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https://www.readbyqxmd.com/read/28097728/dabigatran-etexilate-in-a-vitamin-k-antagonist-non-responder-patient-during-heartware-hvad-support
#1
Andrea Baronetto, Paolo Centofanti, Matteo Attisani, Massimo Boffini, Davide Ricci, Erika Simonato, Mauro Rinaldi
We report a case of a patient supported with a HeartWare left ventricular assist device for idiopathic cardiomyopathy who was resistance to vitamin-K antagonists three months after implantation. The patient initially started low-molecular-weight heparin therapy and then, after the onset of an ischemic stroke, switched to dabigatran etexilate (DE). The patient had progressive recovery of cardiac function for which the device was explanted. No thrombotic or bleeding events occurred during DE therapy.
January 17, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28093805/heartware-ventricular-assist-device-implantation-in-patients-with-fontan-physiology
#2
Bartlomiej R Imielski, Robert A Niebler, Steven J Kindel, Ronald K Woods
We aim to describe the clinical course of a series of patients with hypoplastic left heart syndrome and refractory systolic heart failure supported with a HeartWare ventricular assist device (HVAD) following Fontan palliation. This is a retrospective review of three consecutive patients supported with a HVAD following Fontan palliation through February 2016. Data include patient characteristics, operative variables, postimplantation hemodynamic/device parameters, event outcomes, and duration of HVAD support...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28058699/international-coordinator-survey-results-on-the-outpatient-management-of-patients-with-the-heartware%C3%A2-ventricular-assist-system
#3
Thomas Schlöglhofer, Desiree Robson, Jayne Bancroft, Gro Sørensen, Friedrich Kaufmann, Leslie Sweet, Neil Wrightson
PURPOSE: While the HeartWare® Ventricular Assist System (HVAS) is a successful therapy for end-stage heart failure, outpatient management methods can vary significantly and require further investigation. METHODS: A survey to assess the long-term HVAS patient management and monitoring strategies was completed by 36 international heart centers that currently have over 1,450 patients on VAD support either at home or in the hospital. Multiple choice questions examined VAD program characteristics, anticoagulation management, driveline exit-site dressing and showering recommendations, blood pressure and pump parameter monitoring, and patient discharge protocols...
December 26, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28033184/effect-of-outflow-graft-size-on-flow-in-the-aortic-arch-and-cerebral-blood-flow-in-continuous-flow-pumps-possible-relevance-to-strokes
#4
Sindhoor Bhat, Jayakala Mathews, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is a stroke, with a higher incidence in Heartware HVAD as compared to HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Since outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates.A Computational fluid structure interaction model was created from the CT scan of a patient. Pressures were used as the boundary condition and the flow through the cerebral vessels was derived as outputs...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28029573/mechanical-circulatory-support-and-heart-transplantation-in-the-asia-pacific-region
#5
EDITORIAL
Cumaraswamy Sivathasan, Choon Pin Lim, Ka Lee Kerk, David K L Sim, Mandeep R Mehra
Globalization has resulted in epidemiologic transition in developing countries from infectious disease and nutritional deficiencies to non-communicable diseases. Epidemiologic data on heart failure (HF), particularly advanced HF therapy, in Asia are increasingly becoming available, although they remain sparse. Heart transplantation for advanced stage HF remains very low in Asia-approximately 0.075 heart transplants per 1 million population. North America, which comprises 7.5% of the world population, accounted for 55...
September 29, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27899134/a-modified-park-s-stitch-to-correct-aortic-insufficiency-for-bioprosthetic-valve-at-time-of-left-ventricular-assist-device-implant-a-case-report
#6
Toshinobu Kazui, Nicole Sydow, Mark Friedman, Samuel Kim, Scott Lick, Zain Khalpey
BACKGROUND: Aortic valve insufficiency (AI) at the time of left ventricular assist device (LVAD) insertion needs to be corrected, however there is little known about how to manage bioprosthetic valvular AI. CASE PRESENTATION: A 55-year-old female with dilated cardiomyopathy who previously had a bioprosthetic aortic valve replacement needed a LVAD as a bridge to transplant. Her left ventricular ejection fraction was 10% and had mild to moderate transvalvular AI. She underwent a HeartWare HVAD insertion along with aortic valvular coaptation stitch repair (Park's stitch) to the bioprosthetic valve...
November 30, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27873344/impact-of-residual-mitral-regurgitation-on-right-ventricular-systolic-function-after-left-ventricular-assist-device-implantation
#7
Serkan Ertugay, Hatice S Kemal, Umit Kahraman, Catagay Engin, Sanem Nalbantgil, Tahir Yagdi, Mustafa Ozbaran
Significant mitral regurgitation (MR) is thought to decrease after left ventricular assist device (LVAD) implantation, and therefore repair of mitral valve is not indicated in current practice. However, residual moderate and severe MR leads to pulmonary artery pressure increase, thereby resulting in right ventricular (RV) dysfunction during follow-up. We examined the impact of residual MR on systolic function of the right ventricle by echocardiography after LVAD implantation. This study included 90 patients (mean age: 51...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27863356/left-ventricular-assist-devices-and-gastrointestinal-evaluation-results-of-a-consecutive-case-series
#8
Sultan Alotaibi, Raimund Erbel, Till Neumann
AIMS: To evaluate the benefit of preoperative gastrointestinal endoscopic evaluation in patients undergoing continuous flow left ventricular assist devices (CF-LVADs) implantation. METHODS AND RESULTS: A retrospective review of all fifty-three patients undergoing CF-LVADs at West-German Heart and Vascular Center, University of Duisburg-Essen was performed. A routine preoperative esophagogastroduodenoscopy was performed in seven patients to assess gastrointestinal (GI) bleeding...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27862075/minimally-invasive-implantation-of-heartware-assist-device-and-simultaneous-tricuspid-valve-reconstruction-through-partial-upper-sternotomy
#9
Julia Hillebrand, Andreas Hoffmeier, Tonny Djie Tiong Tjan, Juergen R Sindermann, Christoph Schmidt, Sven Martens, Mirela Scherer
Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27794072/off-pump-left-ventricular-assist-device-exchange-via-re-do-left-mini-thoracotomy-with-original-outflow-graft-preservation
#10
Jessika Iwanski, Phat L Tran, Catherine Jerman, Richard Smith, Toshinobu Kazui, Zain Khalpey
Complications associated with long-term left ventricular assist device (LVAD) use may require pump exchange due to device thrombosis or thromboembolism. Minimally invasive off-pump procedures represent an advantageous alternative to standard full sternotomy exchanges and those performed with the use of cardiopulmonary bypass. By mitigating surgical invasion and trauma to the central chest, the potential for post-operative bleeding, transfusions and complications can be reduced. This case report describes the successful off-pump exchange of a HeartWare LVAD via left re-do-thoracotomy with the re-use of the original outflow graft...
October 27, 2016: Perfusion
https://www.readbyqxmd.com/read/27776988/impact-of-aortic-valve-closure-on-adverse-events-and-outcomes-with-the-heartware-ventricular-assist-device
#11
David Dobarro, Marian Urban, Karen Booth, Neil Wrightson, Javier Castrodeza, Jerome Jungschleger, Nicola Robinson-Smith, Andrew Woods, Gareth Parry, Stephan Schueler, Guy A MacGowan
BACKGROUND: This study examined whether aortic valve opening (AVO) and other echocardiographic parameters influence outcomes in patients on left ventricular (LV) assist device (LVAD) support. Pump thrombosis (PT) and ischemic stroke (IS) are known complications of LVAD, but mechanisms that could influence them are not completely understood. METHODS: This was a retrospective analysis of 147 patients who received a HeartWare Ventricular Assist Device ( HeartWare International) as a bridge to transplant or to candidacy between July 2009 and August 2015, of whom 126 had at least 30 days of follow-up before the first event (30-days-out cohort)...
August 18, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27774264/initial-3-year-outcomes-with-left-ventricular-assist-devices-in-a-country-with-a-nascent-heart-transplantation-program
#12
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/27765177/survival-after-orthotopic-heart-transplantation-in-patients-undergoing-bridge-to-transplantation-with-the-heartware-hvad-versus-the-heartmate-ii
#13
J Trent Magruder, Joshua C Grimm, Todd C Crawford, Ryan J Tedford, Stuart D Russell, Christopher M Sciortino, Glenn J R Whitman, Ashish S Shah
BACKGROUND: Our objective was to determine whether the choice of a HeartWare HVAD as opposed to a Heartmate II left ventricular assist device (HMII LVAD), impacts survival after heart transplantation after controlling for patient, donor, and center characteristics. METHODS: We queried the United Network for Organ Sharing (UNOS) database, which has recently made pretransplantation device duration available, for all adult patients undergoing bridge to transplantation (BTT) between January 2011 and March 2016...
October 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27749316/comparing-the-effectiveness-of-an-axial-and-a-centrifugal-left-ventricular-assist-device-in-ventricular-unloading
#14
David M Turer, Kelly L Koch, Todd M Koelling, Audrey H Wu, Francis D Pagani, Jonathan W Haft
Centrifugal (CFG) and axial flow (AX) left ventricular assist devices have different hydrodynamic properties that may impact the effectiveness of left ventricular unloading. We sought to determine whether patients implanted with the HeartWare HVAD (CFG) and HeartMate II (AX) had a similar degree of hemodynamic support by comparing parameters measured using echocardiography and right heart catheterization. Using our prospectively collected database, we identified 268 patients implanted with the AX and 93 with the CFG...
November 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27676411/short-term-experience-with-off-pump-versus-on-pump-implantation-of-the-heartware-left-ventricular-assist-device
#15
Igor D Gregoric, Rajko Radovancevic, Mehmet H Akay, Mateja K Jezovnik, Sriram Nathan, Manish Patel, Jayeshkumar A Patel, Elena Nedelcu, Nghia D Nguyen, Pranav Loyalka, Biswajit Kar
Implantation of left ventricular assist devices while avoiding cardiopulmonary bypass (CPB) may decrease bleeding and improve postoperative recovery. To understand the effectiveness of this approach, we reviewed the charts of 26 patients who underwent HeartWare left ventricular assist device (HVAD) implantation without use of CPB (off-CPB group) and 22 patients who had HVAD implanted with CPB (CPB group) with an emphasis on the 30 day postoperative period. Preoperatively, both groups had similar demographic, functional, and hemodynamic characteristics...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27660906/heat-generation-in-axial-and-centrifugal-flow-left-ventricular-assist-devices
#16
Gardner Yost, Christine Rachel Joseph, Thomas Royston, Antone Tatooles, Geetha Bhat
Despite increasing use of left ventricular assist devices (LVADs) as a surgical treatment for advanced heart failure in an era of improved outcomes with LVAD support, the mechanical interactions between these pumps and the cardiovascular system are not completely understood. We utilized an in vitro mock circulatory loop to analyze the heat production incurred by operation of an axial flow and centrifugal flow LVAD.A HeartMate II and a HeartWare HVAD were connected to an abbreviated flow loop and were implanted in a viscoelastic gel...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27660575/mechanical-circulatory-support-for-the-failing-heart-continuous-flow-left-ventricular-assist-devices
#17
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/27605222/evaluation-of-the-heartware-ventricular-assist-device-lavare-cycle-in-a-particle-image-velocimetry-model-and-in-clinical-practice
#18
Daniel Zimpfer, Martin Strueber, Philipp Aigner, Jan D Schmitto, Arnt E Fiane, Robert Larbalestier, Steven Tsui, Paul Jansz, Andre Simon, Stephan Schueler, Francesco Moscato, Heinrich Schima
OBJECTIVES: Ventricular blood stasis is a concern for continuous flow mechanical support devices and might contribute to the formation of thromboembolic events. The HeartWare® Ventricular Assist System (HVAD®) is equipped with the Lavare™ cycle that is a periodic speed modulation feature designed to alter flow patterns within the left ventricle and reduce areas of potential blood stasis. Here, we report in vitro and clinical findings on the effects of the Lavare cycle. METHODS: The effect of pump speed changes on the intraventricular flow field was examined with an in vitro particle image velocimetry model...
November 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27569964/thrombosis-in-continuous-flow-left-ventricular-assist-devices-our-clinical-experience-with-medical-and-surgical-management
#19
U Köksel, O Erbasan, Ö Bayezid, C Kemaloğlu, S Özçobanoğlu, I Gölbaşı, C Türkay
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVADs) such as the HeartMate II and HeartWare left ventricular assist device are important alternatives to heart transplantation. Thrombosis is a serious complication in both devices and we present our approach to treating thrombosis and analysis of predisposition factors. METHODS: Our center's CF-LVADs database was retrospectively reviewed for pump thrombosis between January 2011 and January 2015. The patients were grouped for pump thrombosis (n = 13) and nonpump thrombosis (n = 85)...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27569963/outcomes-and-readmissions-after-continuous-flow-left-ventricular-assist-device-heartmate-ii-versus-heartware-ventricular-assist-device
#20
O N Tuncer, C Kemaloğlu, O Erbasan, I Gölbaşı, C Türkay, Ö Bayezid
INTRODUCTION: Donor organ shortage is still a problem for heart transplantation. Only 10% of patients in waiting list undergo heart transplantation. Over the last 5 years, 2 different continuous flow pumps, the HeartMate II and the HeartWare, have been successful clinically in the alternative treatment of patients with end-stage heart disease. METHODS: Fifty-five patients underwent left ventricular assist device implantation between 2011 and 2014. Patients were followed on pump support for complications and intraoperative outcomes...
July 2016: Transplantation Proceedings
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