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https://www.readbyqxmd.com/read/28606584/impact-of-a-modified-anti-thrombotic-guideline-on-stroke-in-children-supported-with-a-pediatric-ventricular-assist-device
#1
David N Rosenthal, Chacy A Lancaster, Doff B McElhinney, Sharon Chen, MaryLyn Stein, Aileen Lin, Lan Doan, Jenna M Murray, Mary Alice Gowan, Katsuhide Maeda, Olaf Reinhartz, Christopher S Almond
BACKGROUND: Stroke is the most feared complication associated with the Berlin Heart EXCOR pediatric ventricular assist device (VAD), the most commonly used VAD in children, and affects 1 in 3 children. We sought to determine whether a modified anti-thrombotic guideline, involving more intense platelet inhibition and less reliance on platelet function testing, is associated with a lower incidence of stroke. METHODS: All children supported with the EXCOR at Stanford from 2009 to 2014 were divided into 2 cohorts based on the primary anti-thrombotic guideline used to prevent pump thrombosis: (1) the Edmonton Anti-thrombotic Guideline (EG) cohort, which included children implanted before September 2012 when dual anti-platelet therapy was used with doses titrated to Thromboelastrography/PlateletMapping (TEG/PM); and (2) the Stanford Modified Anti-thrombotic Guideline (SG) cohort, which included children implanted on or after September 2012 when triple anti-platelet therapy was used routinely and where doses were uptitrated to high, weight-based dosing targets, with low-dose steroids administered as needed for inflammation...
May 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28551351/identifying-children-appropriate-for-bridge-to-transplantation-with-the-berlin-heart-excor
#2
EDITORIAL
Ryan R Davies
No abstract text is available yet for this article.
May 12, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28546755/pediatric-ventricular-assist-devices-current-challenges-and-future-prospects
#3
REVIEW
Sarah Burki, Iki Adachi
The field of mechanical circulatory support has made great strides in the preceding 2 decades. Although pediatric mechanical circulatory support has lagged behind that of adults, the gap between them is expected to close soon. The only device currently approved by the US Food and Drug Administration for use in children is the Berlin Heart EXCOR ventricular assist device (VAD). The prospective Berlin Heart Investigational Device Exemption Trial demonstrated good outcomes, such as bridge to transplantation or recovery, in ~90% of children supported with this device...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28509675/acute-and-long-term-effects-of-left-ventricular-assist-device-support-on-right-ventricular-function-in-children-with-pediatric-pulsatile-ventricular-assist-devices
#4
Roberta Iacobelli, Arianna Di Molfetta, Gianluca Brancaccio, Sergio Filippelli, Stefano Morelli, Benedetta Natali, Alessandra Toscano, Fabrizio Drago, Antonio Amodeo
Right ventricular failure (RVF) is a significant issue when considering left ventricular assist device (LVAD) implantation in pediatrics. The aim of this study was to evaluate the effects of LVAD on right ventricular (RV) function in children. We retrospectively reviewed clinical and echocardiographic data of children who underwent Berlin Heart EXCOR LVAD focusing on RV function before and after implantation (1, 3, and 6 month follow-up). An isolated LVAD was used in 27 patients. Median age was 11 months (interquartile range [IQR]: 5-24 months), with a median weight of 6...
May 12, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28486624/ventricular-assist-device-support-in-patients-with-single-ventricles-the-melbourne-experience%C3%A2
#5
Chin L Poh, Roberto Chiletti, Diana Zannino, Christian Brizard, Igor E Konstantinov, Stephen Horton, Johnny Millar, Yves d'Udekem
OBJECTIVES: The capacity and limitations of ventricular assist device (VAD) support in single-ventricle physiology remains poorly understood. We aimed to review our experience in the use of VAD support in the single-ventricle circulation to determine its feasibility in this population. METHODS: We reviewed our experience with VAD support in patients with single ventricles over the past 25 years. Fifty-seven patients received 64 runs of VAD support between 1990 and 2015 at a median age of 13 days [interquartile range (IQR) 4...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28453795/closing-the-gap-in-paediatric-ventricular-assist-device-therapy-with-the-berlin-heart-excor%C3%A2-15-ml-pump%C3%A2
#6
Fabrizio De Rita, Massimo Griselli, Eugen Sandica, Oliver Miera, Ann Karimova, Yves d'Udekem, Ranny Goldwasser, Katarzyna Januszewska, Antonio Amodeo, Nadine Jurrmann, Simon Ersel, Ares K Menon
OBJECTIVES: The Berlin Heart EXCOR ® (EXCOR) paediatric ventricular assist device is used worldwide for mechanical support of infants and small children with end-stage heart failure. A clinically important gap between the smallest EXCOR blood pump (10 ml) and the next larger size (25 ml) limited the choice of pump size in patients with a body surface area (BSA) between 0.33 and 0.5 m 2 . We present the first clinical experience from the early product surveillance (EPS) of the new EXCOR 15-ml blood pump...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28366497/experience-with-a-long-term-pulsatile-ventricular-assist-device-as-a-bridge-to-heart-transplant-in-adults
#7
Manuel Gómez Bueno, Javier Segovia Cubero, Santiago Serrano Fiz, Juan Ugarte Basterrechea, Francisco José Hernández Pérez, Josebe Goirigolzarri Artaza, Evaristo Castedo Mejuto, Raúl Burgos Lázaro, Carlos García Montero, Vanessa Moñivas Palomero, Susana Mingo Santos, Ana Isabel González Román, José Manuel Álvarez Avelló, Mercedes Vidal Fernández, Alberto Forteza Gil, Luis Alonso-Pulpón
INTRODUCTION AND OBJECTIVES: Most long-term ventricular assist devices (VADs) that are currently implanted are intracorporeal continuous-flow devices. Their main limitations include their high cost and inability to provide biventricular support. The aim of this study was to describe the results of using paracorporeal pulsatile-flow VADs as a bridge to transplant (BTT) in adult patients. METHODS: Retrospective analysis of the characteristics, complications, and outcomes of a single-center case series of consecutive patients treated with the EXCOR VAD as BTT between 2009 and 2015...
March 30, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28329112/comparison-of-paracorporeal-and-continuous-flow-ventricular-assist-devices-in-children-preliminary-results
#8
Mohamed S Nassar, Asif Hasan, Teresa Chila, Stephan Schueler, Carola Pergolizzi, Zdenka Reinhardt, Stephen Lord, Fabrizio De Rita, Lee Ferguson, Jon Smith, Simon Haynes, John O'Sullivan, Bari Murtuza
OBJECTIVES: With the scarcity of organs, a durable, reliable ventricular assist device (VAD) is required. The Berlin Heart EXCOR ® (BH) remains the most established VAD in the paediatric population. Implantable continuous flow (CF) VADs have been introduced to the paediatric field with encouraging early results. In this study, we compared the results of a newly introduced CF VAD (HeartWare VAD [HVAD] ® ) to results in a matched group of BH recipients. METHODS: The study included patients aged <16 years who received mechanical left VAD (LVAD) support between December 2005 and January 2016...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28259596/berlin-heart-excor-use-in-patients-with-congenital-heart-disease
#9
David L S Morales, Farhan Zafar, Christopher S Almond, Charles Canter, Francis Fynn-Thompson, Jennifer Conway, Iki Adachi, Angela Lorts
BACKGROUND: Management of mechanical circulatory support in children with congenital heart disease (CHD) is challenging due to physiologic variations and anatomic limitations to device placement. In this study we examine the use of Berlin Heart EXCOR in CHD patients. METHODS: CHD patients were identified from the EXCOR Pediatric Study data set (2007 to 2010). Mortality and serious adverse events were compared between CHD and non-CHD cohorts, and predictors of poor outcomes in the CHD cohort were identified...
February 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28184979/association-between-hematologic-and-inflammatory-markers-and-31-thrombotic-and-hemorrhagic-events-in-berlin-heart-excor-patients
#10
Amit Iyengar, Matthew L Hung, Kian Asanad, Oh Jin Kwon, Nicholas J Jackson, Brian L Reemtsen, Myke D Federman, Reshma M Biniwale
Bleeding and thrombotic events remain a significant cause of morbidity in pediatric patients supported with ventricular assist devices (VADs). The objective of this study is to identify the association between markers of anticoagulation and bleeding and thrombosis events during Berlin Heart ExCor support. A retrospective, single-center analysis of 9 patients supported with the Berlin Heart ExCor was performed. Inflammatory and anticoagulation parameters including C-reactive protein, fibrinogen, partial thromboplastin time (PTT), and platelet count were measured at 48 and 24 h before and after bleeding or thrombosis events...
April 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28174391/-ventricular-assist-device
#11
Minoru Ono
In Japan the 1st paracorporeal ventricular assist device (VAD) was implanted in 1980. Since then, more than 2,000 VADs were used. Small size continuous-flow VAD (CFVAD) was developed in 1990s, which dramatically improved safety and efficacy of long-term support. EVAHEART and DuraHeart, both of which were developed in Japan, were approved for health insurance coverage in 2011, followed by approval of HeartMate II in 2013 and Jarvik 2000 in 2014. Although these approvals were limited for bridge to transplantation, CFVADs gained rapid acceptance for treatment of end-stage heart failure...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28119406/closing-the-gap-in-paediatric-ventricular-assist-device-therapy-with-the-berlin-heart-excor%C3%A2-15-ml-pump%C3%A2
#12
Fabrizio De Rita, Massimo Griselli, Eugen Sandica, Oliver Miera, Ann Karimova, Yves d'Udekem, Ranny Goldwasser, Katarzyna Januszewska, Antonio Amodeo, Nadine Jurrmann, Simon Ersel, Ares K Menon
OBJECTIVES: The Berlin Heart EXCOR(®) (EXCOR) paediatric ventricular assist device is used worldwide for mechanical support of infants and small children with end-stage heart failure. A clinically important gap between the smallest EXCOR blood pump (10 ml) and the next larger size (25 ml) limited the choice of pump size in patients with a body surface area (BSA) between 0.33 and 0.5 m(2) We present the first clinical experience from the early product surveillance (EPS) of the new EXCOR 15-ml blood pump...
January 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27999550/the-use-of-berlin-heart-excor-vad-in-children-less-than-10-kg-a-single-center-experience
#13
Arianna Di Molfetta, Fabrizio Gandolfo, Sergio Filippelli, Gianluigi Perri, Luca Di Chiara, Roberta Iacobelli, Rachele Adorisio, Isabella Favia, Alessandra Rizza, Giuseppina Testa, Matteo Di Nardo, Antonio Amodeo
Objective: Despite the improvement in ventricular assist device (VAD) therapy in adults and in adolescents, in infant population only Berlin Heart EXCOR (BHE) is licensed as long term VAD to bridge children to Heart Transplantation (HTx). Particularly demanding in terms of morbidity and mortality are smallest patients namely the ones implanted in the first year of life or with a lower body surface area. This work aims at retrospective reviewing a single center experience in using BHE in children with a body weight under 10 kg...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27923944/membrane-oxygenator-use-with-biventricular-assist-device-facilitation-of-support-and-lung-recovery
#14
Kristen Nelson-McMillan, William J Ravekes, William R Thompson, Kristen M Brown, Larry Wolff, Rajeev S Wadia, LeAnn M McNamara, Donald H Shaffner, Ivor D Berkowitz, Marshall L Jacobs, Luca A Vricella
We present the use of a low-resistance membrane oxygenator (Quadrox D, Maquet) in series with a pulsatile right ventricular assist device (Berlin Heart EXCOR, Berlin Heart) in a patient with biventricular support who required high-frequency oscillatory ventilation (HFOV), due to refractory acute respiratory distress syndrome associated with Cytomegalovirus pneumonia. The high mean airway pressure associated with the use of HFOV resulted in a significant negative impact on left ventricular assist device (LVAD) filling that led to a combined respiratory and metabolic acidosis and the need for vasopressor support...
December 6, 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27862040/central-extracorporeal-life-support-with-left-ventricular-decompression-to-berlin-heart-excor-a-reliable-bridge-to-bridge-strategy-in-crash-and-burn-patients
#15
Alexander Weymann, Mina Farag, Anton Sabashnikov, Javid Fatullayev, Mohamed Zeriouh, Bastian Schmack, Rawa Arif, Florian Müller, Christina Alt, Philip Raake, Nikhil Prakash Patil, Aron-Frederik Popov, Andre Rüdiger Simon, Matthias Karck, Arjang Ruhparwar
The aim of this study was to compare patients with severe biventricular heart failure who underwent Berlin Heart Excor implantation with (cardiogenic shock [CS] status) or without the need for preoperative extracorporeal life support (ECLS) as a bridge to long-term device. A total of 40 consecutive patients with severe biventricular heart failure underwent Berlin Heart Excor implantation with (CS status, n = 20, 50%) or without (control, n = 20, 50%) the need for preoperative ECLS as a bridge to long-term device from March 2007 to May 2015 at our institution...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27832004/neurologic-neurocognitive-and-functional-outcomes-in-children-under-6-years-treated-with-the-berlin-heart-excor-ventricular-assist-device
#16
Juliana H VanderPluym, Charlene M T Robertson, Ari R Joffe, Jennifer Conway, Ivan M Rebeyka, David B Ross, Gonzalo Garcia Guerra, Mohammed M Al Aklabi, Holger Buchholz
The objective of this study is to describe the neurologic, neurocognitive, and functional outcomes of children aged under 6 years supported on the Berlin Heart EXCOR ventricular assist device (VAD) followed in the Complex Pediatric Therapies Follow-up Program (CPTFP). Sixteen patients were prospectively followed through this longitudinal, developmental program. The patients were evaluated with neurologic physical examination. Intelligence quotients (IQ) and functional outcome scores (ABAS-II scores) were obtained...
March 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27784856/early-single-institutional-experience-of-berlin-heart-excor-%C3%A2-pediatric-ventricular-assist-device-in-japan
#17
Takashi Kakuta, Takaya Hoashi, Heima Sakaguchi, Koji Kagisaki, Jun Negishi, Masatoshi Shimada, Etsuko Tsuda, Isao Shiraishi, Norihide Fukushima, Hajime Ichikawa
BACKGROUND: Since August 2015, the pediatric ventricular assist device (VAD), Berlin Heart EXCOR(®), has been accepted for use in Japan.Methods and Results:Between August 2015 and July 2016, 4 pediatric patients with endstage heart failure underwent LVAD implantation with the EXCOR(®)device. The median age and body weight at operation were 8 months and 4.8 kg. During a median follow-up of 7.3 months (range, 5.0-10.3), all patients survived. Two patients went on to heart transplantation and the remaining 2 are on a waiting list with stable hemodynamics...
November 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27660899/transplant-survival-after-berlin-heart-excor-support
#18
Roosevelt Bryant, Farhan Zafar, Chesney Castleberry, John L Jefferies, Angela Lorts, Clifford Chin, David L S Morales
The Berlin Heart EXCOR pediatric ventricular assist device (VAD) is approved by the Food and Drug Administration for bridge to cardiac transplantation (BTT) in children. As the clinical outcomes of the EXCOR continue to be evaluated in the United States, data on post-transplant survival are needed. The UNOS database was used to identify patients <18 years old undergoing orthotopic heart transplantation (OHT) from June 2004 to June 2014. Patients undergoing BTT with the EXCOR were identified. A matched cohort of (358) patients undergoing OHT without pretransplant mechanical circulatory support (no-MCS) was also identified as control subjects...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27637444/emergent-interhospital-transport-of-pediatric-patient-with-a-berlin-heart-device
#19
James H Hertzog, Thomas E Pearson, Marc A Priest, Ellen Spurrier, Ryan R Davies
Ventricular assist devices (VADs) for the mechanical support of cardiac failure are being used more frequently in children of increasingly younger age. These children have significant and multiple medical comorbidities, and their length of hospital stay has been increasing. As this population of hospitalized VAD-supported children increases, so does the possibility of their need for interfacility transport for specialized diagnostic or therapeutic procedures. Reports on such transports are limited to 3 children who underwent scheduled elective transfers...
September 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27587498/pediatric-acquired-von-willebrand-disease-with-berlin-heart-excor-ventricular-assist-device-support
#20
REVIEW
Nathan Gossai, Nicholas M Brown, Rebecca Ameduri, Nicole D Zantek, James St Louis, Marie E Steiner
BACKGROUND: The balance of hemostasis and anticoagulation is a concern for patients dependent upon ventricular assist devices (VADs). Bleeding is a common complication with both short- and long-term use of these devices. A better understanding of the risk factors and etiologies of bleeding associated with these devices is needed and could improve the overall results. We sought to determine the relationship of mechanical circulatory assist device use with acquired von Willebrand disease (avWD) in children...
September 2016: World Journal for Pediatric & Congenital Heart Surgery
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