keyword
https://read.qxmd.com/read/37591455/widening-care-gap-in-vad-therapy
#21
JOURNAL ARTICLE
Jennifer Conway, Shahnawaz Amdani, David L S Morales, Angela Lorts, David N Rosenthal, Jeffrey P Jacobs, Joseph Rossano, Devin Koehl, James K Kirklin, Scott R Auerbach
BACKGROUND: The removal of the HeartWare ventricular assist device (HVAD) due to pump malfunctions and inferior outcomes compared to HeartMate 3 (HM3) in adults has created a care gap for younger patients. It is unclear if the reported HVAD survival differs by age and if the initial experience with HM3 can bridge the gap. METHODS: Using the Society of Thoracic Surgeons (STS) Intermacs and Pedimacs registries, durable ventricular assist device (VAD) implants between September 2012 and December 2021 were identified...
August 15, 2023: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/37306082/in-silico-hemodynamic-ramp-testing-of-ventricular-assist-device-implanted-patients-using-acausal-cardiovascular-vad-modeling
#22
JOURNAL ARTICLE
Khunsha Mehmood, Munam Arshad, Ismail Lazoglu, Deniz Süha Küçükaksu, Vedat Bakuy
BACKGROUND: While cardiovascular system and mechanical circulatory support devices are efficiently model the effect of disease and assistance, they can also lend valuable insights into clinical procedures. This study demonstrates the use of a CVS-VAD model for an invasive procedure; hemodynamic ramp testing, in-silico. METHODS: The CVS model is developed using validated models in literature, using Simscape™. An analytically derived pump model is calibrated for the HeartWare VAD...
June 12, 2023: Artificial Organs
https://read.qxmd.com/read/37215974/endovascular-stenting-of-an-hvad%C3%A2-outflow-graft-pseudoaneurysm-that-exerts-compression-and-kinking-stenosis-on-the-soft-portion-of-the-prosthesis
#23
Mohamed Elbayomi, Michael Weyand, Michael Uder, Matthias S May, Katrin Steger, Jan-Peter Roth, Rene Tandler
KEY CLINICAL MESSAGE: Complex presentations of MCS patients may necessitate a multidisciplinary approach involving HF cardiologists, CT surgeons, advanced cardiac imagers, and interventional cardiologists in order to define the optimal management strategy. ABSTRACT: Left ventricle assist devices (LVADs) provide life-sustaining treatment for patients with terminal heart failure, but their intricacy allows for complications. One complication is LVAD outflow graft obstruction due to the graft's intraluminal thrombus or extraluminal compression...
May 2023: Clinical Case Reports
https://read.qxmd.com/read/37188121/long-term-assist-device-patients-admitted-to-icu-tips-and-pitfalls
#24
REVIEW
Michiel Morshuis, Hendrik Fox, Volker Lauenroth, Rene Schramm
Left ventricular assist device (LVAD) therapy is well-established in the treatment of end-stage cardiac failure. Indications are bridge to transplant (BTT), bridge to candidacy (BTC), bridge to recovery (BTR), and destination therapy (DT). The durability and adverse event (AE) rate of LVADs have improved over the years. However, due to donor shortage, the duration of support in the BTT population has increased tremendously; similarly, DT patients are on the device for a long time. Consequently, the number of readmissions of long-term LVAD patients has increased...
April 30, 2023: J Intensive Med
https://read.qxmd.com/read/37146602/acute-outflow-graft-occlusion-a-novel-predictable-complication-of-lysis-therapy-for-the-treatment-of-left-ventricular-assist-device-intra-pump-thrombosis
#25
JOURNAL ARTICLE
Christoph Hoermandinger, Nadine Riedler, Julia Stein, Philipp Stawowy, Evgenij Potapov, Felix Schoenrath, Isabell A Just
Lysis therapy is an established treatment option for intra-pump thrombosis of left ventricular assist devices (LVADs). In clinical routine, we observed repeated cases of acute outflow graft occlusions (OGO) associated with lysis therapy with need for urgent intervention. The aim of this investigation was to gain understanding of this observation. We screened data of 962 HeartWare ventricular assist device (HVAD) patients. One hundred twenty (13.8%) had intra-pump thromboses; 58 were treated with recombinant tissue-type plasminogen activator (rtPA)...
May 8, 2023: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/37021015/subcutaneous-implantable-cardioverter-defibrillator-noise-following-left-ventricular-assist-device-implantation
#26
JOURNAL ARTICLE
Banveet Kaur Khetarpal, Awad Javaid, Justin Z Lee, Fred Kusumoto, Siva K Mulpuru, Dan Sorajja, Yong-Mei Cha, Komandoor Srivathsan
BACKGROUND: The incidence and impact of noise in a subcutaneous implantable cardioverter defibrillator (S-ICD) after left ventricular assist device (LVAD) implantation is not well established. METHODS: We performed a retrospective study of patients implanted with LVAD and with a pre-existing S-ICD between January 2005 and December 2020 at the three Mayo Clinic centers (Minnesota, Arizona, and Florida). RESULTS: Of the 908 LVAD patients, a pre-existing S-ICD was present in 9 patients (mean age 49...
April 2023: Journal of Arrhythmia
https://read.qxmd.com/read/36867846/first-in-man-use-of-a-modified-controller-to-resolve-hvad-failure-to-restart
#27
JOURNAL ARTICLE
Song Li, Jennifer A Beckman, Lisa Wiederspan, Lisa Guertin, Jay Pal, Claudius Mahr
We report a case of Medtronic HeartWare ventricular assist device (HVAD) pump failure-to-restart. Despite HVAD withdrawal from the market in June 2021, up to 4,000 patients remain on HVAD support worldwide, and many are at high risk for this serious complication. This report describes the first-in-man use of a new HVAD controller that restarted a defective HVAD pump and avoided a fatal outcome. This new controller has the potential of preventing unnecessary VAD exchanges and saving lives.
March 3, 2023: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/36798028/identifying-patients-at-risk-multi-centre-comparison-of-heartmate-3-and-heartware-left-ventricular-assist-devices
#28
JOURNAL ARTICLE
Lieke Numan, Daniel Zimpfer, Osnat Itzhaki Ben Zadok, Emmeke Aarts, Michiel Morshuis, Sabina P W Guenther, Julia Riebandt, Dominik Wiedemann, Faiz Z Ramjankhan, Anne-Marie Oppelaar, Tuvia Ben-Gal, Binyamin Ben-Avraham, Folkert W Asselbergs, Rene Schramm, Linda W Van Laake
AIMS: Since the withdrawal of HeartWare (HVAD) from the global market, there is an ongoing discussion if and which patients require prophylactically exchange for a HeartMate 3 (HM3). Therefore, it is important to study outcome differences between HVAD and HM3 patients. Because centres differ in patient selection and standard of care, we performed a propensity score (PS)-based study including centres that implanted both devices and aimed to identify which HVAD patients are at highest risk...
February 16, 2023: ESC Heart Failure
https://read.qxmd.com/read/36745955/a-mathematical-model-for-assessing-shear-induced-bleeding-risk
#29
JOURNAL ARTICLE
Yuan Li, Hongyu Wang, Yifeng Xi, Anqiang Sun, Lizhen Wang, Xiaoyan Deng, Zengsheng Chen, Yubo Fan
PURPOSE: The objective of this study is to develop a bleeding risk model for assessing device-induced bleeding risk in patients supported with blood contact medical devices (BCMDs). METHODS: The mathematical model for evaluating bleeding risk considers the effects of shear stress on von Willebrand factor (vWF) unfolding, high molecular weight multimers-vWF (HMWM-vWF) degradation, platelet activation and receptor shedding and platelet-vWF binding ability. Functions of the effect of shear stress on the above factors are fitted/employed and solved by the Eulerian transport equation...
February 1, 2023: Computer Methods and Programs in Biomedicine
https://read.qxmd.com/read/36730294/insights-in-the-prothrombotic-changes-after-implantation-of-a-left-ventricular-assist-device-in-patients-with-end-stage-heart-failure-a-longitudinal-observational-study
#30
JOURNAL ARTICLE
Omayra C D Liesdek, Rolf T Urbanus, Steven de Maat, Linda M de Heer, Faiz Z Ramjankhan, Silvie A E Sebastian, Albert Huisman, Nicolaas de Jonge, Aryan Vink, Kathelijn Fischer, Coen Maas, Willem J L Suyker, Roger E G Schutgens
Thrombus formation is a common complication during left ventricular assist device (LVAD) therapy, despite anticoagulation with vitamin K antagonists (VKA) and a platelet inhibitor. Plasma levels of markers for primary and secondary hemostasis and contact activation were determined before LVAD implantation and 6 and 12 months thereafter in 37 adults with end-stage heart failure. Twelve patients received a HeartMate 3, 7 patients received a HeartWare, and 18 patients received a HeartMate II. At baseline, patients had elevated plasma levels of the platelet protein upon activation, β-thromboglobulin, and active von Willebrand factor in thrombogenic state (VWFa), which remained high after LVAD implantation...
November 22, 2022: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/36529649/results-of-non-elective-withdrawal-of-continuous-flow-left-ventricular-assist-devices-in-selected-patients
#31
JOURNAL ARTICLE
Jan Knierim, Dmytro Tsyganenko, Julia Stein, Johanna Mulzer, Markus Müller, Yuriy Hrytsyna, Felix Schoenrath, Volkmar Falk, Evgenij Potapov
BACKGROUND: Protocols have been developed to identify patients for elective withdrawal of continuous-flow left ventricular device (cfLVAD) support. However, little is known about non-elective explantation or decommissioning of cfLVADs. METHODS: A retrospective analysis of all patients who underwent left ventricular assist device (LVAD) explantation or decommissioning at a single center between 2002 and 2021 was performed. RESULTS: Sixty-one patients underwent withdrawal of a cfLVAD (HeartMate II [Abbott] n = 17, HeartMate 3 [Abbott] n = 2, HeartWare HVAD [Medtronic] n = 36, INCOR [Berlin Heart] n = 6)...
December 6, 2022: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/36476648/heartware-to-heartmate-3-left-ventricular-assist-device-exchange-via-a-left-lateral-thoracotomy
#32
Gaik Nersesian, Matteo Montagner, Pia Lanmueller, Daniel Lewin, Karel M Van Praet, Markus Kofler, Sascha Ott, Volkmar Falk, Evgenij Potapov
A continuous-flow left ventricular assist device implant is a well-established therapy for patients with end-stage heart failure. Currently, the HeartMate 3 device is the only commercially available durable left ventricular assist device. Therefore, patients on HeartWare HVAD support who require a pump exchange must have a HeartMate 3 implanted.
December 6, 2022: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://read.qxmd.com/read/36462544/the-society-of-thoracic-surgeons-intermacs-2022-annual-report-focus-on-the-2018-heart-transplant-allocation-system
#33
COMMENT
Melana Yuzefpolskaya, Sarah E Schroeder, Brian A Houston, Monique R Robinson, Igor Gosev, Alex Reyentovich, Devin Koehl, Ryan Cantor, Ulrich P Jorde, James K Kirklin, Francis D Pagani, David A D'Alessandro
The 13th annual report from The Society of Thoracic Surgeons (STS) Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) highlights outcomes for 27,314 patients receiving continuous-flow durable left ventricular assist devices (LVAD) during the last decade (2012-2021). In 2021, 2464 primary LVADs were implanted, representing a 23.5% reduction in the annual volume compared with peak implantation in 2019 and an ongoing trend from the prior year. This decline is likely a reflection of the untoward effects of the coronavirus disease 2019 pandemic and the change in the United States heart transplant allocation system in 2018...
February 2023: Annals of Thoracic Surgery
https://read.qxmd.com/read/36396220/emergency-department-evaluation-and-management-of-patients-with-left-ventricular-assist-devices
#34
REVIEW
Akilesh Honasoge, Kami M Hu
With the increasing use of left ventricular assist devices (LVADs) as destination therapy in patients with severe left heart failure, emergency physicians are more likely to encounter patients with LVAD in their emergency department (ED). Emergency physicians should have a basic understanding of LVAD mechanics, a specific approach to LVAD patient evaluation, and awareness of the must-not-miss LVAD therapy complications and their management to optimize outcomes in this patient population.
November 2022: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/36345682/recovery-of-a-dilated-left-ventricle-after-cessation-of-cocaine-and-hvad%C3%A2-explanation-using-a-titanium-plug
#35
Mohamed Elbayomi, Michael Weyand, Timo Seitz, Christian Heim, Katrin Steger, Rene Tandler
The ultimate goal in the treatment of end-stage heart failure is the recovery of cardiac function following mechanical assistance of the left ventricle. The HVAD™ pump (HeartWare Inc.) left ventricular assist device (LVAD) can be explanted without resternotomy. This article illustrates that the usage of a custom-made mechanical plug (manufactured by INNOVO Solutions GmbH), which can be inserted into the LVAD's sewing ring, is feasible. This mechanical plug explicitly designed for device explantation is a viable alternative to the current standard of care...
November 8, 2022: Journal of Cardiac Surgery
https://read.qxmd.com/read/36321720/redo-heart-transplantation-in-a-high-risk-patient-due-to-severe-aortic-regurgitation-and-accompanying-right-ventricular-failure-after-lvad-implantation-and-temporary-rvad-support
#36
Muhammad R Arab, Yeong-Hoon Choi, Oliver J Liakopoulos, Mohamed Zeriouh
BACKGROUND: We report a 62-year-old patient who received redo-orthotopic heart transplantation due to worsening severe aortic regurgitation after 19 months of continuous flow left ventricular assist device  (LVAD) (cf-LVAD) and temporary right ventricular assist device (RVAD) support for 1 month. CASE REPORT: The patient received a heartware LVAD (heartware ventricular assist device) and annuloplasty of the tricuspid valve due to end-stage heart failure (as a consequence of dilated cardiomyopathy) and severe tricuspid regurgitation in addition to right-sided extracorporeal membrane oxygenation (ECMO) implantation...
November 2, 2022: Journal of Cardiac Surgery
https://read.qxmd.com/read/36272893/bridging-to-transplant-with-heartmate-3-left-ventricular-assist-devices-in-the-new-heart-organ-allocation-system-an-individualized-approach
#37
JOURNAL ARTICLE
Matan H Uriel, Kevin J Clerkin, Koji Takeda, Yoshifumi Naka, Gabriel T Sayer, Nir Uriel, Veli K Topkara
BACKGROUND: Following the MOMENTUM 3 trial and the discontinuation of the HeartWare HVAD, the HeartMate 3 LVAD (HM 3) has become the main durable device for bridging to transplantation; however, outcome of this strategy in the new heart allocation system is not well understood. METHODS: The United Network for Organ Sharing (UNOS) registry was queried to include adult patients (≥18 years old) listed for heart transplantation between 2010 and 2020. Trends in durable LVAD utilization and outcomes of patients with HM 3 LVAD were examined in the pre- vs post-heart allocation system...
September 10, 2022: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/36194097/in-silico-prediction-of-thrombosis-risk-in-a-ventricular-assist-device-supported-right-heart-the-impact-of-cannulation-site
#38
JOURNAL ARTICLE
Kar Ying Thum, Sam Liao, Josie Carberry, David McGiffin, Shaun D Gregory
Right ventricular assist device (RVAD) associated thrombosis is a serious complication that may arise due to unfavorable blood flow dynamics (blood stasis) caused by RVAD cannula protrusion within the chambers. This study aims to investigate the thrombosis risk of cannulation via the right atrium (RA) and right ventricle (RV) (diaphragmatic) under full RVAD support using computational fluid dynamics. A HeartWare HVAD inflow cannula was virtually implanted in either the RA or RV of a rigid-walled right heart geometry (including RA, RV, superior, and inferior vena cava) extracted from computed tomography data of a biventricular support patient...
October 1, 2022: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/36148887/bleeding-and-thrombotic-complications-and-their-impact-on-mortality-in-patients-supported-with-left-ventricular-assist-device-for-cardiogenic-shock
#39
JOURNAL ARTICLE
Ingrid Bekono-Nessah, Alex Rosenburg, Christopher T Bowles, Fernando Riesgo-Gil, Ulrich Stock, Richard R Szydlo, Mike Laffan, Deepa J Arachchillage
INTRODUCTION: Thrombosis and bleeding are major complications in patients supported with left ventricular assist devices (LVADs). We aimed to assess the incidence of bleeding and thrombosis in patients supported with a HeartWare left ventricular assist device (HVAD), their predictive factors and their impact on mortality. METHODS: A single centre retrospective observational study of patients supported with HVAD over 5 years from January 2015 to October 2020. RESULTS: A total 139 patients (median age 52...
September 23, 2022: Perfusion
https://read.qxmd.com/read/36114791/microembolic-signal-monitoring-in-patients-with-left-ventricular-assist-devices-heartmate-3-and-heartware-association-with-antithrombotic-treatment-and-cerebrovascular-events
#40
JOURNAL ARTICLE
Kim Kristin Ravenberg, Maria Magdalena Gabriel, Andrei Leotescu, Anh Thu Tran, Gerrit Maximilian Grosse, Ramona Schuppner, Johanna Ernst, Ralf Lichtinghagen, Andreas Tiede, Sonja Werwitzke, Christoph Leon Bara, Jan Dieter Schmitto, Karin Weissenborn, Jasmin Sarah Hanke, Hans Worthmann
BACKGROUND: In patients with left ventricular assist devices (LVADs) ischemic and hemorrhagic stroke are dreaded complications. Predictive markers for these events are lacking. This study aimed to investigate the prevalence and predictive value of microembolic signals (MES) for stroke, detected by Transcranial Doppler sonography (TCD) in patients with HeartMate 3 (HM 3) or HeartWare (HW). METHODS: A thirty-minute bilateral TCD monitoring of the middle cerebral artery (MCA) was performed in 62 outpatients with LVAD (HM 3 N=31, HW N=31) and 31 healthy controls...
September 17, 2022: Artificial Organs
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