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Coronary artery bypass,LVAD

Masashi Kawabori, Chitaru Kurihara, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Left ventricular assist devices (LVADs) have become the standard therapy for patients with end-stage heart failure, and the use of LVADs for long-term support has grown exponentially over the past decade. As the number of LVAD implantations has increased, surgeons have faced more challenging cases, such as those in which the patient has previously undergone a sternotomy. The HeartMate II is one of the most widely implanted LVADs. The standard procedure for HeartMate II implantation is median sternotomy and sewing the outflow graft to the ascending aorta...
May 21, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Hazem El Beyrouti, Angela Kornberger, Nancy Halloum, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Coronary involvement in aortic dissection heralds a poor outcome. Involvement of the left main stem may lead to left ventricular (LV) failure requiring mechanical circulatory support. CASE REPORT: A staged approach was applied in a 24-year-old female who suffered extensive infarction due to aortic dissection with left main stem involvement. After replacement of the ascending aorta and grafting of the left internal thoracic artery to the left anterior descending artery following a failed attempt at reconstruction of the left coronary ostium, she failed to wean from cardiopulmonary bypass (CPB) and underwent implantation of an extracorporeal life support (ECLS) system as a bridge to decision...
May 21, 2018: Annals of Thoracic and Cardiovascular Surgery
Robert J Steffen, Eugene H Blackstone, Nicholas G Smedira, Edward G Soltesz, Katherine J Hoercher, Lucy Thuita, Randall C Starling, Maria Mountis, Nader Moazami
BACKGROUND: Optimal timing of heart transplantation in patients supported with second-generation left ventricular assist devices (LVADs) is unknown. Despite this, patients with LVADs continue to receive priority on the heart transplant waiting list. Our objective was to determine the optimal timing of transplantation for patients bridged with continuous-flow LVADs. METHODS: A total of 301 HeartMate II LVADs (Thoratec Corp, Pleasanton, CA) were implanted in 285 patients from October 2004 to June 2013, and 86 patients underwent transplantation through the end of follow-up...
November 2017: Annals of Thoracic Surgery
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Amrish Deshmukh, Gene Kim, Martin Burke, Emeka Anyanwu, Valluvan Jeevanandam, Nir Uriel, Roderick Tung, Cevher Ozcan
BACKGROUND: The incidence, predictors, and impact of atrial arrhythmias along with left atrial structural changes in patients with left ventricular assist devices (LVADs) remain undetermined. METHODS AND RESULTS: All patients who underwent LVAD implantation from 2008 to 2015 at the University of Chicago Medical Center were included. Electronic medical records, electrocardiograms, echocardiograms, and cardiac electrical device interrogations were reviewed. The association of arrhythmias and clinical covariates with survival was evaluated by Kaplan-Meier and Cox proportional hazards analyses...
March 8, 2017: Journal of the American Heart Association
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
Tony Lu, Shayan Owji, Ponraj Chinnadurai, Thomas M Loh, Adeline Schwein, Alan B Lumsden, Jean Bismuth
A 62-year-old man with coronary artery disease and ischemic cardiomyopathy after coronary artery bypass grafting and insertion of a HeartMate II (Thoratec, Pleasanton, CA) left ventricular assist device (LVAD) presented with spontaneous incisional bleeding and an ascending aortic pseudoaneurysm. Aortic angiography revealed an anomalous connection between the pseudoaneurysm and the LVAD conduit. We were able to partially embolize the tract with standard techniques, but the patient returned with repeated bleeding...
November 2016: Annals of Thoracic Surgery
Johannes Blumenstein, Suzanne de Waha, Holger Thiele
Percutaneous mechanical circulatory support devices, such as intra-aortic balloon pump (IABP), active left ventricular assist devices (LVAD) or extracorporeal life support (ECLS), are treatment options for selected patients in cardiogenic shock, undergoing cardiopulmonary resuscitation, or high-risk percutaneous coronary intervention and coronary artery bypass grafting. Potential benefits include the maintenance of organ function and the reduction of intracardiac pressures, volumes, and oxygen consumption. On the other hand, they are invasive, resource intensive, and can be associated with serious complications...
May 17, 2016: EuroIntervention
Lisheng Qiu, Xiafeng Yu, Jinfen Liu, Wei Zhang
OBJECTIVE: To review the experience of left ventricular assistance device (LVAD) using for anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) in perioperative period. METHODS: There were 29 patients with ALCAPA underwent surgical repair from May 2006 to May 2013. The mean age was 6.5 months (ranging from 3.3 to 12.1 months). The mean weight was 6.2 kg (ranging from 4.1 to 9.5 kg). Diagnosis was established by echocardiography in all patients...
June 1, 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Simon Schopka, Alois Philipp, Michael Hilker, Thomas Müller, Markus Zimmermann, Matthias Arlt, Leopold Rupprecht, Christof Schmid, Dirk Lunz
BACKGROUND: Interhospital transfer of patients experiencing circulatory failure and shock has a significant risk of cardiovascular deterioration and death. Extracorporeal life support (ECLS) is a rescue tool for hemodynamic stabilization that makes patient transportation much safer. METHODS: Demographic data, clinical course, and outcome data were reviewed for patients who underwent placement of a venoarterial ECLS in a remote hospital and were transported to our tertiary care facility...
August 2015: Resuscitation
Jun-Ming Zhu, Rui-Dong Qi, Yong-Min Liu, Jun Zheng, Xiao-Yan Xing, Li-Zhong Sun
BACKGROUND: Mitral regurgitation (MR) is very rare in patients with type A dissection. We retrospectively reviewed our experience of total arch replacement (TAR) with mitral valve surgery for type A dissection with MR. METHODS: From November 2009 to October 2012, 14 patients with type A dissection (chronic = 11; acute = 3) with MR underwent TAR combined with mitral valve surgery under hypothermic cardiopulmonary bypass with selective cerebral perfusion. The Bentall procedure was performed in 11 patients, aortic valve replacement (AVR) in one patient, coronary artery bypass grafting (CABG) in three patients, and tricuspid valvuloplasty (TVP) in one patient...
May 2015: Journal of Cardiac Surgery
Adrian Bauer, Jan Schaarschmidt, F Oliver Grosse, Nidal Al Alam, Harald Hausmann, Klaus Krämer, Martin Strüber, Friedrich W Mohr
The use of extracorporeal life support systems (ECLS) in patients with postcardiotomy low cardiac output syndrome (LCO) as a bridge to recovery and bridge to implantation of ventricular assist device (VAD) is common nowadays. A 59-year-old patient with acute myocardial infarction received a percutaneous transluminal angioplasty and stenting of the circumflex artery. During catheterization of the left coronary artery (LAD), the patient showed ventricular fibrillation and required defibrillation and cardiopulmonary resuscitation...
June 2014: Journal of Extra-corporeal Technology
Amol Raizada, Marian Petrasko, Tomasz P Stys, Adam T Stys
Coronary artery disease (CAD) involving the left main (LM) artery has traditionally been considered an indication for coronary artery bypass surgery (CABG). With recent advances in the field of percutaneous coronary interventions (PCI), angioplasty and stenting of the unprotected' LM has been performed in patients at high surgical risk. This is a challenging intervention as a large area of myocardium is at risk during the procedure. Features that make it especially high risk are distal stenosis of this vessel and presence of coronary disease in other territories...
July 2014: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Lauren Ng, Jing Wang, Laith Altaweel, M Kamran Athar
In this review, cardiac arrest is discussed, with a focus on neuroprognostication and the emerging data, with regard to identifying more accurate predictors of neurologic outcomes in the era of therapeutic hypothermia. Topics discussed include recent controversies with regard to targeted temperature management in comatose survivors of cardiac arrest; neurologic complications associated with surgical disease and procedures, namely aortic dissection, infective endocarditis, left ventricular assist devices, and coronary artery bypass grafting; and the cause, pathogenesis, and management of neurogenic stunned myocardium...
July 2014: Critical Care Clinics
Abhishek Bose, Gaurav A Upadhyay, Jagdesh Kandala, Edwin K Heist, Theofanie Mela, Kimberly A Parks, Jagmeet P Singh
AIMS: Cardiac valve surgery (CVS) has been implicated as a potential barrier to optimal response after cardiac resynchronization therapy (CRT) though prospective data regarding outcome remains limited. We sought to determine CRT response in patients with a prior history of CVS. METHODS AND RESULTS: We performed a retrospective analysis of a prospectively acquired cohort of CRT patients with history of CVS. Echocardiographic response was evaluated at baseline and 6 months...
November 2014: Journal of Cardiovascular Electrophysiology
William G Cotts, Edwin C McGee, Susan L Myers, David C Naftel, James B Young, James K Kirklin, Kathleen L Grady
BACKGROUND: Few studies have reported on hospital length of stay (LOS) after left ventricular assist device (LVAD) implantation. The purpose of this study was to determine pre- and peri-operative predictors of hospital LOS after LVAD implantation. METHODS: We analyzed adult primary continuous-flow LVAD patients implanted between June 23, 2006 and December 31, 2010 at 105 institutions from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
July 2014: Journal of Heart and Lung Transplantation
Suzanne de Waha, Steffen Desch, Ingo Eitel, Georg Fuernau, Philipp Lurz, Marcus Sandri, Gerhard Schuler, Holger Thiele
Intra-aortic balloon pump (IABP) counterpulsation has been the most widely used left ventricular assist device for nearly five decades. Due to diastolic inflation and systolic deflation, coronary blood flow is increased and afterload decreased translating into augmentation of oxygen supply and lowering of oxygen demand. However, IABP may be associated with serious complications, including major bleeding, stroke, local and systemic infections and vascular complications. These might counterbalance the potential beneficial hemodynamic effects...
April 2014: Vascular Pharmacology
Navin K Kapur, Vikram Paruchuri, Anand Jagannathan, Daniel Steinberg, Anjan K Chakrabarti, Duane Pinto, Nima Aghili, Samer Najjar, John Finley, Nicole M Orr, Michael Tempelhof, James O Mudd, Michael S Kiernan, Duc Thinh Pham, David DeNofrio
OBJECTIVES: The aim of this study was to explore the clinical utility of a commercially available centrifugal flow pump as a centrifugal flow-right ventricular support device (CF-RVSD) in patients with right ventricular failure (RVF). BACKGROUND: RVF is associated with high in-hospital mortality. Limited data regarding efficacy of the CF-RVSD for RVF exist. METHODS: We retrospectively reviewed data from 46 patients receiving a CF-RVSD for RVF from a registry comprising data from 8 tertiary-care hospitals in the United States...
April 2013: JACC. Heart Failure
Mamoru Arakawa, Takashi Nishimura, Yoshiaki Takewa, Akihide Umeki, Masahiko Ando, Hideo Adachi, Eisuke Tatsumi
OBJECTIVE: We previously developed a native heart load control system for a continuous-flow left ventricular assist device and demonstrated that the rotational speed synchronized with the cardiac cycle can alter left ventricular preload and myocardial oxygen consumption. In the present study, we assessed this system in a conscious goat model of chronic heart failure. METHODS: Chronic heart failure was induced by coronary microsphere embolization of the left ascending artery and subsequent rapid ventricular pacing in 6 goats...
August 2014: Journal of Thoracic and Cardiovascular Surgery
Andre Babak Akhondi, Michael S Lee
Patients with high-risk coronary lesions may be denied coronary artery bypass grafting due to excessive comorbidities. Percutaneous coronary intervention (PCI) may be a feasible revascularization strategy in high-risk patients who present with ST-elevation myocardial infarction and cardiogenic shock. Historically, the use if intra-aortic balloon pump (IABP) has been used in high-risk PCI and cardiogenic shock. However, recent data has shown that elective IABP insertion did not reduce the incidence of major cardiovascular events following PCI...
2013: Reviews in Cardiovascular Medicine
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