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https://www.readbyqxmd.com/read/29020341/percutaneous-short-term-active-mechanical-support-devices-in-cardiogenic-shock-a-systematic-review-and-collaborative-meta-analysis-of-randomized-trials
#1
Holger Thiele, Alexander Jobs, Dagmar M Ouweneel, Jose P S Henriques, Melchior Seyfarth, Steffen Desch, Ingo Eitel, Janine Pöss, Georg Fuernau, Suzanne de Waha
Aims: Evidence on the impact on clinical outcome of active mechanical circulatory support (MCS) devices in cardiogenic shock (CS) is scarce. This collaborative meta-analysis of randomized trials thus aims to investigate the efficacy and safety of percutanzeous active MCS vs. control in CS. Methods and results: Randomized trials comparing percutaneous active MCS to control in patients with CS were identified through searches of medical literature databases. Risk ratios (RR) and 95% confidence intervals (95% CI) were calculated to analyse the primary endpoint of 30-day mortality and device-related complications including bleeding and leg ischaemia...
July 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28992106/a-simple-method-for-environmental-cell-depressurization-for-use-with-an-electron-microscope
#2
Naoki Ogawa, Ryo Mizokawa, Minoru Saito, Akira Ishikawa
With the aid of the environmental cell (EC) in electron microscopy, hydrated specimens have been observed at high resolutions that optical microscopy cannot attain. Due to the ultra-high vacuum conditions of the inner column of the electron microscope, the EC requires sealing films that are sufficiently thin to allow electron transmission and that are sufficiently tough to withstand the pressure difference between the inside and outside of the EC. However, most hydrated specimens can be observed at low vacuum because the saturated vapor pressure of water is known to be 0...
August 9, 2017: Microscopy
https://www.readbyqxmd.com/read/28988424/maintenance-of-valvular-integrity-with-impella-left-heart-support-results-from-the-multicenter-protect-ii-randomized-study
#3
James A Goldstein, Simon R Dixon, Pamela S Douglas, E Magnus Ohman, Jeffrey Moses, Jeffrey J Popma, William W O'Neill
BACKGROUND: The Impella 2.5 axial flow pump, which is positioned across the aortic valve, is widely employed for hemodynamic support. The present study compared structural and functional integrity of the left heart valves in patients undergoing Impella vs intra-aortic balloon pump in the randomized PROTECT II trial. METHODS AND RESULTS: Transthoracic echocardiograms were performed at baseline, 1 and 3 months in 445 patients in the PROTECT II trial. Serial studies were analyzed by an independent echocardiography core laboratory for aortic and mitral valve structure and function, and left ventricular ejection fraction (LVEF)...
October 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28975854/clinical-application-of-intra-aortic-balloon-counterpulsation-in-high-risk-patients-undergoing-cardiac-surgery
#4
Dengbang Hou, Feng Yang, Xiaotong Hou
The intra-aortic balloon pump (IABP) has been the most commonly used mechanical circulatory support device for nearly five decades. In theory, the IABP can increase the blood and oxygen supply of the coronary artery by increasing the diastolic pressure in the aortic root when the balloon is inflated and reduce left ventricular afterload by rapidly deflating the balloon during the systolic phase. Therefore, some researchers put forward the idea of preoperative prophylactic use of an IABP, which has been frequently performed in high-risk patients undergoing elective percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG)...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28973669/transcranial-doppler-waveforms-during-intra-aortic-balloon-pump-counterpulsation-for-vasospasm-detection-after-subarachnoid-hemorrhage
#5
Nicholas A Morris, Nathan Manning, Randolph S Marshall, E Sander Connolly, Jan Claassen, Sachin Agarwal, David J Roh, J Michael Schmidt, Soojin Park
BACKGROUND: Transcranial Doppler ultrasound is a standard screening tool for vasospasm after subarachnoid hemorrhage. Prevention of vasospasm-induced delayed cerebral ischemia after subarachnoid hemorrhage depends on optimization of cerebral perfusion pressure, which can be challenged by neurogenic stress cardiomyopathy. Intra-aortic balloon pumps have been utilized to augment cerebral perfusion, but they change the transcranial Doppler waveform, altering its interpretability for vasospasm screening...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28966325/rotational-atherectomy-followed-by-drug-coated-balloon-dilation-for-left-main-in-stent-restenosis-in-the-setting-of-acute-coronary-syndrome-complicated-with-right-coronary-chronic-total-occlusion
#6
Jun Shiraishi, Keisuke Shoji, Takashi Yanagiuchi, Masaki Yashige, Akira Shikuma, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
An 83-year-old man presented with recurrent acute coronary syndrome (ACS) at the left main coronary artery (LMCA) complicated with ostial chronic total occlusion (CTO) in the right coronary artery (RCA) (RCA-CTO). At the first LMCA-ACS approximately 1 year earlier, he had undergone LMCA-crossover stenting with a biolimus-eluting stent in the presence of RCA-CTO. At the second LMCA-ACS, we angiographically confirmed severe in-stent restenosis in the distal LMCA, in addition to angled severe stenosis in the just proximal LCx, and performed primary PCI for the LMCA bifurcation lesion under intra-aortic balloon pumping support...
September 30, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28963749/chronic-total-occlusion-in-non-infarct-related-artery-is-associated-with-increased-short-and-long-term-mortality-in-patients-with-st-segment-elevation-acute-myocardial-infarction-complicated-by-cardiogenic-shock-from-the-credo-kyoto-ami-registry
#7
Hiroki Watanabe, Takeshi Morimoto, Hiroki Shiomi, Tetsuma Kawaji, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takeshi Kimura
OBJECTIVES: We aimed to investigate the effect of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on short- and long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock (CS). BACKGROUND: Previous studies show contradictory results about the clinical effect of CTO in non-IRA on short-term mortality in STEMI patients with CS. METHODS: From the CREDO-Kyoto AMI registry enrolling 5429 patients, the current study population consisted of 313 STEMI patients with multivessel disease complicated by CS who underwent primary PCI for the nonleft main coronary artery culprit lesion within 24 hr after onset...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28962495/is-there-a-role-for-upper-extremity-intra-aortic-balloon-counterpulsation-as-a-bridge-to-recovery-or-a-bridge-to-transplant-in-the-treatment-of-end-stage-heart-failure
#8
Nnamdi Nwaejike, Andre Y Son, Carmelo A Milano, Mani A Daneshmand
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Is there a role for upper-extremity intra-aortic balloon pump counterpulsation (UE-IABP) in the treatment of end-stage heart failure? Altogether 230 papers were found using the reported search, of which 6 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28958345/intermacs-analysis-of-stroke-during-support-with-continuous-flow-left%C3%A2-ventricular-assist-devices-risk-factors-and-outcomes
#9
Deepak Acharya, Renzo Loyaga-Rendon, Charity J Morgan, Kara A Sands, Salpy V Pamboukian, Indranee Rajapreyar, William L Holman, James K Kirklin, José A Tallaj
OBJECTIVES: This study sought to evaluate predictors of stroke during left ventricular assist device (LVAD) support from data available prior to implantation, and quantify stroke-related morbidity and mortality. BACKGROUND: Stroke is a major complication after LVAD. Pre-implant factors that influence stroke are not well understood. METHODS: We evaluated all patients in INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) who were implanted with continuous flow LVADs from May 1, 2012, to March 31, 2015...
October 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28955074/internal-mammary-artery-flow-in-different-racial-groups-of-pakistan
#10
Mudassir Iqbal Dar, Asim Hassan Dar, Mansoor Ahmed, Abdul Haseeb, Muhammad Bilal
OBJECTIVE: To find out any differences in free flow of internal mammary artery among different ethnic groups. METHODS: This observational, cross-sectional study was conducted at the Civil Hospital, Karachi, from January 2013 to December 2015, and comprised patients who underwent coronary artery bypass grafting. The participants were divided into 5 groups, i.e. Sindhi, Muslim migrants from India, Punjabi, Pathan and Balochi patients. Free flow of internal mammary artery was measured immediately after harvesting within a syringe, and its flow was measured in 30 seconds...
October 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28948299/-cardiogenic-shock-current-evidence
#11
H Thiele
This CME article addresses the pathophysiology, incidence, current survival outcome and treatment options for patients with cardiogenic shock as a complication of acute myocardial infarction. The shock spiral of left heart failure due to cardiac infarction, subsequent vasoconstriction and paradoxical vasodilation due to the systemic inflammation response syndrome (SIRS) is a vicious circle which must be interrupted. Treatment focuses on the evidence from randomized clinical trials and the current guideline recommendations...
September 25, 2017: Herz
https://www.readbyqxmd.com/read/28942979/differences-and-similarities-in-risk-factors-for-postoperative-acute-kidney-injury-between-younger-and-older-adults-undergoing-cardiac-surgery
#12
Nadim Saydy, Amine Mazine, Louis-Mathieu Stevens, Hughes Jeamart, Philippe Demers, Pierre Pagé, Yoan Lamarche, Ismail El-Hamamsy
OBJECTIVES: Acute kidney injury is a frequent complication after cardiac surgery. The purpose of this study was to assess the risk factors for acute kidney injury in patients ≤60 years of age undergoing cardiac surgery and to compare these risk factors with those identified in patients ≥65 years of age. METHODS: From 2010 to 2012, 1253 patients ≤60 years (mean age 52 ± 9 years) and 2488 patients ≥65 years (mean age 74 ± 6 years) underwent cardiac surgery...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28941480/a-double-crossover-technique-in-an-obese-patient-undergoing-transfemoral-transcatheter-aortic-valve-implantation-how-to-accomplish-hemostasis-percutaneously
#13
Hirokazu Onishi, Toru Naganuma, Sunao Nakamura
Percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI) is generally an acceptable procedure but may be associated with vascular complications at femoral access sites, particularly in obese patients. This report aimed to describe a case of successful performance of our "double crossover technique" in an obese patient undergoing TF-TAVI with a percutaneous transfemoral intra-aortic balloon pump (TF-IABP). A 75-year-old man presented with heart failure due to a left ventricular ejection fraction of 35% and low-flow, low-gradient severe aortic stenosis...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28941078/the-effectiveness-and-safety-of-the-impella-ventricular-assist-device-for-high-risk-percutaneous-coronary-interventions-a-systematic-review
#14
Jamal Ait Ichou, Natasha Larivée, Mark J Eisenberg, Karine Suissa, Kristian B Filion
BACKGROUND: Small randomized controlled trials (RCTs) and observational studies have examined the effectiveness and safety of the Impella device, a percutaneous left ventricular assist device, in the setting of high-risk percutaneous coronary intervention (PCI). However, data are sparse and results are conflicting. Our objective was to evaluate the effectiveness and safety of the Impella device in high-risk patients undergoing PCI via a systematic review of the literature. METHODS: We searched Medline, EMBASE, and the Cochrane Library for RCTs and observational studies that evaluated the Impella device in high-risk patients undergoing PCI...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28935461/short-and-long-term-outcome-in-very-old-patients-with-st-elevation-myocardial-infarction-after-primary-percutaneous-coronary-intervention
#15
Roberta Sappa, Maria Teresa Grillo, Martino Cinquetti, Giulio Prati, Leonardo Spedicato, Gaetano Nucifora, Andrea Perkan, Davide Zanuttini, Gianfranco Sinagra, Alessandro Proclemer
BACKGROUND: Although octogenarians constitute a fast-growing portion of cardiovascular patients, few data are available on the outcome of patients aged ≥85 years with ST-Elevation Myocardial Infarction (STEMI). METHODS AND RESULTS: We analyzed 126 consecutive patients aged ≥85 years (age 88±2 years) with STEMI, undergoing primary percutaneous coronary intervention (pPCI) within 12 hours from symptoms onset. Long-term follow-up (median 898 days) was obtained for the 102 patients surviving the index-hospitalization...
September 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28935326/use-of-intraaortic-balloon-pumps-in-acute-type-a-aortic-dissection
#16
Helen Weaver, Shakil Farid, Samer Nashef, Pedro Catarino
Cardiac failure may occur after repair of type A aortic dissections and contributes significantly to mortality. The use of an intraaortic balloon pump (IABP) for circulatory support in these patients is traditionally considered contraindicated because of concerns over extension of the residual dissection flap or aortic rupture. We propose that the use of an IABP may be appropriate and safe to improve cardiac function in patients after type A dissection repair. The two cases presented here contribute to increasing the body of evidence to support the appropriate use of IABP in these patients...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28932597/reply-to-opinions-about-intraaortic-balloon-pumping-under-venoarterial-extracorporeal-membrane-oxygenation
#17
COMMENT
Shotaro Aso, Hideo Yasunaga
No abstract text is available yet for this article.
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28915508/preoperative-intraaortic-balloon-pump-improves-early-outcomes-following-high-risk-coronary-artery-bypass-graft-surgery-a-meta-analysis-of-randomized-trials-and-prospective-study-design
#18
Penelope P Rampersad, Jacob A Udell, Rami Zawi, Maral Ouzounian, Christopher B Overgaard, Vinoda Sharma, Vivek Rao, Michael E Farkouh, Vladimír Džavík
BACKGROUND: Despite widespread use, evidence to support preemptive intraaortic balloon pump (IABP) insertion for patients undergoing high-risk coronary artery bypass graft (CABG) surgery remains sparse, and in need of a well-defined clinical trial. To inform the design of a prospective trial, we sought to review outcomes in randomized controlled trials (RCTs) of anticipatory IABP use vs control in patients undergoing high-risk CABG through meta-analysis. The primary endpoint was all-cause mortality within 30 days of surgery...
September 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28913740/temporary-mechanical-circulatory-support-for-cardiogenic-shock
#19
REVIEW
Jean Touchan, Maya Guglin
Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO)...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28894056/-emergency-mitral-valvoplasty-for-papillary-muscle-rupture
#20
Keishi Ueyama, Motohiro Koyama, Kenji Otaki, Kae Ito
We experienced 2 emergency surgical cases of severe mitral valve regurgitation due to papillary muscle rupture. Case 1:a 69-year-old man presented with respiratory and cardiac failure due to mitral regurgitation. He had no history of myocardial infarction. Mitral valve repair with artificial cords was performed. The papillary muscle of the anterior leaflet was ruptured. The postoperative course was uneventful. Case 2:a 80-year-old man came to our hospital with cardiac arrest. Emergency coronary intervention was performed to the right coronary and intraaortic balloon pumping was inserted...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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