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LVAD DESTINATION THERAPY

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https://www.readbyqxmd.com/read/28525417/assessing-frailty-in-patients-undergoing-destination-therapy-left-ventricular-assist-device-observations-from-interagency-registry-for-mechanically-assisted-circulatory-support
#1
Lauren B Cooper, Bradley G Hammill, Larry A Allen, JoAnn Lindenfeld, Robert J Mentz, Joseph G Rogers, Carmelo A Milano, Chetan B Patel, Karen P Alexander, Adrian F Hernandez
Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data of destination therapy (DT) LVAD patients from January 1, 2012, to March 31, 2014, we examined preimplantation provider-assessed frailty and gait speed testing and the association with 1 year postimplantation outcomes. Of 2,469 patients, 227 (9...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28522783/splenic-abcesses-as-infectious-complication-following-127-implantation-of-left-ventricular-asssist-device-case-report
#2
Sławomir Gajda, Anna M Szczepanik, Grzegorz Religa, Andrzej Misiak, Andrzej B Szczepanik
Left ventricular assist device (LVAD) is one of the modern management therapies in patients with advanced heart failure, and it serves as a bridge to heart transplantation or even as destination therapy. However, it is burdened with a high risk of thromboembolic, hemorrhagic, and infectious complications despite prophylactic management. Splenic abscesses, as septic complications following implantation of mechanical ventricular support, have not yet been described in the literature. We report of a patient with severe left ventricular insufficiency (NYHA II/III), pulmonary hypertension, and arrhythmia who underwent implantation of the Heart Ware® pump for left ventricular support with simultaneous tricuspidvalvoplasty, as a bridge therapy to heart transplantation...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28504892/palliative-care-interventions-before-left-ventricular-assist-device-implantation-in-both-bridge-to-transplant-and-destination-therapy
#3
Shunichi Nakagawa, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Craig D Blinderman
BACKGROUND: The optimal level of palliative care (PC) involvement in left ventricular assist device (LVAD) therapy has yet to be determined. OBJECTIVE: Describe the feasibility of PC intervention to elucidate patients' goals and values in LVAD therapy in both destination therapy (DT) and bridge to transplant (BTT). DESIGN: Single center, prospective, single-arm study. SETTING/SUBJECTS: All patients who received mandatory PC consultation, using a semistructured script, before LVAD implantation (PreVAD evaluation)...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28483949/development-of-high-grade-daptomycin-resistance-in-corynebacterium-striatum-while-on-therapy
#4
Saira Ajmal, Omar Abu Saleh, Elena Beam
We report of a 62-year-old male with ischemic cardiomyopathy complicated by cardiogenic shock who underwent placement of a left-ventricular assist device (HeartMate II LVAD) in July 2013 as destination therapy.….
May 8, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28472406/short-term-mechanical-circulatory-support-as-a-bridge-to-durable-left-ventricular-assist-device-implantation-in-refractory-cardiogenic-shock-a-systematic-review-and-meta-analysis
#5
Corstiaan A den Uil, Sakir Akin, Lucia S Jewbali, Dinis Dos Reis Miranda, Jasper J Brugts, Alina A Constantinescu, Arie Pieter Kappetein, Kadir Caliskan
Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016...
May 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28441157/new-role-of-mechanical-assist-device-as-bridge-to-transplant-usa-perspective
#6
Ambreen Mohamed, Natasha Mehta, Howard J Eisen
PURPOSE OF REVIEW: Cardiac transplant remains the gold standard of care for patients with end-stage heart failure. Unfortunately, due to the limited availability of donor hearts in the United States, not all eligible candidates are able to be transplanted. Since the introduction of mechanical assist devices for the treatment of advanced heart failure, patients gain a significant survival benefit while awaiting transplant. With rapidly evolving technology, it is important to appreciate the advances in the current use of mechanical assist devices...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28430300/left-ventricular-assist-pump-pocket-infection-conservative-treatment-strategy-for-destination-therapy-candidates
#7
Elie Haddad, François-Xavier Lescure, Walid Ghodhbane, Laurent Lepage, Camille D'humieres, William Vindrios, Yazdan Yazdanpanah, Patrick Nataf, Matthias Kirsch
BACKGROUND: Heart failure is a major cause of mortality and morbidity, particularly among patients with advanced disease and no access to cardiac transplantation. LVAD implantation is not only a bridge-to-transplantation option for patients awaiting a heart donor, but is often used as bridge-to-destination therapy in patients unsuited for transplantation for various reasons. LVAD infection is considered the second-most common cause of death in patients who survive the initial 6 months on LVAD support...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28408022/left-ventricular-assist-device-as-a-bridge%C3%A2-to-recovery-for-patients-with-advanced-heart-failure
#8
Djordje G Jakovljevic, Magdi H Yacoub, Stephan Schueler, Guy A MacGowan, Lazar Velicki, Petar M Seferovic, Sandeep Hothi, Bing-Hsiean Tzeng, David A Brodie, Emma Birks, Lip-Bun Tan
BACKGROUND: Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, as destination therapy, or in some patients, as a bridge to recovery. OBJECTIVES: This study evaluated whether patients undergoing an LVAD bridge-to-recovery protocol can achieve cardiac and physical functional capacities equivalent to those of healthy controls. METHODS: Fifty-eight male patients-18 implanted with a continuous-flow LVAD, 16 patients with LVAD explanted (recovered patients), and 24 heart transplant candidates (HTx)-and 97 healthy controls performed a maximal graded cardiopulmonary exercise test with continuous measurements of respiratory gas exchange and noninvasive (rebreathing) hemodynamic data...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28365215/mean-arterial-pressure-to-central-venous-pressure-ratio-a-novel-marker-for-right-ventricular-failure-after-left-ventricular-assist-device-placement
#9
Burhan Mohamedali, Rami Doukky, Kelly Karavalos, Elizabeth Avery, Geetha Bhat
BACKGROUND: Early right ventricular failure (RVF) is common after left ventricular assist device (LVAD) implantation and often leads to increased morbidity and mortality. It is difficult to predict early RVF on the basis of clinical and hemodynamic parameters. We investigated the utility of mean arterial pressure (MAP) to central venous pressure (CVP) ratio in predicting early RVF. METHOD: We analyzed a retrospective cohort of 212 consecutive patients who underwent hemodynamic assessment prior to destination therapy LVAD implantation...
March 29, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28351172/current-status-of-mechanical-circulatory-support-for-treatment-of-advanced-end-stage-heart-failure-successes-shortcomings-and-needs
#10
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/28341764/transesophageal-echocardiographic-guidance-of-transcatheter-closure-of-the-aortic-valve-in-a-patient-with-left-ventricular-assist-device-related-severe-aortic-regurgitation
#11
Preetham Muskala, Taiyeb M Khumri, Michael L Main
A 68 year-old man with a severe ischemic cardiomyopathy underwent left ventricular assist device (LVAD) implantation (Heart Mate II device) for destination therapy. He presented 49 months following LVAD implant with worsening heart failure symptoms and new severe aortic regurgitation. Given high risk for both surgical and transcatheter aortic valve replacement, he was admitted for transcatheter closure of the aortic valve under transesophageal echocardiographic (TEE) guidance. TEE imaging revealed severe aortic regurgitation (see Figure 1A and 1B, and multimedia files 1 and 2)...
March 24, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28323195/left-ventricular-assist-device-related-infections-a-multicentric-study
#12
S Siméon, E Flécher, M Revest, M Niculescu, J-C Roussel, M Michel, P Leprince, P Tattevin
OBJECTIVES: Implantable left ventricular assist device (LVAD) is a major therapeutic progress for end-stage heart failure in selected patients. As their use is expanding, infectious complications are emerging, with limited data available to guide their management. We aimed to better characterize LVAD-related infections. METHODS: We enrolled all consecutive patients diagnosed with LVAD-related infections in 3 referral centers in France, using standardized definition of infections in patients with LVAD...
March 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28299353/safety-and-efficacy-of-single-balloon-enteroscopy-in-management-of-gastrointestinal-bleeding-in-patients-with-a-left-ventricular-assist-device
#13
Abhinav Koul, Donald M Pham, Arjun Nanda, Kevin E Woods, Steven D Keilin
Background and study aims Left ventricular assist devices (LVADs) are currently the standard of care in treatment of patients with end-stage heart failure waiting for heart transplant as well as destination therapy for non-transplant candidates. However, patients with LVADs are at increased risk of gastrointestinal bleeding due to the device's unique effects on hemodynamics. A major source of gastrointestinal bleeding in these patients are gastrointestinal angioectasias located within the small bowel that can only be reached with deep enteroscopy...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28283496/physical-activity-guided-by-pulse-pressure-in-patients-with-continuous-flow-left-ventricular-assist-devices-a-pilot-study
#14
LETTER
Sven Haufe, Christoph Bara, Julian Eigendorf, Kristine Chobanyan-Jürgens, Sebastian V Rojas, Jan Schmitto, Uwe Tegtbur, Jens Jordan, Jens Tank
No abstract text is available yet for this article.
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#15
Rohan J Kalathiya, Jonathan Grinstein, Nir Uriel, Atman P Shah
Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28198133/left-ventricular-assist-device-therapy-in-advanced-heart-failure-patient-selection-and-outcomes
#16
REVIEW
Finn Gustafsson, Joseph G Rogers
Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25-50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28191682/aortic-root-thrombus-complicated-by-left-main-coronary-artery-occlusion-visualized-by-3d-echocardiography-in-a-patient-with-continuous-flow-left-ventricular-assist-device
#17
Monique S Tanna, Alex Reyentovich, Leora B Balsam, John A Dodson, Alan F Vainrib, Ricardo J Benenstein, Barry P Rosenzweig, Muhamed Saric
Aortic root thrombus is an uncommon complication of continuous-flow left ventricular assist devices (LVAD). We present the case of a 71-year-old man with ischemic cardiomyopathy who underwent destination therapy HeartMate II LVAD placement. Eighteen months later, he presented with a cerebrovascular accident followed by myocardial infarction. Transesophageal echocardiography revealed an aortic root thrombus spanning the left and noncoronary cusps and obliterating the left main coronary artery. We discuss the incidence, risk factors, and management of aortic root thrombus in LVAD patients...
February 2017: Echocardiography
https://www.readbyqxmd.com/read/28168962/changes-in-end-organ-function-in-patients-with-prolonged-continuous-flow-left-ventricular-assist-device-support
#18
Daisuke Yoshioka, Hiroo Takayama, Paolo C Colombo, Melana Yuzefpolskaya, Arthur R Garan, Veli K Topkara, Jiho Han, Paul Kurlansky, Yoshifumi Naka, Koji Takeda
BACKGROUND: Few studies have evaluated the long-term effects of continuous blood flow with reduced pulsatility on end-organ function. METHODS: Between May 2004 and December 2015, 469 patients underwent continuous-flow left ventricular assist device (LVAD) implantation at our center. Our study included 59 (13%) patients who were supported with an LVAD for a minimum of 3 years. We evaluated postoperative renal function and hepatic function at 1 and 6 months, and 1, 2, and 3 years after implantation in those 59 patients...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28161817/curative-surgery-for-gastric-cancer-in-a-patient-with-an-implantable-left-ventricular-assist-device
#19
Yuki Nakamura, Koichi Toda, Teruya Nakamura, Shigeru Miyagawa, Yasushi Yoshikawa, Satsuki Fukushima, Shunsuke Saito, Daisuke Yoshioka, Keitaro Domae, Tsuyoshi Takahashi, Tadayoshi Hashimoto, Yuichiro Doki, Yoshiki Sawa
The number of patients with end-stage heart failure treated by a left ventricular assist device (LVAD) is dramatically increasing, because the LVAD has been widely accepted for its clinical results. According to the initiation of destination therapy, the prevalence of malignancy in patients with an LVAD is estimated to increase. In patients with LVADs, abdominal surgery for visceral malignancy is associated with technical difficulties because of the presence of an LVAD pump or the driveline which is located transversely in the preperitoneal space...
February 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28160976/global-outcome-in-patients-with-left-ventricular-assist-devices
#20
Timothy J Fendler, Michael E Nassif, Kevin F Kennedy, Susan M Joseph, Scott C Silvestry, Gregory A Ewald, Shane J LaRue, Justin M Vader, John A Spertus, Suzanne V Arnold
Left ventricular assist devices (LVADs) improve survival and quality of life (QOL) for most, but not all, patients with advanced heart failure. We described a broader definition of poor outcomes after LVAD, using a novel composite of death, QOL, and other major adverse events. We evaluated the frequency of poor global outcome at 1 year after LVAD among 164 patients (86% Interagency Registry for Mechanically Assisted Circulatory Support profile 1 to 2; shock or declining despite inotropes) at a high-volume center...
April 1, 2017: American Journal of Cardiology
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