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https://www.readbyqxmd.com/read/29626453/meld-xi-scoring-system-to-predict-outcomes-in-patients-who-undergo-lvad-implantation
#1
Andre Critsinelis, Chitaru Kurihara, Nastasya Volkovicher, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Suwei Wang, Andrew B Civitello, Jeffrey A Morgan
BACKGROUND: The use of continuous flow left ventricular assist devices (CF-LVAD) to treat advanced heart failure is increasing. While risk score such as MELD and the HeartMate II Risk Score require the use of INR, many patients are on anticoagulation prior to CF-LVAD implantation. The aim of this study was to evaluate the ability of the Model of End-Stage Liver Disease-eXcluding INR (MELD-XI) scoring system to predict clinical outcomes in patients with advanced heart failure who undergo CF-LVAD implantation...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29567308/ventricular-flow-dynamics-with-varying-lvad-inflow-cannula-lengths-in-silico-evaluation-in-a-multiscale-model
#2
Sam Liao, Michael Neidlin, Zhiyong Li, Benjamin Simpson, Shaun D Gregory
Left ventricular assist devices are associated with thromboembolic events, which are potentially caused by altered intraventricular flow. Due to patient variability, differences in apical wall thickness affects cannula insertion lengths, potentially promoting unfavourable intraventricular flow patterns which are thought to be correlated to the risk of thrombosis. This study aimed to present a 3D multiscale computational fluid dynamic model of the left ventricle (LV) developed using a commercial software, Ansys, and evaluate the risk of thrombosis with varying inflow cannula insertion lengths in a severely dilated LV...
March 10, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29558840/symptoms-of-massive-cardiac-tamponade-during-support-of-biventricular-assist-device
#3
Mosab Al Shakaki, Angelo M Dell'Aquila, Andreas Rukosujew
Typical symptoms of cardiac tamponade are jugular venous distension, pulsus paradoxus, hypotension, and rest dyspnea. However, these clinical symptoms can be masked in patients with ventricular assist device and even more in patients supported with a biventricular-HeartWare ventricular assist device. Hereby, we report the case of a 30-year-old man supported with a biventricular-HeartWare ventricular assist device, who underwent a computed tomography scan due to suspect of ventricular assist device thrombosis...
March 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29554252/left-ventricular-assist-device-implantation-with-left-lateral-thoracotomy-with-anastomosis-to-the-descending-aorta
#4
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/29551744/world-wide-experience-of-a-durable-centrifugal-flow-pump-in-pediatric-patients
#5
J Conway, O Miera, I Adachi, K Maeda, P Eghtesady, H T Henderson, K Guleserian, C-P S Fan, R Kirk
OBJECTIVES: The primary objectives of this study were to describe the characteristics and survival outcomes for children supported with the HeartWare HVAD® system from the global community. METHODS: This was a retrospective survey of patients <18 years with a HVAD® system. Questionnaires were sent to sites across the world in April 2015 and collected between May 2015-16. Information on 205 patients was collected. RESULTS: The median age of implant was 13...
March 15, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29550313/noninvasive-assessment-of-hemodynamic-status-in-heartware-left-ventricular-assist-device-patients-validation-of-an-echocardiographic-approach
#6
Simone Frea, Paolo Centofanti, Stefano Pidello, Francesca Giordana, Virginia Bovolo, Andrea Baronetto, Beatrice Franco, Marco Matteo Cingolani, Matteo Attisani, Mara Morello, Serena Bergerone, Mauro Rinaldi, Fiorenzo Gaita
OBJECTIVES: The aim of this prospective study was to validate an echocardiographic protocol derived from 5 HeartWare left ventricular assist device (HVAD) patients for the noninvasive evaluation of right atrial pressure (RAP) and left atrial pressure (LAP) in HVAD patients. BACKGROUND: Echocardiography is an invaluable tool to optimize medical treatment and pump settings and also for troubleshooting residual heart failure. Little is known about the echocardiographic evaluation of hemodynamic status in HVAD patients...
March 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29538016/noninvasive-blood-pressure-monitor-designed-for-patients-with-heart-failure-supported-with-continuous-flow-left-ventricular-assist-devices
#7
Pavol Sajgalik, Vaclav Kremen, Vratislav Fabian, Simon Maltais, John M Stulak, Sudhir S Kushwaha, Lyle D Joyce, John A Schirger, Bruce D Johnson
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare)...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29530775/construction-of-an-apical-plug-for-explantation-of-heartware-hvad-left-ventricular-assist-device
#8
Shawn M Shah, Nicholas R Teman, Eileen Dearth, Leora T Yarboro, John A Kern
Utilization of a left ventricular assist device (LVAD) as a bridge to myocardial recovery is an established therapy for acute systolic heart failure. However, device removal can present a technical challenge with no clear consensus on preferred method. In this case report, we describe a complex patient who underwent successful explantation of an LVAD using an intraoperatively constructed apical plug. This method utilizes inexpensive and easily accessible materials, minimizes ventricular distortion during device removal, and preserves the ventricular sewing ring for future reimplantation...
March 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29501323/antithrombotic-therapies-in-children-on-durable-ventricular-assist-devices-a-literature-review
#9
Joanna Y Huang, Paul Monagle, M Patricia Massicotte, Christina J VanderPluym
INTRODUCTION: Ventricular Assist Devices (VADs) are increasingly utilised in children with end-stage heart failure, and experience high bleeding and clotting rates. In particular, pediatric VAD patients are more challenging than adults to anticoagulate due to developmental hemostasis, lack of suitable drug preparations, and difficult anticoagulation monitoring often due to poor vascular access; in addition to difficulties of VAD design in smaller children. This review aims to summarize the current evidence related to antithrombotic therapy in pediatric VAD patients...
February 28, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29492386/role-of-paediatric-assist-device-in-bridge-to-transplant
#10
Roland Hetzer, Mariano Francisco Del Maria Javier, Eva Maria Delmo Walter
Background: While heart transplantation has gained recognition as the gold standard therapy for advanced heart failure, the scarcity of donor organs has become an important concern. The evolution of surgical alternatives such as ventricular assist devices (VADs), allow for recovery of the myocardium and ensure patient survival until heart transplantation becomes possible. This report elaborates the role of VADs as a bridge to heart transplantation in infants and children (≤18 years old) with end-stage heart failure...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29485426/the-use-of-computed-tomography-in-preoperative-planning-for-heartware-left-ventricular-assist-device-placement
#11
Deepak Acharya, Sudeep Aryal, Renzo Loyaga-Rendon, Salpy V Pamboukian, Jose Tallaj, James K Kirklin, William L Holman, Satinder Singh
Optimal left ventricular assist device (LVAD) cannula position is important for adequate ventricular unloading and LVAD function. Poor inflow cannula position predisposes to pump thrombosis, inotrope dependence, and mortality. We describe a novel technique of preoperative left ventricular apex marking using CT guidance and demonstrate in three cases the use of this method to achieve optimal inflow cannula positioning for lateral thoracotomy Heartware LVAD implantation.
February 24, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29485425/effect-of-preoperative-atrial-fibrillation-on-patients-with-chronic-heart-failure-who-undergo-long-term-continuous-flow-lvad-implantation
#12
Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Although preoperative atrial fibrillation (AF) is common in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation, how AF affects outcomes remains unclear. We analyzed our single-center experience with CF-LVAD implantation to determine whether preoperative AF was associated with inferior outcomes. From November 2003 through March 2016, 526 patients with chronic heart failure underwent implantation with the HeartMate II (HMII; n = 403) or HeartWare VAD (HVAD; n = 123). We identified 229 patients (165 HMII, 65 HVAD) who had preoperative AF and compared them with non-preoperative AF patients regarding the incidence of postoperative stroke, as well as long-term survival...
February 24, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29473181/bridging-to-a-long-term-ventricular-assist-device-with-short-term-mechanical-circulatory-support
#13
Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Andre C Critsinelis, Suwei Wang, William E Cohn, Andrew B Civitello, O H Frazier, Jeffrey A Morgan
Implanting short-term mechanical circulatory support (MCS) devices as a bridge-to-decision is increasingly popular. However, outcomes have not been well studied in patients who receive short-term MCS before receiving long-term left ventricular assist device (LVAD) support. We analyzed outcomes in our single-center experience with long-term continuous-flow (CF)-LVAD recipients with pre-implantation short-term MCS. From November 2003 through March 2016, 526 patients (mean age, 54.7 ± 13.5 years) with chronic heart failure (mean ejection fraction, 21...
February 23, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29461279/individualized-antithrombotic-therapy-in-heartware-hvad-recipients
#14
Erik N Sorensen, Hannah J Voorhees, Lynn M Dees, Si M Pham, Zachary N Kon, Bartley P Griffith, Erika D Feller
There are no evidence-based guidelines for antithrombotic therapy in left ventricular assist device patients. We evaluated the efficacy of a multi-agent, test-guided protocol, which remained consistent throughout our use of the Heartware HVAD. Thrombelastography and PFA-100 guide antiplatelet titration. Goals are normal kaolin thrombelastography maximum amplitude and prolonged PFA-100. We analyzed incidence and rates of nonprocedural bleeding, stroke, and pump thrombosis for all 81 primary Heartware left ventricular assist devices implanted since 2011...
February 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29436010/changes-in-total-cardiac-output-and-oxygen-extraction-during-exercise-in-patients-supported-with-an-hvad-left-ventricular-assist-device
#15
Thomas Schmidt, Birna Bjarnason-Wehrens, Stephanie Mommertz, Meike Hannig, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO 2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO 2 ). We investigated the changes in CO and avDO 2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29436002/peripheral-artery-disease-and-continuous-flow-left-ventricle-assist-device-an-engaging-complement-analysis-may-help-to-guide-treatment
#16
Calogero Falletta, Salvatore Pasta, Giuseppe Maria Raffa, Francesca Crinò, Sergio Sciacca, Francesco Clemenza
Use of continuous flow left ventricle assist device (CF-LVAD) in advanced heart failure (HF) patients results in clinically relevant improvements in survival, functional capacity, and quality of life. Peripheral artery disease (PAD) can occur in patients with CF-LVAD due to the high rate of concomitance between risk factors for atherosclerosis and HF. Diagnosis of PAD can be difficult in the specific setting of a patient supported by this kind of device because of the marked alteration in waveform morphology and velocity created by the artificial physiology of an LVAD...
February 13, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29433532/is-there-a-difference-in-bleeding-after-left-ventricular-assist-device-implant-centrifugal-versus-axial
#17
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29394347/prognostic-value-of-3-dimensional-echocardiographical-heart-volume-assessment-in-patients-scheduled-for-left-ventricular-assist-device-implantation
#18
Albert Otten, Stephan Kurz, Sibtain Anwar, Jevgenij Potapov, Christian Krall, Benjamin O'Brien, Helmut Habazettl, Thomas Krabatsch, Marian Kukucka
OBJECTIVES: Left ventricular assist device (LVAD) support is an increasingly important and successful therapeutic option for patients with end-stage heart failure. As chronic heart failure progresses, the left and right ventricles adapt by enlarging its volume and patients present for LVAD implantation with varying degrees of dilatation. By quantitatively assessing right ventricular (RV) and left ventricular (LV) volumes using 3D transoesophageal echocardiography and correlating the findings with clinical outcomes, we aim to investigate the prognostic value of LV and RV volumes for early survival after LVAD implantation...
January 30, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29373336/competing-flow-between-partial-circulatory-support-and-native-cardiac-output-a-clinical-computational-fluid-dynamics-study
#19
Jennifer Engelke, Christof Karmonik, Fabian Rengier, Sasan Partovi, Aron-Frederik Popov, Anja Osswald, Rawa Arif, Bastian Schmack, Philip Raake, André R Simon, Andreas Doesch, Alexander Weymann, Joachim Lotz, Matthias Karck, Arjang Ruhparwar
Partial circulatory support is a promising concept for the treatment of heart failure patients. A better understanding of induced hemodynamic changes is essential for optimizing treatment efficacy. Computational fluid dynamics (CFD) is an alternative method to gain insight into flow phenomena difficult to obtain in vivo. In 10 patients implanted with a Circulite Synergy Micro-pump (HeartWare) (a continuous flow partial circulatory assist device connecting the left atrium to the right subclavian artery), transient CFD simulations were performed...
October 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29372417/effect-of-obesity-on-outcomes-in-patients-undergoing-implantation-of-continuous-flow-left-ventricular-assist-devices
#20
Nastasya Volkovicher, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Andrew B Civitello, Jeffrey A Morgan
The purpose of this study was to analyze the effect of obesity on outcomes after continuous-flow left ventricular assist device (CF-LVAD) implantation. A single-center retrospective analysis was performed on 526 chronic heart failure patients who were implanted with the HeartMate II CF-LVAD (n = 403) or HeartWare HVAD (n = 123) between November 2003 and March 2016. Patients were stratified into 4 groups based on BMI: underweight (< 18.5 kg/m2, n = 18, 3.4%), normal-weight (18.5-25 kg/m2, n = 173, 32...
January 25, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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