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https://www.readbyqxmd.com/read/28448170/mechanical-circulatory-support-devices-methods-to-optimize-hemodynamics-during-use
#1
Ben Bow Chung, Gabriel Sayer, Nir Uriel
Introduction Mechanical circulatory support (MCS) is an increasingly utilized mode of therapy in the management of advanced heart failure, both as bridge to heart transplantation and destination therapy. As MCS becomes more prevalent, it is ever more important to understand the complex hemodynamics of these devices, as well as the strategies for hemodynamic optimization. Areas Covered This review provides an overview of hemodynamics in the normal human heart and the failing heart. We discuss the various short-term mechanical circulatory support devices and their hemodynamic consequences...
April 27, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28441642/first-in-man-percutaneous-transaxillary-artery-placement-and-removal-of-the-impella-5-0-mechanical-circulatory-support-device
#2
Kenta Nakamura, Sandeep Krishnan, Claudius Mahr, James M McCabe
We report on the fully percutaneous insertion and removal of the Impella 5.0 microaxial flow device via the axillary artery in a patient with cardiogenic shock and peripheral artery disease. Due to inadequate iliofemoral vasculature and desire for mobility, the axillary artery was felt to be the most appropriate access approach for temporary mechanical circulatory support. The procedure was well tolerated and the patient was supported for 17 days, at which time the device was safely removed in a fully percutaneous manner at the time of permanent left ventricular assist device placement...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#3
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)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28396040/risk-assessment-and-comparative-effectiveness-of-left-ventricular-assist-device-and-medical-management-in-ambulatory-heart-failure-patients-the-roadmap-study-2-year-results
#4
Randall C Starling, Jerry D Estep, Douglas A Horstmanshof, Carmelo A Milano, Josef Stehlik, Keyur B Shah, Brian A Bruckner, Sangjin Lee, James W Long, Craig H Selzman, Vigneshwar Kasirajan, Donald C Haas, Andrew J Boyle, Joyce Chuang, David J Farrar, Joseph G Rogers
OBJECTIVES: The authors sought to provide the pre-specified primary endpoint of the ROADMAP (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients) trial at 2 years. BACKGROUND: The ROADMAP trial was a prospective nonrandomized observational study of 200 patients (97 with a left ventricular assist device [LVAD], 103 on optimal medical management [OMM]) that showed that survival with improved functional status at 1 year was better with LVADs compared with OMM in a patient population of ambulatory New York Heart Association functional class IIIb/IV patients...
March 30, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28387838/temporary-mechanical-circulatory-support-after-orthotopic-heart-transplantation-a-single-centre-experience
#5
Vakhtang Tchantchaleishvili, Katherine L Wood, Laura A Carlson, Bryan Barrus, Michael F Swartz, Himabindu Vidula, Juan M Lehoux, H Todd Massey, Leway Chen
OBJECTIVES: There are various strategies in the use of temporary mechanical circulatory support following orthotopic heart transplant (OHT). We sought to examine the outcomes following different temporary mechanical circulatory support strategies for acute graft failure. METHODS: Patients who received an OHT between 2001 and 2015 at a single institution were retrospectively reviewed. Patients were divided into 2 groups based on the need for temporary mechanical circulatory support (TMCS)...
April 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28385948/hemocompatibility-related-outcomes-in-the-momentum-3-trial-at-6-months-a-randomized-controlled-study-of-a-fully-magnetically-levitated-pump-in-advanced-heart-failure
#6
Nir Uriel, Paolo C Colombo, Joseph C Cleveland, James W Long, Christopher Salerno, Daniel J Goldstein, Chetan B Patel, Gregory A Ewald, Antone J Tatooles, Scott C Silvestry, Ranjit John, Christiano Caldeira, Valluvan Jeevanandam, Andrew J Boyle, Kartik S Sundareswaran, Poornima Sood, Mandeep R Mehra
BACKGROUND : The HeartMate 3 (HM3) Left Ventricular Assist System (LVAS) (Abbott) is a centrifugal, fully magnetically levitated, continuous-flow blood pump engineered to enhance hemocompatibility and reduce shear stress on blood components. The MOMENTUM 3 trial (Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3) compares the HM3 LVAS with the HeartMate II (HMII) LVAS (Abbott) in advanced heart failure refractory to medical management, irrespective of therapeutic intention (bridge to transplant versus destination therapy)...
April 6, 2017: Circulation
https://www.readbyqxmd.com/read/28385314/management-of-ventricular-arrhythmias-in%C3%A2-patients-with-advanced-heart-failure
#7
REVIEW
Pasquale Santangeli, J Eduardo Rame, Edo Y Birati, Francis E Marchlinski
Advanced heart failure (A-HF) is characterized by progressive symptoms of heart failure despite optimal therapy. In patients with A-HF, ventricular arrhythmias (VAs) are common. Clinical studies evaluating different therapies to prevent VAs had very limited representation of patients with A-HF. Among antiarrhythmic drugs, only amiodarone reduces VAs, although its use may be associated with increased mortality. Catheter ablation with substrate modification is effective to achieve VA suppression in patients with A-HF, including those with left ventricular assist devices...
April 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28377296/mechanical-chest-compressions-improve-rate-of-return-of-spontaneous-circulation-and-allow-for-initiation-of-percutaneous-circulatory-support-during-cardiac-arrest-in-the-cardiac-catheterization-laboratory
#8
Joseph M Venturini, Elizabeth Retzer, J Raider Estrada, Janet Friant, David Beiser, Dana Edelson, Jonathan Paul, John Blair, Sandeep Nathan, Atman P Shah
BACKGROUND: Performing advanced cardiac life support (ACLS) in the cardiac catheterization laboratory (CCL) is challenging. Mechanical chest compression (MCC) devices deliver compressions in a small space, allowing for simultaneous percutaneous coronary intervention and reduced radiation exposure to rescuers. In refractory cases, MCC devices allow rescuers to initiate percutaneous mechanical circulatory support (MCS) and extracorporeal life support (ECLS) during resuscitation. This study sought to assess the efficacy and safety of MCC when compared to manual compressions in the CCL...
April 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28365175/outcomes-following-implantation-of-mechanical-circulatory-support-in-adults-with-congenital-heart-disease-an-analysis-of-the-interagency-registry-for-mechanically-assisted-circulatory-support-intermacs
#9
Christina J VanderPluym, Ari Cedars, Pirooz Eghtesady, Bryan G Maxwell, Jill M Gelow, Luke J Burchill, Simon Maltais, Devin A Koehl, Ryan S Cantor, Elizabeth D Blume
BACKGROUND: Adults with congenital heart disease represent an expanding and unique population of patients with heart failure (HF) in whom the use of mechanical circulatory support (MCS) has not been characterized. We sought to describe overall use, patient characteristics, and outcomes of MCS in adult congenital heart disease (ACHD). METHODS: All patients entered into the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) between June 23, 2006, and December 31, 2015, were included...
March 7, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28357450/an-alternative-strategy-for-bridge-to-transplant-recovery-in-small-children-with-dilated-cardiomyopathy
#10
REVIEW
Gilles Mets, Joseph Panzer, Daniël De Wolf, Thierry Bové
Dilated cardiomyopathy in children still has a poor prognosis with high rates of mortality and cardiac transplantation (resp. around 20 and 25%). Awaiting transplantation or possible recovery, these pediatric patients are mechanically supported with extracorporeal membrane oxygenation or a paracorporeal ventricular assist device, both resulting in higher survival rates but also entailing considerable risks of infection, thrombosis, or bleeding. A new indication for an old technique, i.e., pulmonary artery banding, presents itself as an interesting alternative to mechanical circulatory support in selected infants and small children with dilated LV cardiomyopathy and preserved RV function...
March 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28351172/current-status-of-mechanical-circulatory-support-for-treatment-of-advanced-end-stage-heart-failure-successes-shortcomings-and-needs
#11
Gengo Sunagawa, Marijan Koprivanac, Jamshid H Karimov, Nader Moazami, Kiyotaka Fukamachi
Heart failure (HF) remains a major global burden in terms of morbidity and mortality. Despite advances in pharmacological and resynchronization device therapy, many patients worsen to end-stage HF. Although the gold-standard treatment for such patients is heart transplantation, there will always be a shortage of donor hearts. Areas covered: A left ventricular assist device (LVAD) is a valuable option for these patients as a bridge measure (to recovery, to candidacy for transplant, or to transplant itself) or as destination therapy...
May 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28343276/an-updated-review-of-cardiac-devices-in-heart-failure
#12
REVIEW
C Murphy, H Zafar, F Sharif
BACKGROUND: Heart failure has the highest rates of adult hospitalisations, the highest mortality rates and significant costs associated with its care. The cost of heart failure is expected continue to grow on a global scale, with $108 billion spent on heart failure in 2012. Mortality rates are high, with incident cases of heart failure resulting in 30% 1-year mortality, and in hospital mortality of acute heart failure, 28%. METHODS AND RESULTS: This article reviews the devices currently in use for the treatment of heart failure, as well as those that are under investigation...
March 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28340840/short-term-results-of-heartmate-3-ventricular-assist-device-implantation-for-end-stage-heart-failure
#13
P Ozturk, S Ertugay, C Sahutoglu, C Engin, S Nalbantgil, T Yagdi, M Ozbaran
OBJECTIVE: To report our initial experience with Heartmate 3 ventricular assist device (HM3) in cases with end-stage heart failure (ESHF). METHODS: Charts of 8 ESHF patients who underwent HM3 implantation in our clinic from January to June 2016 (group 1) and 16 patients who underwent HM2 implantation during 2015 (group 2) were reviewed retrospectively. Demographics as well as pre- and early postoperative medical data were noted and statistically analyzed between the 2 groups...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28329060/first-series-of-left-ventricular-assist-device-exchanges-to-heartmate-3
#14
Jasmin S Hanke, Sebastian V Rojas, Günes Dogan, Christina Feldmann, Erik Beckmann, Ezin Deniz, Bettina Wiegmann, Jana-Elena Michaelis, L Christian Napp, Dominik Berliner, Malakh Shrestha, Johann Bauersachs, Axel Haverich, Jan D Schmitto
OBJECTIVES: Left ventricular assist device (LVAD) exchange is becoming a standard surgical procedure. The exchange procedure is an opportunity to upgrade patients to a new generation pump that offers advanced reduction of adverse events or longer battery hours. METHODS: We performed an analysis of 6 consecutive patients who underwent LVAD exchange to HeartMate 3 either from a HeartWare or HeartMate (HM) II device. Minimally invasive operations were performed through a lateral thoracotomy...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28321882/optical-dynamic-analysis-of-thrombus-inside-a-centrifugal-blood-pump-during-extracorporeal-mechanical-circulatory-support-in-a-porcine-model
#15
Tatsuki Fujiwara, Daisuke Sakota, Katsuhiro Ohuchi, Shu Endo, Tomoki Tahara, Tomotaka Murashige, Ryo Kosaka, Keiji Oi, Tomohiro Mizuno, Osamu Maruyama, Hirokuni Arai
Complications due to pump thrombus remain the weak point of mechanical circulatory support (MCS), such as the use of a left ventricular assist device (LVAD) or extracorporeal membrane oxygenation, leading to poor outcomes. Hyperspectral imaging (HSI) is an effective imaging method using a hyperspectral (HS) camera, which comprises a spectrophotometer and a charge-coupled device camera to discriminate thrombus from whole blood. Animal experiments were conducted to analyze dynamic imaging of thrombus inside a prototype of a hydrodynamically levitated centrifugal blood pump using an HSI system...
March 20, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28306593/current-concepts-for-sensitized-patients-before-transplantation
#16
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/28299615/remote-monitoring-in-heart-failure-the-current-state
#17
REVIEW
Rajeev C Mohan, J Thomas Heywood, Roy S Small
The treatment of congestive heart failure is an expensive undertaking with much of this cost occurring as a result of hospitalization. It is not surprising that many remote monitoring strategies have been developed to help patients maintain clinical stability by avoiding congestion. Most of these have failed. It seems very unlikely that these failures were the result of any one underlying false assumption but rather from the fact that heart failure is a progressive, deadly disease and that human behavior is hard to modify...
March 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28259366/mechanical-support-with-venoarterial-extracorporeal-membrane-oxygenation-ecmo-va-short-term-and-long-term-prognosis-after-a-successful-weaning
#18
R García-Gigorro, E Renes-Carreño, J L Pérez-Vela, H Marín-Mateos, J Gutiérrez, M A Corrés-Peiretti, J F Delgado, E Pérez-de la Sota, J M Cortina-Romero, J C Montejo-González
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) affords mechanical circulatory assistance associated to high mortality. However, weaning from such mechanical support may not imply improved short- or long-term survival. This study describes the characteristics and evolution of patients with refractory cardiogenic shock (RCS) subjected to venoarterial ECMO (VA-ECMO) in a hospital with a heart transplant program. DESIGN: A single-center, retrospective cohort study was carried out...
March 2, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28243893/successful-management-of-antibody-mediated-rejection-after-cardiac-transplantation-in-a-patient-supported-by-a-left-ventricular-assist-device-for-more-than-3%C3%A2-years
#19
Masatoshi Akiyama, Shingo Takahara, Satoshi Kawatsu, Yoichi Endo, Junko Fujiwara, Osamu Adachi, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki
Due to donor shortage, patients with refractory heart failure need to be supported on mechanical circulatory support (MCS). Critically, patients undergo several deployments of MCS in stages inevitably requiring blood products transfusion. MCSs per se along with blood products can trigger immune allosensitization. Antibody-mediated rejection (AMR) is associated with significant mortality after heart transplantation. Here, we present the case with high panel-reactive antibody over 95% who developed AMR early after heart transplantation...
February 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28222499/prediction-of-the-level-and-duration-of-shear-stress-exposure-that-induces-subhemolytic-damage-to-erythrocytes
#20
Michael J Simmonds, Herbert J Meiselman
BACKGROUND: Current generation mechanical circulatory assist devices are designed to minimize high shears to blood for prolonged durations to avoid hemolysis. However, red blood cells (RBC) demonstrate impaired capacity to deform when exposed to shear stress (SS) well below the "hemolytic threshold". OBJECTIVE: We endeavored to identify how changes in the magnitude and duration of SS exposure alter RBC deformability and subsequently develop a model to predict erythrocyte subhemolytic damage...
2016: Biorheology
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