mechanical circulatory support (MCS), such as the use of a left ventricular assist device (LVAD) or extracorporeal membrane oxygenation, leading to poor outcomes. Hyperspectral imaging (HSI) is an effective imaging method using a hyperspectral (HS) camera, which comprises a spectrophotometer and a charge-coupled device camera to discriminate thrombus from whole blood. Animal experiments were conducted to analyze dynamic imaging of thrombus inside a prototype of a hydrodynamically levitated centrifugal blood pump using an HSI system...
March 20, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28321711/heparin-induced-thrombocytopenia-with-mechanical-circulatory-support-devices-review-of-the-literature-and-management-considerations
#17
REVIEW
Jonathan Bain, Alexander H Flannery, Jeremy Flynn, William Dager
Whether for temporary or long term use, mechanical circulatory support (MCS) has seen increased utilization and interest over the past several years. Even though these devices innately cause thrombocytopenia, co-administration of heparin anticoagulation carries the risk for heparin-induced thrombocytopenia (HIT). This poses challenges for practitioners as very few studies provide guidance for the management of this condition, particularly in this population. This has led to a wide spectrum of treatment protocols within current practice...
March 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28306593/current-concepts-for-sensitized-patients-before-transplantation
#18
Dael Geft, Jon Kobashigawa
PURPOSE OF REVIEW: Antibody allosensitization poses a major immunologic challenge for patients awaiting heart transplantation. It is associated with significant morbidity and mortality for both pretransplant and posttransplant patients by prolonging wait times to transplant and increasing posttransplant rejection and vasculopathy. Many questions remain regarding methods and interpretation of antibody detection, the relevance of sensitization in specific patient populations such as those with mechanical circulatory support and the ideal strategies for desensitization...
March 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28295963/a-multicenter-study-of-the-impella-device-for-mechanical-support-of-the-systemic-circulation-in-pediatric-and-adolescent-patients
#19
V Vivian Dimas, Brian H Morray, Dennis W Kim, Christopher Sd Almond, Shabana Shahanavaz, Sebastian C Tume, Lynn F Peng, Doff B McElhinney, Henri Justino
OBJECTIVES: The objective was to review the use of Impella devices (Abiomed Inc, Danvers, MA) for temporary circulatory support in pediatric and adolescent patients (age ≤ 21 yrs). BACKGROUND: Options for minimally invasive circulatory support in children are limited, and published data are confined to case reports and small case series. METHODS: This was a retrospective, multicenter review of Impella implants in pediatric and adolescent patients from 2009-15, using standardized data collection and INTERMACS definitions...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28259596/berlin-heart-excor-use-in-patients-with-congenital-heart-disease
#20
David L S Morales, Farhan Zafar, Christopher S Almond, Charles Canter, Francis Fynn-Thompson, Jennifer Conway, Iki Adachi, Angela Lorts
BACKGROUND: Management of mechanical circulatory support in children with congenital heart disease (CHD) is challenging due to physiologic variations and anatomic limitations to device placement. In this study we examine the use of Berlin Heart EXCOR in CHD patients. METHODS: CHD patients were identified from the EXCOR Pediatric Study data set (2007 to 2010). Mortality and serious adverse events were compared between CHD and non-CHD cohorts, and predictors of poor outcomes in the CHD cohort were identified...
February 8, 2017: Journal of Heart and Lung Transplantation
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