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LVAD DESTINATION THERAPY

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https://www.readbyqxmd.com/read/27903010/heartmate-ii-left-ventricular-assist-device-pump-exchange-a-single-institution-experience
#1
Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
November 30, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27837385/roads-maps-and-destinations-the-journey-of-left-ventricular-assist-device-implantation-in-ambulatory-patients-with-advanced-heart-failure
#2
REVIEW
Barry H Trachtenberg, Jerry D Estep
PURPOSE OF REVIEW: The benefit of left ventricular assist devices in patients dependent on inotropes or temporary mechanical support is clear. There is a large population of advanced heart failure patients who are ambulatory and not dependent on inotropes, but in whom mortality remains high. We review the limited evidence regarding the benefits and risks of LVADs in this population. RECENT FINDINGS: The REVIVE-IT trial, which aimed to study the use of LVADs in patients who are less sick and do not meet current FDA-indications, was suspended due to lack of equipoise in the setting of a spike in pump thromboses...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27836022/the-nhlbi-revive-it-study-understanding-its-discontinuation-in-the-context-of-current-left-ventricular-assist-device-therapy
#3
EDITORIAL
Francis D Pagani, Keith D Aaronson, Robert Kormos, Douglas L Mann, Cathie Spino, Neal Jeffries, Wendy C Taddei-Peters, Donna M Mancini, Dennis M McNamara, Kathleen L Grady, John Gorcsan, Ralph Petrucci, Allen S Anderson, Henry A Glick, Michael A Acker, J Eduardo Rame, Daniel J Goldstein, Salpy V Pamboukian, Marissa A Miller, J Timothy Baldwin
The National Institutes of Health National Heart, Lung, and Blood Institute convened a working group in March 2008 to discuss how therapies for heart failure (HF) might be best advanced using clinical trials involving left ventricular assist devices (LVAD). This group opined that the field was ready for a trial to assess the use of long-term ventricular assist device therapy in patients who are less ill than patients currently eligible for destination therapy, which resulted in the Randomized Evaluation of VAD InterVEntion before Inotropic Therapy (REVIVE-IT) pilot study...
November 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27801308/how-i-do-it-temporary-rvad-placed-at-the-time-of-implantation-of-a-heartmate-ii-lvad
#4
William Zachary Chancellor, Curt Tribble
Left ventricular assist devices (LVAD) are increasingly used to support patients as they await heart transplantation and as destination therapy for patients with end-stage cardiac failure. While the methods of LVAD implantation have become fairly standardized, early postoperative management of patients receiving these devices remains challenging. One issue that has plagued surgeons, cardiologists, and intensivists caring for patients after LVAD implantation is right heart dysfunction. While many scoring systems have been developed to try to anticipate RV failure, the accuracy of these predictive tools remains low...
October 31, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27785136/monitoring-hemostasis-parameters-in-left-ventricular-assist-device-recipients-a-preliminary-report
#5
Bartosz Hudzik, Jacek Kaczmarski, Jerzy Pacholewicz, Michał Zakliczyński, Mariusz Gąsior, Marian Zembala
INTRODUCTION: Mechanical circulatory support (MCS) therapy is associated with the improvement of long-term prognosis in patients with end-stage heart failure. For years it has been used as a bridge to transplant. However, more recently it is even being used as a destination therapy. Recently, clinicians have identified common MCS therapy-associated complications: pump thrombosis, bleeding, and hemolysis. These complications are very challenging with regard to both diagnosis and management...
September 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27774264/initial-3-year-outcomes-with-left-ventricular-assist-devices-in-a-country-with-a-nascent-heart-transplantation-program
#6
Yuriy Pya, Makhabbat Bekbossynova, Saltanat Jetybayeva, Serik Bekbossynov, Saltanat Andossova, Roman Salov, Assel Medressova, Svetlana Novikova, Muradym Murzagaliyev
AIMS: The need for the left ventricular assist devices (LVAD) in patients with end-stage heart failure is well established, but prior to 2011, this was not available to patients in Kazakhstan. We describe the development of the sole LVAD programme in the context of a nascent heart transplantation programme and clinical outcomes for the first three years. METHODS AND RESULTS: From November 2011 to November 2014, 146 patients underwent implantation of 152 VADs (approximately 50 devices implanted per year)...
March 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27758809/dying-with-a-left-ventricular-assist-device-as-destination-therapy
#7
Shannon M Dunlay, Jacob J Strand, Sara E Wordingham, John M Stulak, Angela J Luckhardt, Keith M Swetz
BACKGROUND: Despite the ability of left ventricular assist device as destination therapy (DT-LVAD) to prolong survival for many patients with advanced heart failure, little is known about the eventual end-of-life care that patients with DT-LVAD receive. METHODS AND RESULTS: All patients undergoing DT-LVAD at the Mayo Clinic in Rochester, Minnesota, from January 1, 2007, to September 30, 2014, who subsequently died before July 1, 2015, were included. Information about end-of-life care was obtained from documentation in the electronic medical record...
October 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27746085/the-incidence-risk-factors-and-outcomes-associated-with-late-right-sided-heart-failure-in-patients-supported-with-an-axial-flow-left-ventricular-assist-device
#8
Jonathan D Rich, Igor Gosev, Chetan B Patel, Susan Joseph, Jason N Katz, Peter M Eckman, Sangjin Lee, Kartik Sundareswaran, Ahmet Kilic, Brian Bethea, Behzad Soleimani, Brian Lima, Nir Uriel, Michael Kiernan
BACKGROUND: Early right-sided heart failure (RHF) after left ventricular assist device (LVAD) implantation is associated with increased mortality, but little is known about patients who develop late RHF (LRHF). We evaluated the incidence, risk factors, and clinical impact of LRHF in patients supported by axial-flow LVADs. METHODS: Data were analyzed from 537 patients enrolled in the HeartMate II (HM II; Thoratec/St. Jude) destination therapy clinical trial. LRHF was defined as the development of clinical RHF accompanied by the need for inotropic support occurring more than 30 days after discharge from the index LVAD implant hospitalization...
August 20, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27692952/left-ventricular-assist-device-as-destination-therapy-in-cardiac-end-stage-dystrophinopathies-midterm-results
#9
Gianluigi Perri, Sergio Filippelli, Rachele Adorisio, Roberta Iacobelli, Francesca Iodice, Giuseppina Testa, Maria Giovanna Paglietti, Domenico D'Amario, Massimo Massetti, Antonio Amodeo
OBJECTIVE: We report our experience with the use of a left ventricular assist device (LVAD) as destination therapy (DT) for the management of patients with cardiac end-stage dystrophinopathies. METHODS: From February 2011 to February 2016, 7 patients with dystrophinopathies and dilated cardiomyopathy (DCM) were treated with LVADs at our institution. Median age at surgery was 16.5 years (range, 14.2-23.4 years). All patients were preoperatively evaluated by a multidisciplinary team approach...
August 28, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27685648/transcriptional-patterns-of-reverse-remodeling-with-left-ventricular-assist-devices-a-consistent-signature
#10
Van-Khue Ton, Gordana Vunjak-Novakovic, Veli K Topkara
Left ventricular assist device (LVAD) therapy has revolutionized the treatment of patients with advanced heart failure. Although originally intended for bridge-to-transplantation and destination therapy indications, a small subset of patients supported with LVADs exhibit complete myocardial recovery leading to device explanation. However, genetic and molecular determinants of partial and/or complete myocardial recovery remain largely unknown. Areas covered: We summarize current knowledge on alterations in heart failure transcriptome in response to LVAD support, as well as discuss common gene signatures potentially responsible for the reverse remodeling phenotype in the failing human heart...
October 14, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27672540/endocarditis-in-left-ventricular-assist-device
#11
REVIEW
Braghadheeswar Thyagarajan, Monisha Priyadarshini Kumar, Rutuja R Sikachi, Abhinav Agrawal
Heart failure is one of the leading causes of death in developed nations. End stage heart failure often requires cardiac transplantation for survival. The left ventricular assist device (LVAD) has been one of the biggest evolvements in heart failure management often serving as bridge to transplant or destination therapy in advanced heart failure. Like any other medical device, LVAD is associated with complications with infections being reported in many patients. Endocarditis developing secondary to the placement of LVAD is not a frequent, serious and difficult to treat condition with high morbidity and mortality...
August 2016: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/27660575/mechanical-circulatory-support-for-the-failing-heart-continuous-flow-left-ventricular-assist-devices
#12
REVIEW
Joseph A R Englert, Jennifer A Davis, Selim R Krim
BACKGROUND: Heart transplantation remains the definitive therapy for patients with advanced heart failure; however, owing to limited donor organ availability and long wait times, continuous-flow left ventricular assist devices (LVADs) have become standard therapy. METHODS: This review summarizes the history, progression, function, and basic management of LVADs. Additionally, we provide some clinical pearls and important caveats for managing this unique patient population...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27659884/exploring-cognitive-bias-in-destination-therapy-left-ventricular-assist-device-decision-making-a-retrospective-qualitative-framework-analysis
#13
Molly Magid, Colleen K Mcllvennan, Jaqueline Jones, Carolyn T Nowels, Larry A Allen, Jocelyn S Thompson, Dan Matlock
BACKGROUND: Cognitive biases are psychological influences, which cause humans to make decisions, which do not seemingly maximize utility. For people with heart failure, the left ventricular assist device (LVAD) is a surgically implantable device with complex tradeoffs. As such, it represents an excellent model within which to explore cognitive bias in a real-world decision. We conducted a framework analysis to examine for evidence of cognitive bias among people deciding whether or not to get an LVAD...
October 2016: American Heart Journal
https://www.readbyqxmd.com/read/27623098/aortic-insufficiency-in-continuous-flow-left-ventricular-assist-device-support-patients-is-common-but-does-not-impact-long-term-mortality
#14
Christopher T Holley, Megan Fitzpatrick, Samit S Roy, M Chadi Alraies, Rebecca Cogswell, Laura Souslian, Peter Eckman, Ranjit John
BACKGROUND: Aortic insufficiency (AI) is a significant long-term complication of continuous-flow left ventricular assist device (CF-LVAD) implantation. We sought to evaluate its impact on clinical outcomes and mortality in CF-LVAD recipients. METHODS: We retrospectively analyzed 237 patients implanted with HeartMate II CF-LVADs at our institution from June 2005 through June 2013. We evaluated recipients' baseline characteristics and annual echocardiograms, grading AI severity as either none, trace, mild, moderate or severe...
July 28, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27594870/evolvement-of-left-ventricular-assist-device-the-implications-on-heart-failure-management
#15
Sek Ying Chair, Doris Sf Yu, Michael Timothy Ng, Qun Wang, Ho Yu Cheng, Eliza Ml Wong, Janet Wh Sit
Heart failure (HF) is a potentially fatal disease that affects increasing number of people worldwide. Although heart transplant is the "gold standard" therapy for HF, due to the limited availability of organs, many patients died when waiting for the transplant. Left ventricular assist device (LVAD), as a mechanical circulatory support, has become a new light for patients with HF. With the technical advancements, LVADs work not only as a bridge to transplant, but also assist heart recovery and even as a destination therapy in long-term treatment...
July 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27556150/outcomes-of-adult-patients-with-small-body-size-supported-with-a-continuous-flow-left-ventricular-assist-device
#16
Sangjin Lee, Jason N Katz, Ulrich P Jorde, Nader Moazami, Ranjit John, Kartik S Sundareswaran, David J Farrar, O H Frazier
There is insufficient data on patients with small body size to determine if this should be considered a risk factor for continuous-flow left ventricular assist device (CF-LVAD) support. We sought to evaluate survival outcomes, adverse events, and functional status of CF-LVAD patients with body surface area (BSA) <1.5 m in a large national registry. Adults with BSA < 1.5 m (n = 128) implanted with a HeartMate II (HMII)-LVAD from the Interagency Registry for Mechanically Assisted Circulatory Support registry from April 2008 to December 2012 formed this cohort...
November 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27539188/prolonged-asystole-in-a-patient-with-an-isolated-left-ventricular-assist-device
#17
Wasim Javed, Parminder S Chaggar, Rajamiyer Venkateswaran, Steven M Shaw
Left ventricular assist devices (LVADs) are well established in the management of end-stage heart failure as either destination therapy, a bridge prior to cardiac transplantation or during myocardial recovery. Despite LVADs requiring adequate left ventricular preload to effectively augment systemic circulation, there have been rare cases of patients with LVADs surviving sustained, normally fatal arrhythmias, such as ventricular fibrillation and asystole. Whilst current reports describe an LVAD patient surviving 15 days with such an arrhythmia, we describe the case of a patient with an LVAD surviving 104 days of asystole via a Fontan mechanism of circulation, which we believe is the longest known survival of a sustained fatal arrhythmia...
September 2016: Future Cardiology
https://www.readbyqxmd.com/read/27521176/heartware-ventricular-assist-device-as-a-bridge-to-heart-transplantation-in-a-patient-with-congenitally-corrected-transposition-of-the-great-arteries-and-dextrocardia
#18
Muhammad A Soofi, Andrew P Ignaszewski, Anson W Cheung, Jamil G Bashir
Congenitally corrected transposition of the great arteries (ccTGA) is a rare condition with prevalence of <0.5%. Dextrocardia is reported among 20% of them. Among patients with ccTGA, heart failure is a common presentation, especially in the fourth or fifth decade of life and survival is dismal without heart transplantation. A left ventricular assist device (LVAD) is considered for bridge to transplantation if early heart transplantation is not available or as destination therapy for patients ineligible for heart transplant...
August 11, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27507111/frequency-of-poor-outcome-death-or-poor-quality-of-life-after-left-ventricular-assist-device-for-destination-therapy-results-from-the-intermacs-registry
#19
Suzanne V Arnold, Philip G Jones, Larry A Allen, David J Cohen, Timothy J Fendler, Jonathan E Holtz, Sanjeev Aggarwal, John A Spertus
BACKGROUND: A left ventricular assist device (LVAD) improves survival and quality of life for many, but not all, patients with end-stage heart failure who are ineligible for transplantation. We sought to evaluate the frequency of poor outcomes using a novel composite measure that integrates quality of life with mortality. METHODS AND RESULTS: Within the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) national registry, poor outcome was defined as death or an average Kansas City Cardiomyopathy Questionnaire <45 during the year after LVAD (persistently limiting heart failure symptoms and poor quality of life)...
August 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27469338/impact-of-preoperative-atrial-fibrillation-on-postoperative-thromboembolic-events-after-left-ventricular-assist-device-implantation
#20
Linnea Xuereb, Pauline H Go, Babbaljeet Kaur, Silvy Akrawe, Hassan W Nemeh, Jamil Borgi, Celeste T Williams, Gaetano Paone, Jeffrey A Morgan
BACKGROUND: The incidence of atrial fibrillation (AF) among patients undergoing left ventricular assist device (LVAD) implantation is high. However, the impact of AF on clinical outcomes has not been clarified. We reviewed our 9-year experience of continuous flow (CF) LVADs to determine the impact of preoperative AF on stroke, device thrombosis, and survival. METHODS: Between March 2006 and May 2015, 231 patients underwent implantation of 240 CF LVADs, 127 (52...
November 2016: Annals of Thoracic Surgery
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