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https://www.readbyqxmd.com/read/28760474/impact-of-postoperative-liver-dysfunction-on-survival-after-left-ventricular-assist-device-implantation
#1
Kaustav Majumder, John R Spratt, Christopher T Holley, Samit S Roy, Rebecca J Cogswell, Kenneth Liao, Ranjit John
BACKGROUND: Liver dysfunction in left ventricular assist device (LVAD) recipients is common both before and after implantation. Postoperative liver dysfunction (PLD) develops in some LVAD recipients without preoperative liver dysfunction. The aim of this study was to assess clinical outcomes in such patients. METHODS: Records of all patients undergoing implantation of a HeartMate II (HM II, St. Jude Medical, Inc, Minneapolis, MN) LVAD at a single center at the University of Minnesota from January 2005 through June 2014 were analyzed...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760470/improved-approach-with-subcostal-exchange-of-the-heartmate-ii-left-ventricular-assist-device-difference-in-on-and-off-pump
#2
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Emily Phillips, Joyce Wald, Matthew L Williams, David W Low, Michael A Acker, Pavan Atluri
BACKGROUND: The HeartMate II (St. Jude Medical, Inc, St. Paul, MN [previously Thoratec]) left ventricular assist device (LVAD) exchange has traditionally involved a redo sternotomy. Alternate minimally invasive subcostal approaches have the advantage of avoiding sternal reentry, excessive bleeding, and prolonged recovery. METHODS: This retrospective review included patients who underwent an exchange from May 2009 to March 2016. The patients were divided into three cohorts: (1) redo sternotomy, (2) subcostal approach involving cardiopulmonary bypass (CPB) (ON-CPB SC), and (3) subcostal approach off the CPB pump (OFF-CPB SC)...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28757150/temporal-differences-in-outcomes-during-long-term-mechanical-circulatory-support
#3
Simon Maltais, Lucman A Anwer, Nicholas A Haglund, Jennifer Cowger, Palak Shah, Keith D Aaronson, Francis D Pagani, Shannon M Dunlay, Ramesh Singh, Christopher T Salerno, John M Stulak
BACKGROUND: Device indications have changed for placement of continuous-flow left ventricular assist devices (CF-LVADs). We performed a multicenter analysis evaluating temporal variations in outcomes after CF-LVAD implantation. METHODS & RESULTS: We retrospectively defined three time intervals to reflect changes in CF-LVAD technology (Period 1: 2004 to 2009; Period 2: 2010 to 2012; and Period 3: 2012 to 2014). A total of 1,064 patients (HeartMate II (HMII)=835, HeartWare (HVAD)=229) underwent CF-LVAD implantation between May 2004 and October 2014...
July 27, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28746083/novel-cardiac-coordinate-modeling-system-for-three-dimensional-quantification-of-inflow-cannula-malposition-of-heartmate-ii-lvads
#4
Brian Lima, Onur Dur, Joyce Chuang, Themistokles Chamogeorgakis, David J Farrar, Kartik S Sundareswaran, Joost Felius, Susan M Joseph, Shelley A Hall, Gonzalo V Gonzalez-Stawinski
Optimal function of left ventricular assist devices (LVADs) depends on proper alignment of the inflow cannula (IC). Quantitative guidelines for IC angulation are lacking because of variation in cardiac geometry and difficulty in analyzing three-dimensional (3D) cannula orientation relative to the left ventricle (LV). Based on contrast-enhanced computed tomography images from five normal and five clinically malpositioned IC cases in patients with HeartMate II LVADs, we developed a method for 3D quantification of IC malpositioning...
July 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28674109/left-ventricular-assist-device-malfunctions-it-s-more-than-just-the-pump
#5
Robert L Kormos, Michael McCall, Andrew D Althouse, Lagazzi Luigi, Richard D Schaub, Michael A Kormos, Jared A Zaldonis, Christopher M Sciortino, Kathleen L Lockard, Nicole M Kuntz, Elizabeth M Dunn, Jeffrey J Teuteberg
Background -Reports of left ventricular assist device (LVAD) malfunction have focused on pump thrombosis. However, the device consists of the pump, driveline and peripherals, all of which are potentially subject to failure. Methods -Prospectively collected data were reviewed for all LVAD device malfunctions (DM) occurring in rotary LVADs implanted at a single center between April 2004 and May 2016. Durable LVADs included 108 Heartmate II (HMII) and 105 HeartWare ventricular assist devices (HVAD). DM data were categorized according to device type and into categories related to the component that failed: a) controller, b) peripheral components and c) the implantable blood pump or its integral electrical driveline...
July 3, 2017: Circulation
https://www.readbyqxmd.com/read/28673108/melody-transcatheter-pulmonary-valve-placement-in-a-heartmate-ii-patient
#6
Tabitha G Moe, Linda Staley, Joseph N Graziano
Transcatheter pulmonary valve placement is emerging as a standard therapy for dysfunctional right ventricular outflow tract conduits. The Melody transcatheter pulmonary valve is indicated for use in the management of pediatric and adult patients with right ventricular outflow tract conduits measuring at least 16 mm in diameter. This is the first reported case of placement in a patient with a left ventricular assist device. We outline the preprocedural evaluation process, the procedural methods, and the outcomes of a successful implantation in a complex patient...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28665827/cessation-of-continuous-flow-left-ventricular-assist-device-related-gastrointestinal-bleeding-after-heart-transplantation
#7
Snehal R Patel, Kyung Taek Oh, Tolulope Ogriki, Daniel Sims, J Julia Shin, Shivank Madan, Omar Saeed, Daniel J Goldstein, Ulrich P Jorde
Gastrointestinal bleeding (GIB) is a major complication of continuous flow left ventricular assist device (CF LVAD) therapy. The precise pathophysiology of CF LVAD-related bleeding remains poorly understood, and the effect of pump removal at the time of transplantation on actual bleeding frequency has not previously been studied. A single-center retrospective review was conducted on patients who received CF LVAD and subsequently developed GIB. Baseline demographics and markers of pulsatility (aortic valve opening and the HeartMate II [HM2] pulse index) were compared between those with and without GIB...
June 28, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28665826/unrecognized-left-heart-failure-in-lvad-recipients-the-role-of-routine-invasive-hemodynamic-testing
#8
Palak Shah, Nina Badoe, Sheila Phillips, Kamil Abdullah, Christopher W May, Jose L Nabut, Ramesh Singh, Christopher deFilippi, Shashank S Desai
The role of routine right heart catheterizations (RHCs) in left ventricular assist device (LVAD) patients is undefined. We analyzed 105 continuous-flow LVAD recipients who underwent an RHC approximately 3 months after implant. In 38 patients, LVAD speed was ramped with the goal of optimizing hemodynamics. Our cohort consisted of 71 (68%) HeartMate II (HMII) and 34 (32%) HeartWare (HVAD) patients. Thirty patients (29%) had either a reduced cardiac index (CI ≤ 2.2 L/min/m), elevated pulmonary capillary wedge pressure (PCWP > 18 mm Hg), or both...
June 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28651783/optimal-timing-of-heart-transplant-after-heartmate-ii-left-ventricular-assist-device-implantation
#9
Robert J Steffen, Eugene H Blackstone, Nicholas G Smedira, Edward G Soltesz, Katherine J Hoercher, Lucy Thuita, Randall C Starling, Maria Mountis, Nader Moazami
BACKGROUND: Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. METHODS: A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up...
June 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28651485/intraoperative-left-atrium-inversion-after-implantation-of-heartmate-iii-ventricular-assist-device
#10
Ayşegül Ozgök, Z Asli Demir, Gökçe Sert, Doğan Sert, Zehra Gölbaşı, Umit Kervan
We report here a case of left atrium inversion after implanting HeartMate III LVAD, which is known to be the first in literature. LVAD can be functional only if there is adequate inflow to the device. Parameters and filling of left ventricle can be assessed by TEE. In our case, initial examination with TEE showed thrombus like images. HeartMate III has a reliable algorithm that automatically reduces pump speed if 'suction effect' is detected. HeartMate III demonstrates clean flow properties and good surface wash...
June 27, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28643335/a-review-of-hemolysis-prediction-models-for-computational-fluid-dynamics
#11
REVIEW
Hai Yu, Sebastian Engel, Gábor Janiga, Dominique Thévenin
Flow-induced hemolysis is a crucial issue for many biomedical applications; in particular, it is an essential issue for the development of blood-transporting devices such as left ventricular assist devices, and other types of blood pumps. In order to estimate red blood cell (RBC) damage in blood flows, many models have been proposed in the past. Most models have been validated by their respective authors. However, the accuracy and the validity range of these models remains unclear. In this work, the most established hemolysis models compatible with computational fluid dynamics of full-scale devices are described and assessed by comparing two selected reference experiments: a simple rheometric flow and a more complex hemodialytic flow through a needle...
June 23, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28621882/exercise-capacity-and-functional-performance-in-heart-failure-patients-supported-by-a-left-ventricular-assist-device-at-discharge-from-inpatient-rehabilitation
#12
Thomas Schmidt, Birna Bjarnason-Wehrens, Petra Bartsch, Ezin Deniz, Jan Schmitto, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Adequate physical and functional performance is an important prerequisite for renewed participation and integration in self-determined private and (where appropriate) professional lives following left ventricular assist device (LVAD) implantation. During cardiac rehabilitation (CR), individually adapted exercise programs aim to increase exercise capacity and functional performance. A retrospective analysis of cardiopulmonary exercise capacity and functional performance in LVAD patients at discharge from a cardiac rehabilitation program was conducted...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28621461/the-use-of-eptifibatide-alone-or-in-combination-with-heparin-or-argatroban-for-suspected-thrombosis-in-patients-with-left-ventricular-assist-devices
#13
Abbas Bitar, Rajakrishnan Vijayakrishnan, Andrew Lenneman, Emma Birks, Todd Massey, Mark Slaughter, Dmitry Abramov
Pump thrombosis and hemolysis in patients with left ventricular assist devices (LVADs) are associated with significant morbidity and mortality. Intensification of anticoagulation has been suggested as potential therapy, with mixed results. The aim of this study is to assess the safety and efficacy of adding eptifibatide with or without an anticoagulation agent in managing patients with LVAD presenting with hemolysis and suspected pump thrombosis. This retrospective single center study included all patients who presented with their first episode of suspected pump thrombosis and were treated with eptifibatide with or without an anticoagulant between March 1, 2011 and July 30, 2015...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28616308/heartmate-3-a-step-in-the-right-direction
#14
EDITORIAL
Juglans Alvarez, Vivek Rao
No abstract text is available yet for this article.
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28601303/device-specific-evaluation-of-intraventricular-left-ventricular-assist-device-position-by-quantitative-coaxiality-analysis
#15
Amedeo Anselmi, Sophie Collin, Pascal Haigron, Jean-Philippe Verhoye, Erwan Flecher
BACKGROUND: Patient-specific anatomy may influence the final intraventricular positioning of inflow cannula in left ventricular assist device (LVAD) recipients. An association exists between such positioning and clinical outcomes (specifically, orientation toward the interventricular septum has negative prognostic implications). Alternative commercially available LVADs are characterized by markedly different design, with potential consequences on intrathoracic fitting among individual patients...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28562236/left-ventricular-assist-device-exchange-the-toronto-general-hospital-experience
#16
Hideki Tsubota, Roberto V P Ribeiro, Filio Billia, Robert J Cusimano, Terrence M Yau, Mitesh V Badiwala, William E Stansfield, Vivek Rao
BACKGROUND: As support times for left ventricular assist devices (LVADs) become longer, several complications requiring device exchange may occur. To our knowledge, this is the first Canadian report regarding implantable LVAD exchange. METHODS: We retrospectively reviewed the cases of consecutive, unique patients implanted with an LVAD between June 2006 and October 2015 at Toronto General Hospital. RESULTS: In total, 122 patients were impanted with an LVAD during the study period...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28557861/heartmate-3-in-lowest-intermacs-profile-cohort-the-swiss-experience
#17
Piergiorgio Tozzi, Carlo Banfi, Kameran Ahmadov, Roger Hullin, Philippe Meyer, Raphael Giraud, Lucas Liaudet, Fabrizio Gronchi, Christophe Huber, Matthias Kirsch
New generation devices for long-term mechanical circulatory support are centrifugal pumps having fully magnetically levitated rotors to reduce blood trauma. Recently, the novel HeartMate 3 was cleared for clinical application in Switzerland. In two Swiss University Hospitals part of the "Lausanne-Geneva Transplantation Network," 10 consecutive patients in end-stage heart failure received the HeartMate 3. Device implantation criteria were persistent low output syndrome despite optimal medical treatment. The primary end-point of the study was survival or transplantation to 90 days on the device...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28546755/pediatric-ventricular-assist-devices-current-challenges-and-future-prospects
#18
REVIEW
Sarah Burki, Iki Adachi
The field of mechanical circulatory support has made great strides in the preceding 2 decades. Although pediatric mechanical circulatory support has lagged behind that of adults, the gap between them is expected to close soon. The only device currently approved by the US Food and Drug Administration for use in children is the Berlin Heart EXCOR ventricular assist device (VAD). The prospective Berlin Heart Investigational Device Exemption Trial demonstrated good outcomes, such as bridge to transplantation or recovery, in ~90% of children supported with this device...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28500612/electric-smog-telemetry-interference-between-icd-and-lvad
#19
REVIEW
David Duncker, Thorben König, Johanna Müller-Leisse, Roman Michalski, Hanno Oswald, Jan D Schmitto, Johann Bauersachs, Christian Veltmann
Electromagnetic interferences between implantable cardioverter/defibrillators (ICD) and left ventricular assist devices (LVAD) impacting telemetry have been described in previous generations of ICD as well as LVAD, but have been predominantly overcome in current ICD generations. After introduction of a new fully magnetically levitated centrifugal continuous-flow circulatory pump, we report a case of tenacious telemetry interference between the HeartMate 3 LVAD and an ICD after battery exchange to an Iforia 5...
May 12, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28488003/daily-transient-discontinuation-of-extracorporeal-lvad-to-prevent-thromboembolism-of-mechanical-aortic-valve-prosthesis
#20
Takamichi Inoue, Tadashi Kitamura, Shinzo Torii, Mitsuhiro Hirata, Toshiaki Mishima, Koichi Sughimoto, Hirotoki Ohkubo, Kensuke Kobayashi, Mamika Motokawa, Miyuki Shibata, Takuya Matsushiro, Yuta Tsuchida, Yurie Miyata, Minoru Ono, Kagami Miyaji
Patients with mechanical aortic valves are generally contraindicated for left ventricular assist device (LVAD) insertion because the prosthetic valve often becomes fixed in closed position. A 41-year-old woman with mechanical aortic valve prosthesis experienced sudden chest pain and developed cardiogenic shock. A paracorporeal pulsatile LVAD and a monopivot centrifugal pump as a right VAD (RVAD) were implanted. The mechanical aortic valve was intentionally left in place. Soon after the operation, LVAD support was discontinued daily for few seconds to allow the mechanical aortic valve to open and to avoid thrombus formation...
May 9, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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