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Teruhiko Imamura, Gene Kim, Jayant Raikhelkar, Nitasha Sarswat, Sara Kalantari, Bryan Smith, Daniel Rodgers, Ben Chung, Ann Nguyen, Takeyoshi Ota, Tae Song, Colleen Juricek, Valluvan Jeevanandam, Daniel Burkhoff, Gabriel Sayer, Nir Uriel
BACKGROUND: Decoupling between diastolic pulmonary artery pressure (dPAP) and pulmonary artery wedge pressure (PAWP) is an index of pulmonary vasculature remodeling and provides prognostic information. Furthermore, decoupling may change during incremental left ventricular assist device (LVAD) speed changes. METHODS: In this prospective study, patients underwent an echocardiographic and hemodynamic ramp test following LVAD implantation and were followed for one year...
August 10, 2018: Journal of Cardiac Failure
Tadahisa Sugiura, Chitaru Kurihara, Masashi Kawabori, Andre C Critsinelis, Andrew B Civitello, Jeffrey A Morgan, O H Frazier
An increasing number of children with congenital heart disease are surviving into adulthood and subsequently developing end-stage heart failure. Two example populations are adults who have been previously operated on for congenitally corrected transposition of the great arteries (CCTGA) and transposition of the great arteries (TGA). Implantation of a continuous flow left ventricular assist device (CF-LVAD) in these patients can present unusual anatomical and physiologic challenges. In this report, we describe outcomes of CF-LVAD implantation in three such patients...
August 10, 2018: Annals of Thoracic and Cardiovascular Surgery
Jae H Choi, Jessica G Y Luc, Ester Moncho Escrivá, Kevin Phan, Syed S A Rizvi, Sinal Patel, John W Entwistle, Rohinton J Morris, H T Massey, Vakhtang Tchantchaleishvili
The aim of this systematic review and meta-analysis was to evaluate the outcomes of concomitant mitral valve surgery for significant preexisting mitral regurgitation (MR) in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation. Electronic search was performed to identify all studies in the English literature examining concurrent mitral valve surgery in patients with CF-LVAD implantation. Identified articles were systematically assessed for inclusion and exclusion criteria...
August 12, 2018: Artificial Organs
Manreet K Kanwar, Lisa C Lohmueller, Robert L Kormos, Jeffrey J Teuteberg, Joseph G Rogers, JoAnn Lindenfeld, Stephen H Bailey, Colleen K McIlvennan, Raymond Benza, Srinivas Murali, James Antaki
OBJECTIVES: This study investigates the use of a Bayesian statistical models to predict survival at various time points in patients undergoing left ventricular assist device (LVAD) implantation. BACKGROUND: LVADs are being increasingly used in patients with end-stage heart failure. Appropriate patient selection continues to be key in optimizing post-LVAD outcomes. METHODS: Data used for this study were derived from 10,277 adult patients from the INTERMACS (Inter-Agency Registry for Mechanically Assisted Circulatory Support) who had a primary LVAD implanted between January 2012 and December 2015...
August 7, 2018: JACC. Heart Failure
Milos Brankovic, K Martijn Akkerhuis, Henk Mouthaan, Alina Constantinescu, Kadir Caliskan, Jan van Ramshorst, Tjeerd Germans, Victor Umans, Isabella Kardys
BACKGROUND: Our aim was to explore potential use of temporal profiles of seven emerging cardio-renal and two pulmonary candidate biomarkers for predicting future adverse clinical outcome in stable patients with chronic heart failure (CHF). METHODS: In 263 CHF patients, we determined the risk of a composite endpoint of HF-hospitalization, cardiac death, LVAD-placement and heart transplantation in relation to repeatedly assessed (567 samples in total) blood biomarker levels, and slopes of their temporal trajectories (i...
August 3, 2018: International Journal of Cardiology
Matthew M Lander, Nicole Kunz, Elizabeth Dunn, Andrew D Althouse, Kathy Lockard, Michael A Shullo, Robert L Kormos, Jeffrey J Teuteberg
BACKGROUND: Driveline infection (DLI) is a cause of morbidity and mortality in patients with continuous flow left ventricular assist devices (CF-LVADs). We hypothesized that an alternative dressing protocol would decrease the rate of DLIs. METHODS AND RESULTS: Retrospective review of CF-LVAD implants at a single institution from January 2010 to October 2015 was conducted. Patients were divided into implants before (Group 1) or after (Group 2) the introduction of the new protocol on 9/1/2012...
August 8, 2018: Journal of Cardiac Failure
Ohlow Marc-Alexander, Michel Christoph, Ting-Hui Chen, Schmidt Andreas, Saenger Joerg, Lauer Bernward, Brunelli Michele
Background: The objective of this study was to identify prognostic indicators in patients with inflammatory cardiomyopathy (iCM) on endomyocardial biopsy (EMB). Methods and results: Between 2007 and 2011 all consecutive patients with diagnosed with iCM at EMB were retrospectively analyzed. The combined primary endpoint (EP) (1°EP) was cardiac death, aborted sudden cardiac death/appropriate implantable cardioverter defibrillator (ICD) shock, progressive heart failure requiring left ventricular assist device (LVAD) implantation and heart transplantation...
May 2018: Journal of Geriatric Cardiology: JGC
Aitor Uribarri, Sebastian V Rojas, Jasmin S Hanke, Günes Dogan, Thierry Siemeni, Tim Kaufeld, Fabio Ius, Tobias Goecke, Sara Rojas-Hernandez, Gregor Warnecke, Christoph Bara, Murat Avsar, Axel Haverich
INTRODUCTION AND OBJECTIVES: Malnutrition has been shown to affect clinical outcomes in patients with heart failure. The aim of this study was to analyze the impact of preoperative nutritional status assessed by the nutritional risk index (NRI) on the prognosis of patients with a continuous-flow left ventricular assist device (cf-LVAD). METHODS: We performed a retrospective study of 279 patients who underwent cf-LVAD implantation between 2009 and 2015 in our center...
August 2, 2018: Revista Española de Cardiología
Christopher T Sparrow, Joel D Schilling
No abstract text is available yet for this article.
August 1, 2018: Journal of Cardiac Failure
Masahiko Ando, Koji Takeda, Paul A Kurlansky, Jiho Han, Arthur R Garan, Veli K Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Maryjane Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Blood type O heart transplant recipients wait longer than non-O and frequently require bridging left ventricular assist devices (LVADs). However, rarely has the effect of this disparity been shown in a large registry. This study aims to clarify the outcome difference between O and non-O candidates and how allocation change could affect survival using Markov simulation. METHODS: We reviewed the United Network for Organ Sharing registry for adults listed for heart transplantation from 2008 to 2015...
August 1, 2018: Annals of Thoracic Surgery
Sajad Shehab, Sabine M Allida, Phillip J Newton, Desiree Robson, Peter S Macdonald, Patricia M Davidson, Paul C Jansz, Christopher S Hayward
Aortic regurgitation (AR), mitral regurgitation (MR), and tricuspid regurgitation (TR) after continuous-flow left ventricular assist device (LVAD) are common and may increase with prolonged LVAD support. The aim of this study was to simulate severe valvular regurgitation (AR, MR, and TR) within a 4-elemental pulsatile mock circulatory loop (MCL) and observe their impact on isolated LVAD and biventricular assist device (BiVAD) with HeartWare HVAD. Aortic regurgitation, MR, and TR were achieved via the removal of one leaflet from bileaflet mechanical valve from the appropriate valves of the left or right ventricles...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Philemon Mikail, Jessica R Crosby, Marvin J Slepian, Richard Smith, Zain Khalpey
There is a need for a consistent, reproducible, and cost-effective method of determining cardiac recovery in patients who receive emerging novel therapeutics for advanced and end-stage heart failure (HF). With the increasing use of ventricular assist devices (VADs) in end-stage HF, objective device diagnostics are available for analysis. Pulsatility, one of the accessible diagnostic measures, is a variable gage of the differential between peak systolic and minimum diastolic flow during a single cardiac cycle...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Chitaru Kurihara, William E Cohn, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Aortic valve insufficiency can be addressed during continuous-flow left ventricular assist device (CF-LVAD) implantation by performing aortic valve repair or replacement, or patch closure of the left ventricular outflow tract (LVOT). However, few studies have examined the safety of long-term CF-LVAD support after LVOT closure. From November 2003 through March 2016, 16 patients with advanced chronic heart failure underwent CF-LVAD implantation and concomitant LVOT closure for severe aortic insufficiency. We compared their long-term outcomes with those of 510 CF-LVAD recipients without concomitant LVOT closure...
August 2, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Himabindu Vidula, Valentina Kutyifa, Brent A Johnson, Robert L Strawderman, Donald Harrington, Bronislava Polonsky, Anna Papernov, Jeffrey D Alexis
As more patients are supported for longer periods by a left ventricular assist device (LVAD), hospital readmission is becoming a growing problem. However, data about temporal changes in readmission rates and causes for patients with prolonged LVAD support are limited. We aimed to evaluate rates, causes, and predictors of any and long-term readmission after LVAD placement at our institution. We followed 177 HeartMate II LVAD patients for a mean of 1.90 ± 1.33 years post initial discharge after implantation...
June 21, 2018: American Journal of Cardiology
Carsten Tschöpe, Alessio Alogna, Frank Spillmann, Alessandro Faragli, Gunther Schmidt, Florian Blaschke, Uwe Kühl, Ewa Hertel, Monika Willner, Daniel Morris, Heiner Post, Michel Noutsias, Burkert Pieske, Florian Krackhardt
BACKGROUND: Recent clinical trials have shown that pulmonary artery pressure-guided therapy via the CardioMEMS™ system reduces the risk of recurrent hospitalizations in chronic heart failure (HF) patients. The CardioMEMS™ pressure sensor is percutaneously implanted in a branch of the pulmonary artery and allows telemetric pressure monitoring via a receiver. According to the most recent ESC guidelines, this technology has currently a class IIb indication in patients with class III New York Heart Association symptoms and a previous hospitalization for congestive heart failure within the last year, regardless of ejection fraction...
July 31, 2018: BMC Cardiovascular Disorders
Massimiliano Carrozzini, Jonida Bejko, Alvise Guariento, Maurizio Rubino, Roberto Bianco, Vincenzo Tarzia, Dario Gregori, Tomaso Bottio, Gino Gerosa
OBJECTIVE: To evaluate the evolution of our surgical experience with the implantation of a continuous flow left ventricular assist device (LVAD), from the original full sternotomy approach to less invasive surgical strategies including mini-sternotomy and/or mini-thoracotomies. METHODS: We reviewed all consecutive patients implanted with a continuous flow LVAD at our Institute. To exclude the possible bias related to the device used, out of 91 collected LVADs implants, we selected only those patients (n=42) who received, between 2012 and 2015, the HeartWare HVAD...
July 30, 2018: Artificial Organs
Daichi Akiyama, Takashi Nishimura, Hirohito Sumikura, Kei Iizuka, Toshihide Mizuno, Tomonori Tsukiya, Yoshiaki Takewa, Minoru Ono, Eisuke Tatsumi
Aortic insufficiency (AI) is an intractable complication during long term left ventricular assist device (LVAD) support. Conventional evaluation of AI depends on ultrasound evaluation, which is mainly a qualitative, not a quantitative method. The pathophysiology of AI during LVAD is shunt formation. Conversely, the methods to quantify the shunt of congenital heart disease are already established, and among these is the thermodilution technique. To develop an accurate quantification method for AI (namely, a shunt), we have adopted this conventional thermodilution technique...
July 31, 2018: Artificial Organs
Bikei Ryu, Tatsuya Ishikawa, Koji Yamaguchi, Go Matsuoka, Seiichiro Eguchi, Takakazu Kawamata
BACKGROUND: Left ventricular assist devices (LVADs) were developed for the treatment of patients with severe heart failure (HF) as a bridge to heart transplantation (HT). Although long-term LVAD support results in substantial improvements, their long-term use often leads to severe acute ischemic stroke (AIS). Serious neurological events make it difficult to continue LVAD support, and these patients are excluded as candidates for HT. AIS remains a challenging problem in patients receiving LVAD support...
July 31, 2018: Acta Neurochirurgica
Nirav Patel, Jason A Gluck, Joseph Radojevic, Craig I Coleman, William L Baker
AIMS: Heart failure (HF) and diabetes mellitus (DM) often coexist and have bidirectional association. Advanced HF is associated with worsened glycaemic control. This meta-analysis investigated the effects of left ventricular assist device (LVAD) implantation on markers of DM control. METHODS AND RESULTS: We performed a systematic search of MEDLINE and Cochrane through October 2017 to identify studies evaluating advanced HF patients who had received an LVAD and reported markers of glycaemic control...
July 27, 2018: ESC Heart Failure
Abhishek Jaiswal, Thierry H Le Jemtel, Rohan Samson, Donna Mancini
The review underlines that advanced heart failure (AHF) patients who experience sustained cardiac recovery in the current left ventricular assist device (LVAD) era have similar clinical characteristics to those who experienced myocardial recovery in the pre-LVAD era. They are young, do not have coronary artery disease and were treated for idiopathic dilated cardiomyopathy within weeks to months of experiencing symptoms. As recently shown with progressive remodeling of the transverse tubular system, AHF results in myocyte and extracellular matrix alterations that with time become irreversible...
July 2018: American Journal of the Medical Sciences
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