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mechanical circulatory assistance

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https://www.readbyqxmd.com/read/28087105/left-ventricular-assist-device-outcomes-based-on-flow-configuration-and-pre-operative-left-ventricular-dimension-an-interagency-registry-for-mechanically-assisted-circulatory-support-analysis
#1
Palak Shah, Sarah Birk, Simon Maltais, John Stulak, Angelo Elmi, Francis D Pagani, Jennifer A Cowger
BACKGROUND: Axial configuration (AC) and centrifugal configuration (CC) left ventricular assist devices (LVAD) have different flow characteristics, and whether the interaction between device flow configuration and the pre-operative left ventricular internal diastolic diameter (LVIDD) mediates adverse events after LVAD implantation is unknown. METHODS: We queried 9,424 continuous-flow LVAD recipients who received LVADs from April 2008 to June of 2015 in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
December 16, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#2
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28073849/caregivers-of-patients-with-left-ventricular-assist-devices-possible-impacts-on-patients-mortality-and-interagency-registry-for-mechanically-assisted-circulatory-support-defined-morbidity-events
#3
Courtenay R Bruce, Charles G Minard, L A Wilhelms, Mackenzie Abraham, Javier Amione-Guerra, Linda Pham, Sherry D Grogan, Barry Trachtenberg, Martin L Smith, Brian A Bruckner, Jerry D Estep, Kristin M Kostick
BACKGROUND: How caregivers contribute to positive or negative outcomes for left ventricular assist device (LVAD) patients remains unclear. Our primary study objectives were to (1) identify caregiver support attributes through a retrospective chart review of social workers' psychosocial assessments for LVAD patients and (2) determine how these attributes associated with patients' post-LVAD placement mortality and Interagency Registry for Mechanically Assisted Circulatory Support-defined morbidity events...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#4
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040188/effect-of-early-initiation-of-mechanical-circulatory-support-on-survival-in-cardiogenic-shock
#5
Mir B Basir, Theodore L Schreiber, Cindy L Grines, Simon F Dixon, Jeffrey W Moses, Brijeshwar S Maini, Akshay K Khandelwal, E Magnus Ohman, William W O'Neill
The role and timing of percutaneous mechanical circulatory support (MCS) devices in the treatment of acute myocardial infarction complicated by cardiogenic shock (AMICS) are not well understood. We sought to evaluate patient characteristics and predictors of outcomes in patients presenting with AMICS supported with an axial flow percutaneous MCS device; 287 consecutive unselected patients enrolled in the catheter-based ventricular assist device registry presenting with AMICS who underwent percutaneous coronary intervention (PCI) were included in this analysis...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28038817/low-partial-pressure-of-end-tidal-carbon-dioxide-predicts-left-ventricular-assist-device-implantation-in-patients-with-advanced-chronic-heart-failure
#6
Osamu Seguchi, Eriko Hisamatsu, Atsushi Nakano, Seiko Nakajima, Kensuke Kuroda, Takuya Watanabe, Takuma Sato, Haruki Sunami, Masanobu Yanase, Hiroki Hata, Toshimitsu Hamasaki, Tomoyuki Fujita, Junjiro Kobayashi, Takeshi Nakatani, Masafumi Kitakaze, Norihide Fukushima
BACKGROUND: This study aimed to clarify the prognostic impact of partial pressure of end-tidal carbon dioxide (PETCO2) in patients with advanced chronic heart failure (HF). METHODS: Forty-eight patients (mean age 43.1±11.9years, 32 males) with chronic HF (44 with non-ischemic and 4 with ischemic cardiomyopathy) were prospectively enrolled. Echocardiography, blood tests, pulmonary function testing, and PETCO2 measurements were performed as noninvasive tests, whereas right heart catheterization and arterial blood gas analysis were conducted as invasive tests...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28033202/the-effect-of-geometry-on-the-efficiency-and-hemolysis-of-centrifugal-implantable-blood-pumps
#7
Sahand Mozafari, Mohammad A Rezaienia, Gordon M Paul, Martin T Rothman, Pihua Wen, Theodosios Korakianitis
The application of centrifugal pumps as heart assist devices imposes design limitations on the impeller geometry. Geometry and operating parameters will affect the performance and the hemocompatibility of the device. Among all the parameters affecting the hemocompatibility, pressure, rotational speed, blade numbers, angle, and width have significant impact on the blood trauma. These parameters directly (pressure, speed) and indirectly (geometry) affect the efficiency of the pump as well. This study describes the experimental investigation on geometric parameters and their effect on the performance of small centrifugal pumps suitable for Mechanical Circulatory Support (MCS) devices...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28033201/right-ventricular-failure-post-lvad-implantation-corrected-with-biventricular-support-an-in-vitro-model
#8
Sajad Shehab, Sabine M Allida, Patricia M Davidson, Phillip J Newton, Desiree Robson, Paul C Jansz, Christopher S Hayward
Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. Management remains limited to pharmacologic therapy and temporary mechanical support. Delayed right ventricular assist device (RVAD) support after LVAD implantation is associated with poorer outcomes. With the advent of miniaturized, durable, continuous flow ventricular assist device systems, chronic RVAD and biventricular assist device (BiVAD) support has been used with some success. The purpose of this study was to assess combined BiVAD and LVAD with delayed RVAD support within a four-elemental mock circulatory loop (MCL) simulating the human cardiovascular system...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28029573/mechanical-circulatory-support-and-heart-transplantation-in-the-asia-pacific-region
#9
EDITORIAL
Cumaraswamy Sivathasan, Choon Pin Lim, Ka Lee Kerk, David K L Sim, Mandeep R Mehra
Globalization has resulted in epidemiologic transition in developing countries from infectious disease and nutritional deficiencies to non-communicable diseases. Epidemiologic data on heart failure (HF), particularly advanced HF therapy, in Asia are increasingly becoming available, although they remain sparse. Heart transplantation for advanced stage HF remains very low in Asia-approximately 0.075 heart transplants per 1 million population. North America, which comprises 7.5% of the world population, accounted for 55...
September 29, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28007064/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-public-reporting-initiative
#10
REVIEW
Jeffrey P Jacobs
Three basic principles provide the rationale for the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (CHSD) public reporting initiative: (1) Variation in congenital and pediatric cardiac surgical outcomes exist. (2) Patients and their families have the right to know the outcomes of the treatments that they will receive. (3). It is our professional responsibility to share this information with them in a format they can understand. The STS CHSD public reporting initiative facilitates the voluntary transparent public reporting of congenital and pediatric cardiac surgical outcomes using the STS CHSD Mortality Risk Model...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/28007060/mechanical-circulatory-support-of-the-fontan-patient
#11
REVIEW
Ronald K Woods, Nancy S Ghanayem, Michael E Mitchell, Steven Kindel, Robert A Niebler
Because of the inadequacies inherent to a circulation supported by a single ventricle, many Fontan patients will experience failure of their circulation. To date, there is no medical regimen that reliably and consistently restores circulatory function in these patients. Because of the shortage of donor organs and the fact that many of these patients present with features that either preclude or render heart transplantation a high risk, there is an intense need to better understand how mechanical circulatory support (MCS) may benefit these patients...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27994387/refractory-pediatric-cardiogenic-shock-a-case-for-mechanical-support
#12
Anil Sachdev, Bharat Mehra, Arun Mohanty, Dhiren Gupta, Neeraj Gupta
Acute left ventricular dysfunction in children justifies aggressive treatment because of the high potential for complete recovery. The options for providing mechanical support to the failing heart in a child include extracorporeal membrane oxygenation, left ventricular assist devices, and the use of the intra-aortic balloon pump (IABP). The IABP is a commonly used method of temporary circulatory support in adults. However, despite the availability of pediatric size balloons, the usage of IABP for temporary circulatory support in children has not been widespread...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27988030/bridge-to-durable-left-ventricular-assist-device-for-refractory-cardiogenic-shock
#13
Daisuke Yoshioka, Hiroo Takayama, Arthur R Garan, Veli K Topkara, Jiho Han, Boyganzi Li, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
OBJECTIVE: The role of short-term mechanical circulatory support has increased in patients with refractory cardiogenic shock. However, limited data exist on the outcomes of a bridge to a durable left ventricular assist device strategy using short-term mechanical circulatory support. METHODS: We retrospectively reviewed 382 patients who underwent continuous-flow left ventricular assist device insertion between 2004 and 2014. Of these, 45 (12%) were bridged with short-term mechanical circulatory support devices for refractory cardiogenic shock...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27987352/design-of-a-right-ventricular-mock-circulation-loop-as-a-test-bench-for-right-ventricular-assist-devices
#14
Indra Mueller, So-Hyun Jansen-Park, Michael Neidlin, Ulrich Steinseifer, Dirk Abel, Rüdiger Autschbach, Rolf Rossaint, Thomas Schmitz-Rode, Simon Johannes Sonntag
Right heart failure (RHF), e.g. due to pulmonary hypertension (PH), is a serious health issue with growing occurrence and high mortality rate. Limited efficacy of medication in advanced stages of the disease constitutes the need for mechanical circulatory support of the right ventricle (RV). An essential contribution to the process of developing right ventricular assist devices (RVADs) is the in vitro test bench, which simulates the hemodynamic behavior of the native circulatory system. To model healthy and diseased arterial-pulmonary hemodynamics in adults (mild and severe PH and RHF), a right heart mock circulation loop (MCL) was developed...
December 17, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27984320/low-accuracy-of-the-heartmate-risk-score-for-predicting-mortality-using-the-intermacs-registry-data
#15
Manreet K Kanwar, Lisa C Lohmueller, Robert L Kormos, Natasha A Loghmanpour, Raymond L Benza, Robert J Mentz, Stephen H Bailey, Srinivas Murali, James F Antaki
Patient selection is a key determinant of clinical outcomes after LVAD placement in patients with end stage heart failure. The HMRS has been proposed to facilitate risk stratification and patient selection for continuous flow pumps. This study retrospectively assessed the performance of HMRS in predicting 90-day and 1-year mortality in patients within the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). 11,523 INTERMACS patients who received a continuous flow LVAD between 2010 and 2015 were retrospectively categorized per their calculated HMRS to predict their 90-day and 1-year risk of mortality...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27984228/new-innovations-in-circulatory-support-with-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-therapy
#16
Robert N Sladen
The past decade has seen an exponential increase in the application and development of durable long-term as well as nondurable short-term mechanical circulatory support for cardiogenic shock and acute or chronic heart failure. Support has evolved from bridge-to-transplant to destination therapy, bridge to rescue, bridge to decision making, and bridge to a bridge. Notable trends include device miniaturization, minimally invasive and/or percutaneous insertion, and efforts to superimpose pulsatility on continuous flow...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27955912/are-biventricular-assist-devices-underused-as-a-bridge-to-heart-transplantation-in-patients-with-a-high-risk-of-postimplant-right-ventricular-failure
#17
Sven-Erik Bartfay, Göran Dellgren, Hans Lidén, Mikael Holmberg, Jakob Gäbel, Bengt Redfors, Odd Bech-Hanssen, Kristjan Karason
OBJECTIVE: Right ventricular failure in patients treated using left ventricular assist devices is associated with poor outcomes. We assessed the strategy of preplanned biventricular assist device implantation in patients with a high risk for right ventricular failure. METHODS: Between 2010 and 2014, we assigned 20 patients to preplanned biventricular assist device and 21 patients to left ventricular assist device as a bridge to heart transplantation on the basis of the estimated risk of postimplant right ventricular failure...
November 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27935084/a-physical-heart-failure-simulation-system-utilizing-the-total-artificial-heart-and-modified-donovan-mock-circulation
#18
Jessica R Crosby, Katrina J DeCook, Phat L Tran, Edward Betterton, Richard G Smith, Douglas F Larson, Zain I Khalpey, Daniel Burkhoff, Marvin J Slepian
With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12...
December 9, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27922885/ventricular-assist-device-implantation-configurations-impact-overall-mechanical-circulatory-support-system-thrombogenic-potential
#19
Wei-Che Chiu, Yared Alemu, Allison J McLarty, Shmuel Einav, Marvin J Slepian, Danny Bluestein
Ventricular assist devices (VAD) became in recent years the standard of care therapy for advanced heart failure with hemodynamic compromise. With the steadily growing population of device recipients, various post-implant complications have been reported, mostly associated with the hyper-shear generated by VADs that enhance their thrombogenicity by activating platelets. While VAD design optimization can significantly improve its thromboresistance, the implanted VAD need to be evaluated as part of a system. Several clinical studies indicated that variability in implantation configurations may contribute to the overall system thrombogenicity...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922882/exercise-hemodynamics-as-a-predictor-of-myocardial-recovery-in-lvad-patients
#20
Louise Segan, Shane Nanayakkara, Angeline Leet, Donna Vizi, David M Kaye
Mechanical circulatory support using left ventricular assist devices (LVADs) has been demonstrated to improve survival in patients with advanced heart failure. LVAD therapy also promotes reverse ventricular remodeling, which in some cases has led to sufficient myocardial recovery to allow LVAD removal. Identification of suitable patients for LVAD removal however remains challenging. We investigated the hypothesis that invasive assessment of exercise hemodynamics may provide additional information in relation to the assessment of contractile reserve in potential candidates for LVAD explant...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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