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https://www.readbyqxmd.com/read/29045747/extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#1
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-following-ventricular-assist-device-implantation
#2
Billie-Jean Martin, Jessica G Y Luc, Michiko Maruyama, Roderick MacArthur, Angela R Bates, Holger Buchholz, Darren H Freed, Jennifer Conway
Driveline infections (DLI) 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. DLI 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 13, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28950296/a-modified-explant-technique-of-heartware-ventricular-assist-device-for-bridge-to-recovery
#9
Yasuhiro Shudo, Chun W Choi, Y Joseph Woo, Richard-Tien V Ha
The HeartWare left ventricular assist device is a miniaturized, continuous centrifugal-flow pump. The implantation technique is well described and relatively standardized across different institutions. However, there still exists a technical concern about handling the inflow cannula at the time of device explant. Specifically, the removal of the sewing ring and plicating the apical defect en masse may distort the geometry of the left ventricle and impart myocardial dysfunction. Additionally, a prefabricated repair mechanism by the manufacturer is not readily available in all countries (i...
July 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28947307/prognostic-implications-of-changes-in-albumin-following-left-ventricular-assist-device-implantation-in-patients-with-severe-heart-failure
#10
Dipika J Gopal, Thomas C Hanff, Jeremy A Mazurek, Wilson E Grandin, Jessica Howard, Rhondalyn Forde-McLean, Joyce Wald, Kathie King, Michael A Acker, Lee R Goldberg, Mariell Jessup, Pavan Atluri, Kenneth B Margulies, Eduardo J Rame, Edo Y Birati
Mechanical assist devices have emerged as an established therapeutic option for patients with end-stage heart failure. Because preimplant hypoalbuminemia is a known risk factor for adverse outcomes, we hypothesized that change in albumin may be a prognostic indicator in patients with continuous-flow left ventricular assist devices (cfLVADs). This is a retrospective single-center study of patients who underwent cfLVAD implantation (HeartMate II and HeartWare HVAD) at an academic center from 2008 to 2014. After excluding those who died, were transplanted, or hospitalized during the first 3 months post-implant, albumin values were obtained and stratified by an increase or a decrease from pre-implant to 3 months post-implant on 171 (81% male, mean age 57 ± 16 years) patients (139 for the survival analysis and 90 for the hospitalization analysis)...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28932915/outcomes-in-patients-with-advanced-heart-failure-and-small-body-size-undergoing-continuous-flow-left-ventricular-assist-device-implantation
#11
Nastasya Volkovicher, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Andrew B Civitello, Jeffrey A Morgan
Left ventricular assist devices (LVADs) have become a preferred treatment option for patients with end-stage heart failure when used as a bridge to transplant or as a destination therapy. However, the association between small body size and postoperative outcomes for continuous-flow (CF) LVAD recipients is still being studied. We sought to determine whether body surface area (BSA) is associated with patient outcomes after CF-LVAD implantation. The study cohort of our single-center, retrospective review consisted of all patients (n = 526) who underwent CF-LVAD implantation (n = 403 HeartMate II, n = 123 HeartWare) between November 2003 and March 2016 regardless of indication...
September 20, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28891183/primary-percutaneous-coronary-intervention-for-inferior-st-segment-elevation-myocardial-infarction-in-a-patient-supported-by-the-heartware-left-ventricular-assist-device
#12
Roberto Spina, Maithri Siriwardena, Nicole Bart, Mayooran Namasivayam, Mark Connellan, Paul Jansz, Philip Spratt, Christopher S Hayward, Eugene Kotlyar, Brendan Gunalingam
A 63-year-old man with an ischaemic cardiomyopathy, supported by the HeartWare left ventricular assist device (LVAD), presented with ventricular tachycardia and inferior ST-elevation myocardial infarction (STEMI) with associated acute right ventricular (RV) dysfunction. He underwent primary percutaneous coronary intervention with balloon angioplasty and placement of three drug-eluting stents in the proximal-to-mid right coronary artery. Post-procedure, ventricular arrhythmias abated, RV systolic dysfunction resolved and RV size normalised...
September 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28887110/percutaneous-decommissioning-of-left-ventricular-assist-device
#13
Jia-Lin Soon, Ju-Le Tan, Choon-Pin Lim, Teing-Ee Tan, Swee-Yaw Tan, Ka-Lee Kerk, Kheng-Leng David Sim, Cumaraswamy Sivathasan
BACKGROUND: The Left Ventricular Assist Device (LVAD) has revolutionised our treatment of advanced stage heart failure, giving debilitated patients a new lease on life. A small proportion of these LVAD patients can be bridged-to-recovery. The identification of these patients and decision to wean, however, can be challenging. METHODS: The need to fully explant the device upon recovery has evolved to a minimalist approach aiming to avoid injury to the 'recovered' heart...
August 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28884121/contrast-microsphere-destruction-by-a-continuous-flow-ventricular-assist-device-an-in-vitro-evaluation-using-a-mock-circulation-loop
#14
David G Platts, Nicole Bartnikowski, Shaun D Gregory, Gregory M Scalia, John F Fraser
OBJECTIVES: Transthoracic echocardiography (TTE) is fundamental in managing patients supported with ventricular assist devices (VAD). However imaging can be difficult in these patients. Contrast improves image quality but they are hydrodynamically fragile agents. The aim was to assess contrast concentration following passage through a VAD utilising a mock circulation loop (MCL). METHODS: Heartware continuous flow (CF) VAD was incorporated into a MCL. Definity® contrast was infused into the MCL with imaging before and after CF-VAD...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28846527/kinking-of-the-outflow-graft-consequent-ventricular-tachycardia-and-the-need-for-reoperation-in-a-patient-with-left-ventricular-assist-device
#15
Dusko Terzic, Emilija Nestorovic, Svetozar Putnik, Dejan Markovic, Miljko Ristic
BACKGROUND: Left ventricular assist devices (LVAD) have become a lifesaving solution for patients awaiting heart transplantation as well as an option to support the failing hearts of non-transplant candidates as a lifelong, or destination therapy (DT). Improvements in LVAD design have enabled greater durability and broader patient applicability, but not without complications. Ventricular arrhythmias in LVAD patients were considered benign in the early days of LVADs, but today are increasingly recognized for their harmful impact on morbidity and quality of life...
August 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28841580/durable-biventricular-support-using-right-atrial-placement-of-the-heartware-hvad
#16
Hao A Tran, Travis L Pollema, Jorge Silva Enciso, Barry H Greenberg, Denise D Barnard, Eric D Adler, Victor G Pretorius
Patients with Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1-2 who either have or are at risk for right ventricular failure face significant morbidity and mortality after continuous flow left ventricular assist device (CF-LVAD) implantation. Currently, the options for biventricular support are limited the Total Artificial Heart (TAH; CardioWest, Syncardia, Tuscon, AZ) or biventricular assist device (BiVAD), which uses bulky extracorporeal or implantable displacement pumps...
August 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28838516/cardiac-regeneration-in-the-human-left-ventricle-after-cormatrix-implantation
#17
Alice Ferng, Alana Connell, Martha Nunez, Kitsie Johnson, Beth Braunhut, Scott Lick, Ankit Desai, Toshinobu Kazui, Ray Runyan, Zain Khalpey
CorMatrix is an organic extracellular matrix (ECM) derived from porcine small intestine submucosa and is used for pericardial closure and cardiac tissue repair. During explantation of a HeartMate II (Thoratec Corp, Pleasanton, CA) left ventricular assist device (LVAD) because of infection, CorMatrix was used to repair the left ventricular apex and aorta. Three months later, a HeartWare HVAD (HeartWare International, Inc, Framingham, MA) was implanted for recurrent heart failure. Excised apical CorMatrix samples showed cardiac tissue remodeling with viable cardiomyoblasts similar to native myocardium...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28821330/systemic-atrioventricular-valve-excision-and-ventricular-assist-devices-in-pediatric-patients
#18
Deipanjan Nandi, Kelley D Miller, Carley M Bober, Tami M Rosenthal, Lisa M Montenegro, Joseph W Rossano, J William Gaynor, Christopher E Mascio
BACKGROUND: Continuous-flow ventricular assist devices (CF VADs) designed for adults are increasingly used in pediatric patients. However, there is greater risk of device inflow obstruction as a result of size and anatomy. METHODS: We reviewed all cases of systemic atrioventricular valve (AVV) excision with HeartWare HVAD (HeartWare, Framingham, MA) implantation in the systemic ventricle performed at our institution from November 2015 to May 2016. RESULTS: AVV excision with CF VAD implantation was undertaken in 3 patients...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28777390/thrombosis-in-left-ventricular-assistance-device-with-centrifugal-technology-is-early-thrombolysis-a-better-solution
#19
Paolo Centofanti, Andrea Baronetto, Matteo Attisani, Davide Ricci, Erika Simonato, Michele W La Torre, Massimo Boffini, Mauro Rinaldi
BACKGROUND: Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. METHODS: We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016...
July 27, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28757150/temporal-differences-in-outcomes-during-long-term-mechanical-circulatory-support
#20
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
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