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https://www.readbyqxmd.com/read/28324260/stroke-and-intracranial-hemorrhage-in-heartmate-ii-and-heartware-left-ventricular-assist-devices-a-systematic-review
#1
Sung M Cho, Nader Moazami, Jennifer A Frontera
BACKGROUND: Ischemic stroke and intracranial hemorrhage (ICH) following left ventricular assist device (LVAD) placement are major causes of morbidity. The incidence and mortality associated with these events stratified by device type have not been systematically explored. METHODS: A systematic review of PubMed was conducted from January 2007 through June 2016 for all English-language articles involving HeartMate II (HMII) and HeartWare LVAD patients. Ischemic stroke and/or ICH incidence (events per patient-year) and associated mortality rates were abstracted for each device type...
March 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28323662/hvad-flow-waveform-morphologies-theoretical-foundation-and-implications-for-clinical-practice
#2
Jonathan D Rich, Daniel Burkhoff
Continuous flow ventricular assist device (cfVAD) performance and patient hemodynamic conditions are intimately interrelated and dynamic, changing frequently with alterations in physiologic conditions, particularly pre- and after-loading conditions. The Heartware cfVAD (HVAD) provides a unique feature among currently approved VADs of providing an estimated instantaneous flow waveform, the characteristics of which can provide significant insights into patient and device properties. Despite being readily available, HVAD waveforms are poorly understood, underutilized and insufficiently leveraged, even by clinicians who regularly manage HVAD patients...
March 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28265217/titanium-plug-closure-after-heartware-ventricular-assist-device-explantation-in-a-15-year-old-girl-first-u-s-experience
#3
Diego A Lara, Aamir Jeewa, Barbara A Elias, Elizabeth O McCullum, Susan W Denfield, William J Dreyer, Iki Adachi
We describe the case of a teenage girl with anthracycline-induced cardiomyopathy who received a HeartWare ventricular assist device and underwent successful device explantation after cardiac recovery. During device support, the patient's cardiac function returned to normal. Twelve months after implantation, we explanted the device via repeat median sternotomy. To close the hole in the left ventricular apex and preserve the sewing ring in case future device support is needed, we used a German-manufactured titanium plug, developed specifically for this purpose...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28238649/comprehensive-assessment-of%C3%A2-the-heartware-hvad-left%C3%A2-ventricular-assist-device-with-4-dimensional%C3%A2-cardiac-computed%C3%A2-tomography
#4
Manuel Barreiro-Pérez, Aitor Uribarri, Javier López-Rodríguez, Sebastián V Rojas, José M González-Santos, Pedro L Sánchez
No abstract text is available yet for this article.
February 23, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28195884/interventional-treatment-of-lvad-outflow-graft-stenosis-by-introduction-of-bare-metal-stents
#5
Dominik Wiedemann, Thomas Schlöglhofer, Thomas Haberl, Julia Riebandt, Kamen Dimitrov, Heinrich Schima, Johannes Kastner, Wolfgang Matzek, Günther Laufer, Daniel Zimpfer
LVAD outflow graft stenosis is a rare but life-threatening complication of MCS-therapy. Current treatment modalities (pump exchange or systemic thrombolytic therapy) are associated with significant mortality and morbidity.Implantation of bare metal stents within the stenosed outflow graft is an alternative. Herein we describe a series of 3-cases with successful stent placement. This seems to be safe and successful however correct and early diagnosis of outflow stenosis can be challenging. Information provided by the HeartWare HVAD logfiles are extremely helpful for diagnosis...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28169115/angiotensin-ii-antagonism-is-associated-with-reduced-risk-for-gastrointestinal-bleeding-caused-by-arteriovenous-malformations-in-patients-with-left-ventricular-assist-devices
#6
Brian A Houston, Andrea L C Schneider, Joban Vaishnav, David M Cromwell, P Elliott Miller, Kamil F Faridi, Ashish Shah, Chris Sciortino, Glenn Whitman, Ryan J Tedford, Gerin R Stevens, Daniel P Judge, Stuart D Russell, Rosanne Rouf
BACKGROUND: Angiogenesis is implicated in formation of gastrointestinal arteriovenous malformations (AVMs). Angiotensin II signaling is involved in angiogenesis through the vascular endothelial growth factor (VEGF) and angiopoietin-2 pathways. We hypothesized that angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) therapy would be associated with a reduced risk of all-cause gastrointestinal bleeding (GIB) and AVM-associated GIB in patients with left ventricular assist devices (LVADs)...
December 30, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28146651/intrapericardial-left-ventricular-assist-device-for-advanced-heart-failure
#7
RANDOMIZED CONTROLLED TRIAL
Joseph G Rogers, Francis D Pagani, Antone J Tatooles, Geetha Bhat, Mark S Slaughter, Emma J Birks, Steven W Boyce, Samer S Najjar, Valluvan Jeevanandam, Allen S Anderson, Igor D Gregoric, Hari Mallidi, Katrin Leadley, Keith D Aaronson, O H Frazier, Carmelo A Milano
Background Mechanical circulatory support with a left ventricular assist device (LVAD) is an established treatment for patients with advanced heart failure. We compared a newer LVAD design (a small intrapericardial centrifugal-flow device) against existing technology (a commercially available axial-flow device) in patients with advanced heart failure who were ineligible for heart transplantation. Methods We conducted a multicenter randomized trial involving 446 patients who were assigned, in a 2:1 ratio, to the study (centrifugal-flow) device or the control (axial-flow) device...
February 2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28118264/in-vitro-examination-of-the-heartware-circulite-ventricular-assist-device-in-the-fontan-connection
#8
Michael Tree, Phillip M Trusty, Timothy C Slesnick, Ajit Yoganathan, Shriprasad Deshpande, Kevin Maher
The failing Fontan physiology may benefit from ventricular assist device (VAD) mechanical circulatory support, though a sub-pulmonary VAD placed at the Fontan connection has never successfully supported the Fontan circulation long term.The HeartWare CircuLite continuous flow VAD was examined for Fontan circulatory support in an in vitro mock circulation. The VAD was tested in three different scenarios: VAD in parallel, baffle restricted VAD in parallel, and VAD in series. Successful support was defined as simultaneous decrease in inferior vena cava (IVC) pressure of 5 mmHg or more and an increase in cardiac output (CO) to 4...
January 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28114194/myocardial-recovery-strategy-with-decommissioning-for-the-heartware-left-ventricular-assist-device
#9
Guy A MacGowan, Neil Wrightson, Nicola Robinson-Smith, Andrew Woods, Gareth Parry, Kate Gould, Stephan Schueler
To manage myocardial recovery in patients with the HeartWare left ventricular assist device (HVAD), we describe a minimally invasive approach ('decommissioning') that involves disconnecting the driveline and occluding the outflow tract through a small left thoracotomy incision leaving the device in situ, in conjunction with optimal medical therapies and comprehensive assessment of left ventricular recovery. Nine patients (all male, 37 ± 12 years, all non-ischemic dilated cardiomyopathy) had an HVAD implanted for 766±343 days...
January 19, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28110971/risk-factors-mortality-and-timing-of-ischemic-and-hemorrhagic-stroke-with-left-ventricular-assist-devices
#10
Jennifer A Frontera, Randall Starling, Sung-Min Cho, Amy S Nowacki, Ken Uchino, M Shazam Hussain, Maria Mountis, Nader Moazami
BACKGROUND: Stroke is a major cause of mortality after left ventricular assist device (LVAD) placement. METHODS: Prospectively collected data of patients with HeartMate II (n = 332) and HeartWare (n = 70) LVADs from October 21, 2004, to May 19, 2015, were reviewed. Predictors of early (during index hospitalization) and late (post-discharge) ischemic and hemorrhagic stroke and association of stroke subtypes with mortality were assessed. RESULTS: Of 402 patients, 83 strokes occurred in 69 patients (17%; 0...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28109455/impact-of-aortic-valve-closure-on-adverse-events-and-outcomes-with-the-heartware-ventricular-assist-device
#11
EDITORIAL
Steve K Singh
No abstract text is available yet for this article.
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28097728/dabigatran-etexilate-in-a-vitamin-k-antagonist-non-responder-patient-during-heartware-hvad-support
#12
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
#13
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
#14
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...
January 13, 2017: 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
#15
Sindhoor Bhat, Jayakala Mathew, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is stroke, with a higher incidence in HeartWare Ventricular Assist Device (HVAD) as compared with HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Because 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 computed tomography (CT) scan of a patient...
March 2017: 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
#16
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...
January 2017: 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
#17
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
#18
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
#19
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
#20
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
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