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Mechanical circulatory support device

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https://www.readbyqxmd.com/read/29674141/trends-in-utilization-of-mechanical-circulatory-support-in-patients-hospitalized-after-out-of-hospital-cardiac-arrest
#1
Nileshkumar J Patel, Nish Patel, Bhaskar Bhardwaj, Harsh Golwala, Varun Kumar, Varunsiri Atti, Shilpkumar Arora, Smit Patel, Nilay Patel, Gabriel A Hernandez, Apurva Badheka, Carlos E Alfonso, Mauricio G Cohen, Deepak L Bhatt, Navin K Kapur
OBJECTIVE: This study sought to examine the trends and predictors of mechanical circulatory support (MCS) use in patients hospitalized after out-of-hospital cardiac arrest (OHCA). BACKGROUND: There is a paucity of data regarding MCS use in patients hospitalized after OHCA. METHODS: We conducted an observational analysis of MCS use in 960,428 patients hospitalized after OHCA between January 2008 and December 2014 in the Nationwide Inpatient Sample database...
April 16, 2018: Resuscitation
https://www.readbyqxmd.com/read/29673634/the-right-tool-for-the-right-job-bridging-a-failing-fontan-to-transplant
#2
Kyle W Riggs, Angela Lorts, Chet R Villa, James Tweddell, Roosevelt Bryant, David Ls Morales
Mechanical circulatory support and heart transplantation are both becoming increasingly common in Fontan patients as this growing cohort of patients is reaching young adulthood. Though device placement may present challenges, the new focus is on selecting the correct cannulation sites and devices at the correct time in order to successfully bridge these challenging patients to heart transplant. Herein, we report the use of multiple mechanical circulatory support strategies tailored to the clinical setting which culminated in 130 days of support prior to cardiac transplantation in a young adult with a failing Fontan circulation...
April 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29664407/mechanical-circulatory-support-device-utilization-and-heart-transplant-waitlist-outcomes-in-patients-with-restrictive-and-hypertrophic-cardiomyopathy
#3
Lakshmi Sridharan, Brian Wayda, Lauren K Truby, Farhana Latif, Susan Restaino, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, Mathew Maurer, Maryjane A Farr, Veli K Topkara
BACKGROUND: Patients with restrictive cardiomyopathy (RCM) and hypertrophic cardiomyopathy (HCM) generally are considered poor candidates for mechanical circulatory support devices (MCSDs) and often not able to be bridged mechanically to heart transplantation. This study characterized MCSD utilization and transplant waitlist outcomes in patients with RCM/HCM under the current allocation system and discusses changes in the era of the new donor allocation system. METHODS AND RESULTS: Patients waitlisted from 2006 to 2016 in the United Network for Organ Sharing registry were stratified by RCM/HCM versus other diagnoses...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29643259/cerebrovascular-accidents-during-mechanical-circulatory-support-new-predictors-of-ischemic-and-hemorrhagic-strokes-and-outcome
#4
Saef Izzy, Daniel B Rubin, Firas S Ahmed, Feras Akbik, Simone Renault, Katelyn W Sylvester, Henrikas Vaitkevicius, Jennifer A Smallwood, Michael M Givertz, Steven K Feske
BACKGROUND AND PURPOSE: Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality...
April 11, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29643128/effects-of-impella-on-coronary-perfusion-in-patients-with-critical-coronary-artery-stenosis
#5
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/29629994/the-achilles-heel-of-left-ventricular-assist-device-therapy-right-ventricle
#6
Neel K Ranganath, Deane E Smith, Nader Moazami
PURPOSE OF REVIEW: Many patients suffer from either persistent right ventricular failure (RVF) at the time of left ventricular assist device (LVAD) or have ongoing symptoms consistent with RVF during chronic mechanical circulatory support. The lack of long-term right ventricular assist devices (RVADs) has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. We aim to review the entire spectrum of RVF in patients receiving LVADs and reflect on why this entity remains the Achilles' heel of LVAD therapy...
April 7, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29628145/percutaneous-biventricular-impella-support-in-therapy-refractory-cardiogenic-shock
#7
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/29623530/novel-insights-and-treatment-strategies-for-right-heart-failure
#8
REVIEW
Weiqin Lin, Ai-Ling Poh, W H Wilson Tang
PURPOSE OF REVIEW: The function of the right ventricle (RV) is intimately linked to its preload (systemic volume status) and afterload (pulmonary vasculature). In this review, we explore current knowledge in RV physiology, RV function assessment, causes of right heart failure (RHF), and specific treatment strategies for RHF. RECENT FINDINGS: We examine the evidence behind new pharmacological therapies available, such as macitentan and riociguat in the treatment of specific etiologies of RHF...
April 6, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29623383/-mechanical-circulatory-support-in-terminal-heart-failure
#9
REVIEW
M Derwall, A Moza, A Brücken
BACKGROUND: After exhaustion of all conservative measures in the treatment of acute and chronic heart insufficiency, there is the possibility to temporarily or permanently support or replace the pump performance of the heart by mechanical circulatory support (MCS) systems. OBJECTIVE: Presentation of the most important cardiac support systems for intensive care medicine, their indications and important risk factors. MATERIAL AND METHODS: Critical review of device manufacturer's specifications, current research and expert opinions...
April 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29623169/mechanical-circulatory-support-in-high-risk-percutaneous-coronary-intervention
#10
REVIEW
Bhuvnesh Aggarwal, Wahaj Aman, Omar Jeroudi, Neal S Kleiman
Due to advancing age and increasing comorbidities, the current population has a higher incidence of complex coronary artery disease, often without surgical options for revascularization. In this setting, hemodynamic support devices are an important adjunct in the interventionist's toolbox as they allow for a safer, more effective procedure. The following paper reviews the indications of various available mechanical support devices, highlights their clinical data and technical parameters, and offers a practical approach towards appropriate patient and device selection...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29608506/the-physiological-rationale-for-incorporating-pulsatility-in-continuous-flow-left-ventricular-assist-devices
#11
Liza Grosman-Rimon, Filio Billia, Jeremy Kobulnik, Stacey Pollock Bar-Ziv, David Z Cherney, Vivek Rao
Over the past few decades, left ventricular assist device (LVAD) support has extended the lives of many patients with end-stage heart failure. The most common devices are continuous-flow (CF) LVADs. The use of the CF-LVADs has required that clinicians learn the physiological and clinical consequences of long-term continuous blood flow. While this alteration in the normal physiology still offers advantages from mechanical circulatory support, the lack of pulsatility may also increase the likelihood of adverse events...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29561310/mechanical-circulatory-support-challenges-in-pediatric-and-adult-congenital-heart-disease
#12
Martin Schweiger, Angela Lorts, Jennifer Conway
PURPOSE OF REVIEW: Increased miniaturization of ventricular assist devices (VADs) and new mechanical support strategies (MCS) has increased the use of MCS in the pediatric and congenital heart disease (CHD) population. This comes with the need for care providers specialized in this field to determine optimal patient and device selection, and to improve outcomes and decrease complication rates for new innovative strategies. A review of the published literature in this field is timely and relevant...
March 20, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29554252/left-ventricular-assist-device-implantation-with-left-lateral-thoracotomy-with-anastomosis-to-the-descending-aorta
#13
Mustafa Ozbaran, Tahir Yagdi, Cagatay Engin, Sanem Nalbantgil, Pelin Ozturk
OBJECTIVES: Standard implantation of the HeartWare left ventricular assist system is performed using the full sternotomy approach. However, successful implantation of left ventricular assist devices in patients with a previous median sternotomy, especially in high-risk patients, remains challenging. Herein, we compared the HeartWare left ventricular assist system implantation by thoracotomy with anastomosis of the outflow graft to the descending aorta with the standard sternotomy approach...
March 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29546747/principles-of-hemodynamic-for-mechanical-circulatory-support-patho-physiological-key-aspects-of-assisted-pci
#14
Eloisa Basile, Giulio Russo, Antonio M Leone
It is essential to understand the pathophysiology of cardiogenic shock and the possible deterioration of contractile function during high-risk PCI in order to select those patients who could benefit from mechanical support thus choosing the most suitable device in every situation. Percutaneous Ventricular Assist Devices (pVAD) provide hemodynamic support by improving cardiac output and mean arterial pressure, but their specific features result in different hemodynamic effects and degrees of myocardial ischemic protection and LV unloading...
March 15, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29540471/outcomes-after-continuous-flow-left-ventricular-assist-device-implantation-as-destination-therapy-at-transplant-versus-nontransplant-centers
#15
D Marshall Brinkley, David DeNofrio, Robin Ruthazer, Amanda R Vest, Navin K Kapur, Gregory S Couper, Michael S Kiernan
BACKGROUND: Since Food and Drug Administration's approval of the HeartMate II left ventricular assist device (LVAD) as destination therapy, the number of hospitals offering LVAD therapy has grown rapidly. A rising number are performed at centers without internal transplant programs. We sought to determine whether outcomes after destination therapy LVAD implantation are similar at transplant and nontransplant centers. METHODS AND RESULTS: Adult recipients of a primary, continuous-flow LVAD as destination therapy between January 2012 and March 2014 from the Interagency Registry for Mechanically Assisted Circulatory Support were included...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29538018/combining-stem-cell-therapy-for-advanced-heart-failure-and-ventricular-assist-devices-a-review
#16
Heidi J Reich, Lawrence S C Czer, Danny Ramzy, Francisco Arabia, Jaime Moriguchi, Deborah D Ascheim, Timothy D Henry
The use of stem cell therapy in combination with a left ventricular assist device (LVAD) for patients with advanced heart failure (HF) is an attractive concept with the potential to alter the natural history of HF. Cell therapy trials for HF have demonstrated excellent safety and encouraging results, but current rates of myocardial recovery after LVAD implantation are limited. Early trials combining these 2 therapies to increase the likelihood of recovery and to potentially obviate the need for subsequent transplantation appear promising...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29538013/advantages-of-integrating-pressure-regulating-devices-into-mechanical-circulatory-support-pumps
#17
David J Horvath, Jamshid H Karimov, Nicole A Byram, Barry D Kuban, Gengo Sunagawa, Nader Moazami, Kiyotaka Fukamachi
Control of mechanical circulatory support pump output typically requires that pressure-regulating functions be accomplished by active control of the speed or geometry of the device, with feedback from pressure or flow sensors. This article presents a different design approach, with a pressure-regulating device as the core design feature, allowing the essential control function of regulating pressure to be directly programmed into the hydromechanical design. We show the step-by-step transformation of a pressure-regulating device into a continuous-flow total artificial heart that passively balances left and right circulations without the need for pressure and flow sensors...
March 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29528890/approach-to-pulmonary-vascular-disease-in-the-icu
#18
Georgia Brown, Tilman Humpl
PURPOSE OF REVIEW: Pulmonary vascular disease (PVD) complicates the course of many cardiovascular, pulmonary and other systemic diseases in children. The physiological sequelae (pulmonary hypertension and elevated pulmonary vascular resistance) can overwhelm the right ventricle and lead to circulatory collapse. Despite the common end-point, the preceding pathophysiology is complex and variable and requires a tailored approach to diagnosis and management. In this article, we will review the most recent evidence and explore an approach to current controversies in the diagnosis and management of common or challenging patient subgroups...
March 9, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29527864/left-ventricular-support-during-complex-transradial-percutaneous-coronary-intervention-for-complete-revascularization
#19
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/29526139/two-year-outcomes-with-a-magnetically-levitated-cardiac-pump-in-heart-failure
#20
Mandeep R Mehra, Daniel J Goldstein, Nir Uriel, Joseph C Cleveland, Melana Yuzefpolskaya, Christopher Salerno, Mary N Walsh, Carmelo A Milano, Chetan B Patel, Gregory A Ewald, Akinobu Itoh, David Dean, Arun Krishnamoorthy, William G Cotts, Antone J Tatooles, Ulrich P Jorde, Brian A Bruckner, Jerry D Estep, Valluvan Jeevanandam, Gabriel Sayer, Douglas Horstmanshof, James W Long, Sanjeev Gulati, Eric R Skipper, John B O'Connell, Gerald Heatley, Poornima Sood, Yoshifumi Naka
Background In an early analysis of this trial, use of a magnetically levitated centrifugal continuous-flow circulatory pump was found to improve clinical outcomes, as compared with a mechanical-bearing axial continuous-flow pump, at 6 months in patients with advanced heart failure. Methods In a randomized noninferiority and superiority trial, we compared the centrifugal-flow pump with the axial-flow pump in patients with advanced heart failure, irrespective of the intended goal of support (bridge to transplantation or destination therapy)...
March 11, 2018: New England Journal of Medicine
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