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Mechanical cardiac support

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https://www.readbyqxmd.com/read/28073853/resuscitation-of-prolonged-cardiac-arrest-from-massive-pulmonary-embolism-by-extracorporeal-membrane-oxygenation
#1
Yun Seok Kim, Wookjin Choi, Jaecheol Hwang
Extracorporeal cardiopulmonary resuscitation can be used as a rescue strategy in cases of prolonged cardiac arrest caused by massive pulmonary embolism. We present a case of a male patient who was in prolonged cardiac arrest following massive pulmonary embolism. Veno-arterial extracorporeal membrane oxygenation was initiated approximately 93 min after prolonged cardiopulmonary resuscitation. After resuscitation, bedside echocardiography and a chest computed tomography angiogram revealed a massive pulmonary embolism during extracorporeal membrane oxygenation support...
January 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28073835/mechanosensitive-transient-receptor-potential-vanilloid-4-regulates-dermatophagoides-farinae-induced-airway-remodeling-via-2-distinct-pathways-modulating-matrix-synthesis-and-degradation
#2
Farai Gombedza, Vinay Kondeti, Nosayba Al-Azzam, Stephanie Koppes, Ernest Duah, Prachi Patil, Madison Hexter, Daniel Phillips, Charles K Thodeti, Sailaja Paruchuri
Contributions of mechanical signals to airway remodeling during asthma are poorly understood. Transient receptor potential vanilloid 4 (TRPV4), a mechanosensitive ion channel, has been implicated in cardiac and pulmonary fibrosis; however, its role in asthma remains elusive. Employing a Dermatophagoides farinae-induced asthma model, we report here that TRPV4 knockout mice were protected from D. farinae-induced airway remodeling. Furthermore, lung fibroblasts that were isolated from TRPV4 knockout mice showed diminished differentiation potential compared with wild-type mice...
January 10, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28072699/prevention-preferable-to-treatment-3-case-reports-of-patients-experiencing-right-sided-heart-failure-after-ebstein-anomaly-correction
#3
Ming Luo, Jing Lin, Zhen Qin, Lei Du
RATIONALE: Ebstein anomaly is a common congenital heart disease that may induce severe tricuspid regurgitation and dilation of the "atrialized" portion of the right ventricle. Patients who undergo surgery to correct Ebstein anomaly are at high risk of postoperative right-sided heart failure, yet little is known about what pre-, peri-, or postoperative procedures may help reduce this risk. PATIENT CONCERNS: Here, we describe 3 cases of adults with Ebstein anomaly who underwent corrective surgery and in whom right-sided heart failure occurred with severe tricuspid regurgitation detected by transesophageal echocardiography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070867/analytical-modeling-for-computing-lead-stress-in-a-novel-epicardial-micropacemaker
#4
Li Zhou, Yaniv Bar-Cohen, Raymond A Peck, Giorgio V Chirikian, Brett Harwin, Ramen H Chmait, Jay D Pruetz, Michael J Silka, Gerald E Loeb
Implantation and maintenance of a permanent cardiac pacing system in children remains challenging due to small patient size, congenital heart defects and somatic growth. We are developing a novel epicardial micropacemaker for children that can be implanted on the epicardium within the pericardial space via a minimally-invasive technique. The key design configurations include a novel open-coiled lead in which living tissue replaces the usual polymeric support for the coiled conductor. To better understand and be able to predict the behavior of the implanted lead, we performed a radiographic image-based modeling study on a chronic animal test...
January 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28065768/ventricular-septal-defect-complicating-st-elevation-myocardial-infarctions-a-call-for-action
#5
Vikas Singh, Alex P Rodriguez, Parth Bhatt, Carlos E Alfonso, Rahul Sakhuja, Igor F Palacios, Ignacio Inglessis-Azuaje, Mauricio G Cohen, Sammy Elmariah, William W O'Neill
BACKGROUND: Ventricular septal defect is a lethal complication after an acute myocardial infarction which have become infrequent with the advent of reperfusion strategies however; they remain a major contributor to mortality. METHODS: We identified patients using the ICD-9CM procedure codes from the Nationwide Inpatient Sample between the years 2001 and 2013. A multivariate hierarchical logistic regression model was used to identify significant predictors of in-hospital mortality...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28063271/hybrid-minimally-invasive-approach-for-transvenous-lead-extraction-a-feasible-technique-in-high-risk-patients
#6
Luca Bontempi, Francesca Vassanelli, Manuel Cerini, Gianluigi Bisleri, Alberto Repossini, Laura Giroletti, Lorenza Inama, Francesca Salghetti, Daria Liberto, Daniele Giacopelli, Abdallah Raweh, Claudio Muneretto, Antonio Curnis
INTRODUCTION: Despite the overall safety, transvenous lead extraction (TLE) remains a challenging procedure with inherent risks, where surgery can still be required in elective cases. In this study, we report our experience with a minimally invasive "hybrid" approach, defined as a procedure performed by an electrophysiologist with the support of a cardiac surgeon in the same operative session. METHODS AND RESULTS: We reported 12 cases of planned hybrid lead extraction; minithoracotomy and thoracoscopy were performed on 10 (83%) and 2 (17%) patients, respectively...
January 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#7
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28054902/novel-goal-directed-hemodynamic-optimization-therapy-based-on-major-vasopressor-during-corrective-cardiac-surgery-in-patients-with-severe-pulmonary-arterial-hypertension-a-pilot-study
#8
Shuwen Li, Qing Ma, Yanwei Yang, Jiakai Lu, Zhiquan Zhang, Mu Jin, Weiping Cheng
INTRODUCTION: Pulmonary arterial hypertension (PAH) is a common and fatal complication of congenital heart disease (CHD). PAH-CHD increases the risk for postoperative complications. Recent evidence suggests that perioperative goal-directed hemodynamic optimization therapy (GDHOT) significantly improves outcomes in surgery patients. Standard GDHOT is based on major solution volume, vasodilators and inotropic therapy, while novel GDHOT is based on major vasopressor and inotropic therapy...
22, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28052047/mechanical-ventilatory-modes-and-cardioventilatory-phase-synchronization-in-acute-respiratory-failure-patients
#9
Claudio Enrico Mazzucco, Andrea Marchi, Vlasta Bari, Beatrice De Maria, Stefano Guzzetti, Ferdinando Raimondi, Emanuele Catena, Davide Ottolina, Carla Amadio, Silvio Cravero, Tommaso Fossali, Riccardo Colombo, Alberto Porta
Cardioventilatory phase synchronization was studied in ten critically ill patients admitted in intensive care unit (ICU) for acute respiratory failure under two mechanical ventilatory modes: i) pressure controlled ventilation (PCV); ii) pressure support ventilation (PSV). The two modalities were administered to the same patient in different times in a random order. Cardioventilatory phase interactions were typified by plotting the relative position of a heartbeat, detected from the electrocardiogram and collected in n groups, within m ventilatory cycles as a function of the progressive cardiac beat number via the synchrogram...
January 4, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28047545/we-fg-206-11-measuring-mechanical-biomarkers-of-liver-tumors-using-tagged-mri
#10
X Xia, M Zhu, L Sun, M Sacks, G Genin, C Hu, L Guo, Y Feng
PURPOSE: Early detection of liver cancer improves patient prognosis dramatically. We propose a novel approach in which liver deformation is tracked during the cardiac cycle using tagged MRI. Strain concentrations that arise from material mismatches between the tumor and non-tumor regions were compared in patients with liver tumors. METHODS: Tagged MR images were acquired from four liver cancer patients in the coronal plane in a 3.0T scanner. In each cardiac cycle, a total of 25 time frames were acquired with a FOV of 289×359 mm2 and a resolution of 180×224...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047187/tu-h-campus-iep2-03-development-of-3d-printed-coronary-phantoms-for-in-vitro-ct-ffr-validation-using-data-from-320-detector-row-coronary-ct-angiography
#11
C Ionita, E Angel, D Mitsouras, S Rudin, D Bednarek, S Zaid, M Wilson, F Rybicki
PURPOSE: To validate Computed Tomography Fractional Flow Reserve (CT-FFR) measurements with accurate 3D printed coronary phantoms. METHODS: DICOM data from four phases in two patients imaged with a standard 320 × 0.5mm coronary CT acquisition (70-80% cardiac cycle) underwent semi-automated segmentation using a research workstation. Both patients had a >50% stenosis from the clinical image interpretation. Each volume was saved as a Stereo Lithographic (STL) file with 250 micron resolution...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045013/extracorporeal-cardiopulmonary-resuscitation-for-refractory-cardiac-arrest-in-children-after-cardiac-surgery
#12
Ersin Erek, Selim Aydın, Dilek Suzan, Okan Yıldız, Fırat Altın, Barış Kırat, Ibrahim Halil Demir, Ender Ödemiş
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is used to provide cardiorespiratory support during cardiopulmonary resuscitation (extracorporeal cardiopulmonary resuscitation; ECPR) unresponsive to conventional methods. In this study, the results of ECPR in a cardiac arrest setting after cardiac surgery in children were analyzed. METHODS: In this retrospective cohort study, between November 2010 and June 2014, 613 congenital heart operations were performed by the same surgical team...
March 3, 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#13
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
December 30, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28038817/low-partial-pressure-of-end-tidal-carbon-dioxide-predicts-left-ventricular-assist-device-implantation-in-patients-with-advanced-chronic-heart-failure
#14
Osamu Seguchi, Eriko Hisamatsu, Atsushi Nakano, Seiko Nakajima, Kensuke Kuroda, Takuya Watanabe, Takuma Sato, Haruki Sunami, Masanobu Yanase, Hiroki Hata, Toshimitsu Hamasaki, Tomoyuki Fujita, Junjiro Kobayashi, Takeshi Nakatani, Masafumi Kitakaze, Norihide Fukushima
BACKGROUND: This study aimed to clarify the prognostic impact of partial pressure of end-tidal carbon dioxide (PETCO2) in patients with advanced chronic heart failure (HF). METHODS: Forty-eight patients (mean age 43.1±11.9years, 32 males) with chronic HF (44 with non-ischemic and 4 with ischemic cardiomyopathy) were prospectively enrolled. Echocardiography, blood tests, pulmonary function testing, and PETCO2 measurements were performed as noninvasive tests, whereas right heart catheterization and arterial blood gas analysis were conducted as invasive tests...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28033201/right-ventricular-failure-post-lvad-implantation-corrected-with-biventricular-support-an-in-vitro-model
#15
Sajad Shehab, Sabine M Allida, Patricia M Davidson, Phillip J Newton, Desiree Robson, Paul C Jansz, Christopher S Hayward
Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. Management remains limited to pharmacologic therapy and temporary mechanical support. Delayed right ventricular assist device (RVAD) support after LVAD implantation is associated with poorer outcomes. With the advent of miniaturized, durable, continuous flow ventricular assist device systems, chronic RVAD and biventricular assist device (BiVAD) support has been used with some success. The purpose of this study was to assess combined BiVAD and LVAD with delayed RVAD support within a four-elemental mock circulatory loop (MCL) simulating the human cardiovascular system...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28024549/temporary-mechanical-circulatory-support-in-cardiac-critical-care-a-state-of-the-art-review-and-algorithm-for-device-selection
#16
REVIEW
A Dave Nagpal, Rohit K Singal, Rakesh C Arora, Yoan Lamarche
With more than 60 years of continuous development and improvement, a variety of temporary mechanical circulatory support (MCS) devices and implantation strategies exist, each with unique advantages and disadvantages. A thorough understanding of each available device is essential for optimizing patient outcomes in a fiscally responsible manner. In this state of the art review we examine the entire range of commonly available peripheral and centrally cannulated temporary MCS devices, including intra-aortic balloon pumps, the Impella (Abiomed, Danvers, MA) family of microaxial pumps, the TandemHeart (CardiacAssist Inc, Pittsburg, PA) pump and percutaneous cannulas, centrally cannulated centrifugal pumps such as the CentriMag (Thoratec Corp, Pleasanton, CA/St Jude Medical, St Paul, MN/Abbott Laboratories, Abbott Park, IL) and Rotaflow (Maquet Holding BV & Co KG, Rastatt Germany), and extracorporeal membrane oxygenation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28019045/autonomic-modulation-for-the-treatment-of-ventricular-arrhythmias-therapeutic-use-of-percutaneous-stellate-ganglion-blocks
#17
Marat Fudim, Richard Boortz-Marx, Chetan B Patel, Albert Y Sun, Jonathan P Piccini
Ventricular tachycardia (VT), ventricular fibrillation (VF) and electrical storm are commonly encountered emergency conditions in cardiac and surgical intensive care units. In most cases, recurrent ventricular arrhythmias or electrical storm are associated with a heightened sympathetic tone. These arrhythmias can be difficult to treat and may be refractory to beta-blockade, antiarrhythmic therapy, sedation, and mechanical hemodynamic support. While monomorphic ventricular tachycardia and PVC-triggered polymorphic ventricular tachycardia may sometimes be amenable to successful ablation, some patients may be too critically ill to make such an approach feasible...
December 26, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28018687/fatal-dengue-myocarditis-despite-the-use-of-extracorporeal-membrane-oxygenation
#18
Yee-Huang Ku, Wen-Liang Yu
Dengue is an important mosquitoes-borne viral disease which is endemic in tropics and subtropics region. Rapid spreading of disease to previously unaffected region was found in recent years. Atypical manifestations, such as myocarditis, were reported during large outbreak. There is a wide range of clinical manifestations of cardiac involvement in dengue, but rarely fatal. Here we reported a case of fulminant dengue myocarditis in fatal outcome despite cardiac mechanical support.
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28018230/myofilament-calcium-sensitivity-mechanistic-insight-into-tni-ser-23-24-and-ser-150-phosphorylation-integration
#19
Hussam E Salhi, Nathan C Hassel, Jalal K Siddiqui, Elizabeth A Brundage, Mark T Ziolo, Paul M L Janssen, Jonathan P Davis, Brandon J Biesiadecki
Troponin I (TnI) is a major regulator of cardiac muscle contraction and relaxation. During physiological and pathological stress, TnI is differentially phosphorylated at multiple residues through different signaling pathways to match cardiac function to demand. The combination of these TnI phosphorylations can exhibit an expected or unexpected functional integration, whereby the function of two phosphorylations are different than that predicted from the combined function of each individual phosphorylation alone...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/28011838/analysis-of-lead-placement-optimization-metrics-in-cardiac-resynchronization-therapy-with-computational-modelling
#20
Andrew Crozier, Bojan Blazevic, Pablo Lamata, Gernot Plank, Matthew Ginks, Simon Duckett, Manav Sohal, Anoop Shetty, Christopher A Rinaldi, Reza Razavi, Steven A Niederer, Nicolas P Smith
AIMS: The efficacy of cardiac resynchronization therapy (CRT) is known to vary considerably with pacing location, however the most effective set of metrics by which to select the optimal pacing site is not yet well understood. Computational modelling offers a powerful methodology to comprehensively test the effect of pacing location in silico and investigate how to best optimize therapy using clinically available metrics for the individual patient. METHODS AND RESULTS: Personalized computational models of cardiac electromechanics were used to perform an in silico left ventricle (LV) pacing site optimization study as part of biventricular CRT in three patient cases...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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