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https://www.readbyqxmd.com/read/29223289/frequency-and-consequences-of-right-sided-heart-failure-after-continuous-flow-left-ventricular-assist-device-implantation
#1
Chitaru Kurihara, Andre C Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Gabriel Loor, Andrew B Civitello, Jeffrey A Morgan
Postoperative right-sided heart failure (RHF) is a common complication after continuous-flow left ventricular assist device implantation. Studies have examined RHF in the perioperative period, but few have assessed late-onset RHF. We analyzed the incidence of early and late RHF in patients with HeartMate II and HeartWare left ventricular assist devices and associated morbidity, mortality, and independent predictors of RHF. We retrospectively analyzed records of 526 patients with chronic heart failure who underwent continuous-flow left ventricular assist device implantation; 147 (27...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29206805/axial-to-centrifugal-continuous-flow-lvad-pump-exchange-using-minimally-invasive-technique
#2
Amit A Pawale, Ariel Farkash, Dimosthenis Pandis, Anelechi C Anyanwu
Driveline or device infection may complicate left ventricular assist device implants, and only curative option may be pump exchange. Replacement with similar device may be liable to reinfection, because pump configuration is such that the new device and driveline may partly lie within the pocket of the previous pump. One approach to overcome this is using a different pump design such that the new pump would lie in a different location from the old pump. We describe treatment of severe HeartMate II (Abbott, [St Jude Thoratec Corp], Pleasanton, CA USA) left ventricular assist device infection by minimally invasive exchange to an intrapericardial HVAD (HeartWare International, Inc, Framingham, MA USA) left ventricular assist device...
December 4, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29197135/biventricular-support-with-heartware-ventricular-assist-device-in-a-pediatric-patient
#3
Shriprasad R Deshpande, Mallory M Carroll, Chad Mao, William T Mahle, Kirk Kanter
Use of ventricular assist devices is increasing in the pediatric population. This has included the extended use of adult continuous-flow devices in the pediatric population. In a minority of cases, biventricular support may be needed. In these situations, biventricular support with continuous-flow devices can be surgically challenging, and therefore, only few cases have been reported. Here, we present a case of implantation of two HeartWare HVAD devices for biventricular support for a decompensating patient with acute myocarditis as well as present an alternative implantation surgical strategy...
December 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29174532/acute-kidney-injury-and-1-year-mortality-after-left-ventricular-assist-device-implantation
#4
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Kavita Sharma, Nisha A Gilotra, Alina A Constantinescu, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Stuart D Russell, Olivier C Manintveld
BACKGROUND: Data on the consequences of acute kidney injury (AKI) after continuous-flow left ventricle assist device (LVAD) implantation are scarce and inconsistent. In this study, we evaluated the incidence, predictors and the impact of AKI on mortality and renal function in the first year after LVAD implantation. METHODS: A retrospective, multicenter cohort study was conducted, including all patients (age ≥18 years) undergoing LVAD implantation (91% with a HeartMate II device and 9% with a HeartWare device)...
November 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29165737/management-of-hemostasis-for-pediatric-patients-on-ventricular-assist-devices
#5
Iki Adachi, Vadim Kostousov, Lisa Hensch, Martin A Chacon-Portillo, Jun Teruya
Ventricular-assist devices (VADs) have seen increased utilization in the pediatric population. Formerly, this therapeutic modality was limited to only the pulsatile VAD, EXCOR (Berlin Heart GmbH). However, the continuous flow VAD devices, HeartMate II (Abbott Inc.) and HeartWare (Medtronic Inc.), are now increasingly used in this population. Postoperatively, VAD patients are acutely anticoagulated using unfractionated heparin, often beginning 24 to 48 hours after VAD placement. Once the patient is stabilized and ready to transition to a lower acuity or outpatient setting, low-molecular-weight heparin or warfarin therapy may be instituted...
November 17, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29141690/resternotomy-does-not-adversely-affect-outcome-after-left-ventricular-assist-device-implantation
#6
Maria Papathanasiou, Loukas Tsourelis, Nikolaus Pizanis, Achim Koch, Markus Kamler, Tienush Rassaf, Peter Luedike
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients...
November 15, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29095735/single-versus-multidrug-regimen-for-surgical-infection-prophylaxis-in-left-ventricular-assist-device-implantation
#7
Nana Aburjania, Brennan M Ertmer, Saira Farid, Melody Berg, Juhsien J C Nienaber, Vakhtang Tchantchaleishvili, John M Stulak, Muhammad R Sohail
Infection is a serious complication of left ventricular assist device (LVAD) therapy. However, an optimal antimicrobial surgical infection prophylaxis (SIP) regimen for LVAD implantation is not well established. We retrospectively reviewed all adults who underwent continuous-flow LVAD implantation from February 2007 to March 2015 at Mayo Clinic Rochester. Left ventricular assist device infection (LVADI) was defined using criteria published by the International Society for Heart and Lung Transplant. Patients excluded from the analysis included those who did not have HeartMate II or HeartWare device, patients with incomplete documentation of SIP, and those with an actively treated infection at the time of LVAD implantation...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29095733/left-lateral-thoracotomy-for-centrifugal-continuous-flow-left-ventricular-assist-device-placement-an-analysis-from-the-mechanical-circulatory-support-research-network
#8
Simon Maltais, Lucman A Anwer, Vakhtang Tchantchaleishvili, Nicholas A Haglund, Shannon M Dunlay, Keith D Aaronson, Francis D Pagani, Jennifer Cowger, Christopher T Salerno, Palak Shah, Zain Khalpey, Jan Schmitto, John M Stulak
Continuous-flow left ventricular assist devices (CF-LVADs) have revolutionized the management of patients with advanced heart failure. Alternative implant strategies are increasingly used for device placement. We reviewed our experience from the Mechanical Circulatory Support Research Network registry with the HeartWare centrifugal CF-LVAD (HVAD). From May 2004 to August 2015, 1,150 patients underwent primary CF-LVAD implantation at our institutions. Within this group, a total of 283 patients (25%) were implanted with the HVAD...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29059075/extracorporeal-membrane-oxygenation-berlin-and-ventricular-assist-devices-a-primer-for-the-cardiologist
#9
Charlotte S Van Dorn, Devon O Aganga, Jonathan N Johnson
PURPOSE OF REVIEW: Mechanical circulatory support (MCS) has become an indispensable tool in the management of children with impending respiratory and cardiac failure. Though extracorporeal membrane oxygenation (ECMO) was classically the only form of support available to pediatric patients, considerable advances have allowed ventricular assist devices (VADs) to become increasingly utilized in children. This review provides an update of recent advances in ECMO and VAD management in children...
October 20, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29056459/low-flow-support-of-the-chronic-pressure-overloaded-right-ventricle-induces-reversed-remodeling
#10
Tom Verbelen, Piet Claus, Daniel Burkhoff, Ronald B Driesen, Chandan Kadur Nagaraju, Erik Verbeken, Karin Sipido, Marion Delcroix, Filip Rega, Bart Meyns
BACKGROUND: Mechanical right ventricular (RV) support in pulmonary arterial hypertension patients has been feared to cause pulmonary hemorrhage and to be detrimental for the after-load-sensitive RV. Continuous low-flow pumps offer promise but remain insufficiently tested. METHODS: The pulmonary artery was banded in 20 sheep in this study. Eight weeks later, a Synergy micro-pump (HeartWare International, Framingham MA) was inserted in 10 animals, driving blood from the right atrium to the pulmonary artery...
September 29, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29049614/anticoagulation-management-following-left-ventricular-assist-device-implantation-is-similar-across-all-provider-strategies
#11
Asia McDavid, Kelly MacBrair, Sitaramesh Emani, Lianbo Yu, Peter H U Lee, Bryan A Whitson, Brent C Lampert, Riddhima Agarwal, Ahmet Kilic
OBJECTIVES: Thromboembolic and bleeding events are potential complications following left ventricular assist device implantation. A tight control of the international normalized ratio (INR) is believed to be crucial in the reduction of postimplant complications. There is significant variability among institutions as to whether a device implanting centre should be managing the INR. In this study, we evaluated the effect of INR management strategies in maintaining a therapeutic INR. METHODS: A retrospective review was utilized to identify patients implanted with either the HeartMate II or the HeartWare HVAD between January 2011 and February 2016...
August 14, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29048703/a-pilot-study-on-the-efficacy-and-safety-of-a-minimally-invasive-surgical-and-anesthetic-approach-for-ventricular-assist-device-implantation
#12
Jonida Bejko, Demetrio Pittarello, Gianclaudio Falasco, Guido Di Gregorio, Vincenzo Tarzia, Giulio Rizzoli, Dario Gregori, Gino Gerosa, Tomaso Bottio
BACKGROUND: The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation. METHODS: 68 patients (50.4 ± 17.1 years old) were supported with the HeartWare® HVAD (32 patients) and the Jarvik 2000 VAD (36 patients) between January 2010 and August 2016. Two surgical techniques were applied: a minimally invasive approach with the aid of paravertebral-block (mini-invasive group, 41 patients) and a standard-surgical-approach with the aid of general anesthesia (27 patients)...
October 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29045747/extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#13
Julia Riebandt, Thomas Haberl, Dominik Wiedemann, R Moayedifar, Thomas Schloeglhofer, Stéphane Mahr, Kamen Dimitrov, Philipp Angleitner, Guenther Laufer, Daniel Zimpfer
OBJECTIVES: Right ventricular (RV) failure complicating left ventricular assist device implantation is associated with increased mortality. Despite a lack of supporting evidence, venoarterial extracorporeal membrane oxygenation (ECMO) support is increasingly being used as an alternative to traditional temporary RV support. We report our institutional experience with ECMO-facilitated RV support after left ventricular assist device implantation. METHODS: We retrospectively reviewed the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29035899/driveline-site-is-not-a-predictor-of-infection-after-ventricular-assist-device-implantation
#14
Billie-Jean Martin, Jessica G Y Luc, Michiko Maruyama, Roderick MacArthur, Angela R Bates, Holger Buchholz, Darren H Freed, Jennifer Conway
Driveline infections (DLIs) remain a major source of morbidity for patients requiring long-term ventricular assist device (VAD) support. We aimed to assess whether VAD driveline exit site (DLES) (abdomen versus chest wall) is associated with DLI. All adult patients who underwent insertion of a HeartWare HVAD or HeartMate II (HMII) between 2009 and 2016 were included. Driveline infection was defined as clinical evidence of DLI accompanied by a positive bacterial swab and need for antibiotics. Competing risks analysis was used to assess the association between patient characteristics and DLI...
October 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29032583/third-generation-ventricular-assist-device-mid-term-outcomes-of-the-heartware-hvad-in-pediatric-patients
#15
Mustafa Pac, Sinan Sabit Kocabeyoglu, Umit Kervan, Dogan Emre Sert, Serhat Koca, Ibrahim Ece, Feyza Aysenur Pac
The HeartWare HVAD is a small, third generation continuous flow pump that is intracorporeally placed for support of a failing ventricle in adult patients. This device is small in size when compared to other left ventricular assist devices and can therefore be used in smaller sized pediatric patients. We present our initial experience using the HVAD as a bridge to heart transplantation in the pediatric population. We performed a retrospective, single center, nonrandomized review of 17 pediatric patients who underwent HVAD implantation between June 2013 and March 2016...
October 15, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28988400/left-ventricle-assist-devices-and-driveline-s-infection-incidence-a-single-centre-experience
#16
Jonida Bejko, Francesca Toto, Dario Gregori, Gino Gerosa, Tomaso Bottio
Different left ventricular assist devices (LVADs) are provided of different driveline exit sites: HeartWare HVAD presents abdominal power-cable-supply, while the Jarvik 2000 LVAD is powered by a retroauricular driveline. We analyzed 93 LVAD-implanted patients from January-2009 to October-2016 (41 HeartWare and 52 Jarvik 2000), hypothesizing a different incidence of infection, according to driveline exit site. The two populations were propensity matched for the demographic data and preoperative variables, and the outcomes were further analyzed...
October 7, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28982636/cannula-and-pump-positions-are-associated-with-left-ventricular-unloading-and-clinical-outcome-in-patients-with-heartware-left-ventricular-assist-device
#17
Teruhiko Imamura, Sirtaz Adatya, Ben Chung, Ann Nguyen, Daniel Rodgers, Gabriel Sayer, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, Colleen Juricek, Diego Medvedofsky, Valluvan Jeevanandam, Roberto Lang, Jerry D Estep, Daniel Burkhoff, Nir Uriel
BACKGROUND: Cannula and pump positions are associated with clinical outcomes such as device thrombosis in patients with HeartMate II. However, clinical implications of HVAD cannula position are unknown. This study aims to assess the relationship between cannula position, left ventricular (LV) unloading and patient prognosis. METHODS AND RESULTS: Twenty-seven HVAD patients (60.0 ± 12.6 years old and 19 male [70%]) underwent ramp test. Device position was quantified from chest X-ray parameters obtained at time of hemodyamic ramp test: (1) cannula coronal angle, (2) pump depth, (3) cannula sagittal angle and (4) pump area...
October 2, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28962493/first-results-of-heartware-left-ventricular-assist-device-implantation-with-tunnelling-of-the-outflow-graft-through-the-transverse-sinus
#18
Jasmin S Hanke, Sebastian V Rojas, Tomislav Cvitkovic, Bettina Wiegmann, Alexander Horke, Gregor Warnecke, Axel Haverich, Jan D Schmitto
OBJECTIVES: The number of left ventricular assist device (LVAD) implants for the treatment of advanced heart failure is increasing tremendously. The main therapeutic goal of this operation is to provide a bridge to transplant for patients awaiting a donor heart. In 2011, we developed a novel, minimally invasive surgical technique for LVAD implantation. To avoid possible outflow graft injuries during redo sternotomies as well as to provide a more physiological outflow towards the aortic arch, a further modification of this approach was made with outflow graft tunnelling through the transverse sinus...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28958451/preoperative-prealbumin-level-as-a-predictor-of-outcomes-in-patients-who-underwent-left-ventricular-assist-device-implantation
#19
Andre C Critsinelis, Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Malnutrition has been associated with an increased risk of morbidity and mortality in patients who undergo cardiac surgery. However, many measurements of malnutrition have been inadequate prognostic markers. In this study, we sought to determine whether low preoperative serum prealbumin level was associated with morbidity and mortality in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. From November 2003 to March 2016, 526 patients with chronic heart failure underwent implantation of a CF-LVAD (HeartMate II, n = 403; HeartWare HVAD, n = 123)...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28957820/risk-factors-of-gastrointestinal-bleeding-after-continuous-flow-left-ventricular-assist-device
#20
Ozlem Balcioglu, Hatice S Kemal, Serkan Ertugay, Pelin Ozturk, Yaprak Engin, Sanem Nalbantgil, Cagatay Engin, Tahir Yagdi, Mustafa Ozbaran
This study aimed to compare von Willebrand factor (vWF) levels, ristocetin cofactor levels, platelet counts, aortic valve movements, and right heart failure (RHF) as risk factors of gastrointestinal (GI) bleeding in patients with continuous flow left ventricular assist device (cf-LVAD). In a single centre, 90 patients (mean age 52.0 ± 10.5 years), of which 59 were male and 31 were female, had cf-LVAD implantation from October 2010 to November 2012. Seventy-six (84.4%) patients had HeartWare (Medtronic, Mounds View, MN) and 14 (15...
September 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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