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Ventricular assist device

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https://www.readbyqxmd.com/read/28325006/a-simplified-state-space-model-of-biventricular-assist-device-cardiovascular-system-interaction
#1
Vivian C A Koh, Einly Lim, Boon Chiang Ng, Yong Kuen Ho, Nigel H Lovell
A simplified state-space model of biventricular assist device (BiVAD)-cardiovascular system (CVS) interaction is presented. The state-space equations includes a six-compartments CVS model incorporating the ventricles, the pulmonary and systemic circulations as well as the non-linear behavior of the valve flow, together with a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) component. The left and right pump speeds serve as the input variables for the state-space model. The model is simulated with three operational modes, i...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324260/stroke-and-intracranial-hemorrhage-in-heartmate-ii-and-heartware-left-ventricular-assist-devices-a-systematic-review
#2
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/28323663/percutaneous-single-site-cannulation-for-acute-right-sided-support
#3
Mahim Malik, Ahmet Kilic, Bryan A Whitson
Right ventricular failure (RVF) is a challenging problem after left ventricular device implantation, leading to considerable morbidity and mortality. When inotropic support is no longer adequate, a temporary right ventricular assist device is needed which often mandates reopening of the sternotomy for implant and explant. We describe our technique to percutaneously place a right-internal jugular cannula for extra-corporeal support.
March 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28323662/hvad-flow-waveform-morphologies-theoretical-foundation-and-implications-for-clinical-practice
#4
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/28319524/combined-therapy-of-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-for-profound-acute-cardiopulmonary-failure
#5
Kevin Fujita, Koji Takeda, Boyganzi Li, Christine Mauro, Paul Kurlansky, Sowmyashree Sreekanth, Jiho Han, Lauren K Truby, Reshad Garan, Veli Topkara, Melana Yuzefpolskaya, Paolo Colombo, Yoshifumi Naka, Hiroo Takayama
Short-term ventricular assist devices (ST-VAD) have been effective in treating patients with refractory cardiogenic shock. Membrane oxygenators (MO) can be added to the circuit for concomitant profound refractory hypoxia. This study reports outcomes of combined therapy in this portion of patients. This is a retrospective review of 166 patients who received an ST-biventricular assist device (BiVAD) or right ventricular assist device (RVAD) for cardiogenic shock between November 2007 and November 2014. An MO was added to the RVAD for profound hypoxia refractory to maximized ventilation...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319523/plasma-levels-of-microrna-155-are-upregulated-with-long-term-left-ventricular-assist-device-support
#6
Teresa Wang, Emily C OʼBrien, Joseph G Rogers, Daniel L Jacoby, Michael E Chen, Jeffrey M Testani, Dawn E Bowles, Carmelo A Milano, G Michael Felker, Chetan B Patel, Pramod N Bonde, Tariq Ahmad
Left ventricular assist device (LVAD) therapy unloads the failing heart but exposes the human body to unique pathophysiological demands such as continuous blood-flow and complete univentricular support, which are associated with increased risk of adverse clinical outcomes. MiRNAs are 22-23 nucleotide RNAs involved in regulation of multiple biological processes including the pathogenesis of heart failure (HF). Thus, measurement of miRNAs may have potential in both diagnostics as circulating biomarkers, and in therapeutics for targeted interventions...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319521/warfarin-and-aspirin-versus-warfarin-alone-for-prevention-of-embolic-events-in-patients-with-a-heartmate-ii%C3%A2-left-ventricular-assist-device
#7
Joseph S Van Tuyl, Ian B Hollis, Khalid A Alburikan, Richard Tran, Brian P Murray, Jo E Rodgers, Jason N Katz, Brett C Sheridan
Acquired von Willebrand disease increases bleeding risk in patients implanted with a continuous-flow left ventricular assist device. Lower aspirin doses decrease the risk of bleeding without an increased risk of embolic events. No published studies in the U.S. have compared the incidence of bleeding and thrombotic events between antithrombotic regimens with and without aspirin. A single-center, retrospective analysis was conducted of adult patients implanted with a HM II. Patients received warfarin and aspirin 81 mg daily or warfarin alone...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28316276/levosimendan-in-patients-with-left-ventricular-dysfunction-undergoing-cardiac-surgery
#8
Rajendra H Mehta, Jeffrey D Leimberger, Sean van Diepen, James Meza, Alice Wang, Rachael Jankowich, Robert W Harrison, Douglas Hay, Stephen Fremes, Andra Duncan, Edward G Soltesz, John Luber, Soon Park, Michael Argenziano, Edward Murphy, Randy Marcel, Dimitri Kalavrouziotis, Dave Nagpal, John Bozinovski, Wolfgang Toller, Matthias Heringlake, Shaun G Goodman, Jerrold H Levy, Robert A Harrington, Kevin J Anstrom, John H Alexander
Background Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery. Methods In a multicenter, randomized, placebo-controlled, phase 3 trial, we evaluated the efficacy and safety of levosimendan in patients with a left ventricular ejection fraction of 35% or less who were undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients were randomly assigned to receive either intravenous levosimendan (at a dose of 0...
March 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28315573/mortality-length-of-stay-and-cost-implications-of-procedural-bleeding-after-percutaneous-interventions-using-large-bore-catheters
#9
Björn Redfors, Brendan M Watson, Thomas McAndrew, Emilie Palisaitis, Dominic P Francese, Mehdi Razavi, Jordan Safirstein, Roxana Mehran, Ajay J Kirtane, Philippe Généreux
Importance: Bleeding complications after percutaneous transcatheter interventions that used large-bore catheters are frequent and associated with high mortality and morbidity. Objective: To describe the incidence of bleeding complications among patients undergoing contemporary endovascular interventions involving large-bore catheters and its association with in-hospital mortality, length of stay, and health care cost. Design, Setting, and Participants: This retrospective cohort study analyzed all 17 672 patients from the Healthcare Cost and Utilization Project's National Inpatient Sample database who were recorded as having undergone a transcatheter aortic valve replacement (n = 3223), an endovascular aneurysm repair (n = 12 633), or a percutaneous left ventricular assist device implant (n = 1816) between January 1, 2012, and December 31, 2013...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28315502/the-effect-of-left-ventricular-assist-device-therapy-in-patients-with-heart-failure-and-mixed-pulmonary-hypertension
#10
Hoong S Lim, Neil Howell, Aaron Ranasinghe
BACKGROUND: Diastolic pressure gradient (DPG) of ≥7 mmHg has been proposed to distinguish mixed pulmonary hypertension from isolated post-capillary pulmonary hypertension in heart failure (HF). We evaluated the changes in pulmonary hemodynamics with left ventricular assist devices (LVADs) in patients with DPG of ≥7 or <7 mmHg, and effects on peak oxygen uptake (VO2) in patients with advanced HF. METHODS: Pre- and post-LVAD implant pulmonary hemodynamics (including right atrial (RA) pressures, DPG, pulmonary vascular resistance (PVR), pulmonary capacitance (PCap) and cardiac output), echocardiography, cardiopulmonary exercise test were measured in 38 consecutive patients...
March 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28306593/current-concepts-for-sensitized-patients-before-transplantation
#11
Dael Geft, Jon Kobashigawa
PURPOSE OF REVIEW: Antibody allosensitization poses a major immunologic challenge for patients awaiting heart transplantation. It is associated with significant morbidity and mortality for both pretransplant and posttransplant patients by prolonging wait times to transplant and increasing posttransplant rejection and vasculopathy. Many questions remain regarding methods and interpretation of antibody detection, the relevance of sensitization in specific patient populations such as those with mechanical circulatory support and the ideal strategies for desensitization...
March 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28306362/cardiac-passive-aggressive-behavior-the-right-ventricle-in-patients-with-a-left-ventricular-assist-device
#12
Donna May Kimmaliardjuk, Marc Ruel
Right ventricular failure (RVF) affects up to 50% of patients post-left ventricular assist device (LVAD) implantation, and carries significant morbidity and mortality. There is no widely-used long-term mechanical support option for the right ventricle, thus early identification, prevention and medical treatment of RVF is of the upmost importance. Areas covered: A PubMed search was first completed searching "Right ventricular failure post-LVAD" which yielded 152 results, and a subsequent search was performed under "RV mechanical support" which yielded 374 results, and was filtered to "humans" and literature written in English, generating 219 results...
March 17, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28302642/pregnancy-and-the-risk-of-spontaneous-coronary-artery-dissection-an-analysis-of-120-contemporary-cases
#13
Ofer Havakuk, Sorel Goland, Anil Mehra, Uri Elkayam
BACKGROUND: Because of the rarity of this condition, information on pregnancy-associated spontaneous coronary artery dissection is limited. We reviewed a large number of contemporary pregnancy-associated spontaneous coronary artery dissection cases in an attempt to define the clinical characteristics and provide management recommendations. METHODS AND RESULTS: A literature search for cases of pregnancy-associated spontaneous coronary artery dissection reported between 2000 and 2015 included 120 cases; 75% presented with ST-segment-elevation myocardial infarction, and 80% had anterior myocardial infarction...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28300527/the-development-of-an-evacuation-protocol-for-patients-with-ventricular-assist-devices-during-a-disaster
#14
Katherine J Davis, Joseph Suyama, Jennifer Lingler, Michael Beach
Introduction Health care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster. METHODS: This is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol...
March 16, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28299353/safety-and-efficacy-of-single-balloon-enteroscopy-in-management-of-gastrointestinal-bleeding-in-patients-with-a-left-ventricular-assist-device
#15
Abhinav Koul, Donald M Pham, Arjun Nanda, Kevin E Woods, Steven D Keilin
Background and study aims Left ventricular assist devices (LVADs) are currently the standard of care in treatment of patients with end-stage heart failure waiting for heart transplant as well as destination therapy for non-transplant candidates. However, patients with LVADs are at increased risk of gastrointestinal bleeding due to the device's unique effects on hemodynamics. A major source of gastrointestinal bleeding in these patients are gastrointestinal angioectasias located within the small bowel that can only be reached with deep enteroscopy...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28295972/first-report-of-a-simultaneous-transcatheter-mitral-valve-in-valve-and-aortic-valve-replacement-in-a-left-ventricular-assist-device-patient
#16
Christopher Meduri, James Kauten, Mani Vannan, Vivek Rajagopal
Transcatheter aortic valve replacement is standard of care for patients with severe aortic stenosis at high risk for surgical aortic valve replacement. Although not intended for treatment of primary aortic insufficiency, several transcatheter aortic valve prostheses have been used to treat patients with severe aortic insufficiency (AI), including patients with left ventricular assist devices (LVAD), in whom significant AI is not uncommon. Similarly, transcatheter valve replacements have been used for valve-in-valve treatment, in the pulmonary, aortic, and mitral positions, either via a retrograde femoral approach or antegrade transseptal approach (mitral valve-in-valve)...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28289529/optimal-timing-of-same-admission-orthotopic-heart-transplantation-after-left-ventricular-assist-device-implantation
#17
Gunsagar Gulati, David Ouyang, Richard Ha, Dipanjan Banerjee
AIM: To investigate the impact of timing of same-admission orthotopic heart transplant (OHT) after left ventricular assist device (LVAD) implantation on in-hospital mortality and post-transplant length of stay. METHODS: Using data from the Nationwide Inpatient Sample from 1998 to 2011, we identified patients 18 years of age or older who underwent implantation of a LVAD and for whom the procedure date was available. We calculated in-hospital mortality for those patients who underwent OHT during the same admission as a function of time from LVAD to OHT, adjusting for age, sex, race, household income, and number of comorbid diagnoses...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28288574/association-of-global-and-disease-specific-health-status-with-outcomes-following-continuous-flow-left-ventricular-assist-device-implantation
#18
Kelsey M Flint, John A Spertus, Fengming Tang, Philip Jones, Timothy J Fendler, Larry A Allen
BACKGROUND: The prognostic value of heart failure specific and global health status before and after left ventricular assist device (LVAD) implantation in the usual care setting is not well studied. METHODS: We included 3,836 continuous-flow LVAD patients in the INTERMACS registry. Health status was measured pre-operatively and 3 months post-LVAD using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol visual analog scale (VAS). Primary outcomes were mortality/rehospitalization...
March 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28286902/catch-22-a-case-of-incessant-ventricular-tachycardia-post-left-ventricular-assist-device-resulting-in-right-ventricular-failure-left-ventricular-cavity-obliteration-and-failure-of-endocardial-ventricular-tachycardia-ablation
#19
Amit J Thosani, Stephen H Bailey, Amresh Raina
Ventricular tachycardia (VT) in the setting of left ventricular assist device (LVAD) therapy has been well described. We present a case of incessant ventricular tachycardia resulting in severe right ventricular (RV) failure and subsequent left ventricular (LV) cavity obliteration, which in turn diminished the feasibility of initial attempt at VT ablation.
March 12, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28285802/long-term-prognosis-and-cost-effectiveness-of-left-ventricular-assist-device-as-bridge-to-transplantation-a-systematic-review
#20
Michael Seco, Dong Fang Zhao, Michael J Byrom, Michael K Wilson, Michael P Vallely, John F Fraser, Paul G Bannon
BACKGROUND: This systematic review aimed to evaluate the clinical outcomes and cost-effectiveness of left ventricular assist devices (LVADs) used as bridge to transplantation (BTT), compared to orthotopic heart transplantation (OHT) without a bridge. METHOD: Systematic searches were performed in electronic databases with available data extracted from text and digitized figures. Meta-analysis of short and long-term term post-transplantation outcomes was performed with summation of cost-effectiveness analyses...
March 3, 2017: International Journal of Cardiology
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