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Ventricle assist device

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https://www.readbyqxmd.com/read/28093805/heartware-ventricular-assist-device-implantation-in-patients-with-fontan-physiology
#1
Bartlomiej R Imielski, Robert A Niebler, Steven J Kindel, Ronald K Woods
We aim to describe the clinical course of a series of patients with hypoplastic left heart syndrome and refractory systolic heart failure supported with a HeartWare ventricular assist device (HVAD) following Fontan palliation. This is a retrospective review of three consecutive patients supported with a HVAD following Fontan palliation through February 2016. Data include patient characteristics, operative variables, postimplantation hemodynamic/device parameters, event outcomes, and duration of HVAD support...
January 2017: Artificial Organs
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
#2
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/28043423/vasodilatory-shock-after-ventricular-assist-device-placement-a-bench-to-bedside-review
#3
REVIEW
John Baer, Shea Stoops, Brigid Flynn
With more than 2000 ventricular assist devices (VAD) placed annually in the United States, understanding postoperative management is important. One of the most common postoperative morbidities encountered with VAD implantation is vasodilatory shock. The mechanisms for this phenomenon are numerous and include cellular and hormonal aberrancies unique to the VAD recipient. Management of vasodilatory shock in VAD patients needs to be undertaken with an understanding of the side effects associated with each treatment, especially the effects on the right ventricle and pulmonary vasculature...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040759/novel-application-of-a-percutaneous-left-ventricular-assist-device-as-a-bridge-to-transplant-in-a-paediatric-patient-with-severe-heart-failure-due-to-viral-myocarditis
#4
Paul Perry, Elizabeth David, Broadus Atkins, Gary Raff
A 13-year obese female with suspected viral myocarditis presented with acute decompensated heart failure. Due to her body habitus, she was a poor candidate for immediate heart transplantation. A peripherally inserted left ventricular assist device (LVAD) was implanted via the right axillary artery. Following device insertion the patient experienced rapid improvement in symptoms. The LVAD provided effective left ventricular unloading for 50 days, promoting myocardial recovery and maintaining excellent patient performance status...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28038771/superior-performance-of-continuous-over-pulsatile-flow-ventricular-assist-devices-in-the-single-ventricle-circulation-a-computational-study
#5
Tyler Schmidt, David Rosenthal, Olaf Reinhartz, Kirk Riemer, Fei He, Tain-Yen Hsia, Alison Marsden, Ethan Kung
This study compares the physiological responses of systemic-to-pulmonary shunted single ventricle patients to pulsatile and continuous flow ventricular assist devices (VADs). Performance differences between pulsatile and continuous flow VADs have been clinically observed, but the underlying mechanism remains poorly understood. Six systemic-to-pulmonary shunted single ventricle patients (mean BSA=0.30m(2)) were computationally simulated using a lumped-parameter network tuned to match patient specific clinical data...
December 20, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/28025826/concurrent-use-of-continuous-and-pulsatile-flow-ventricular-assist-device-on-a-fontan-patient-a-simulation-study
#6
Arianna Di Molfetta, Gianfranco Ferrari, Roberta Iacobelli, Sergio Filippelli, Antonio Amodeo
The aim of this work is to develop and test a lumped parameter model of the cardiovascular system to simulate the concurrent use of pulsatile (PVAD) and continuous flow (CVAD) ventricular assist device (VAD) on Fontan patients. Echocardiographic and hemodynamic data of five Fontan patients were retrospectively collected and used to simulate the patients' baseline hemodynamics. Then, for each patient, the following assistance modality was simulated for the cavopulmonary and the single ventricle (SV): (a) CVAD for cavopulmonary assistance (RCF) and PVAD assisting the SV (LCF) (RPF + LCF), (b) CVAD assisting SV and PVAD for cavopulmonary assistance (LPF + RCF)...
December 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/28017353/significance-of-residual-mitral-regurgitation-after-continuous-flow-left%C3%A2-ventricular-assist-device-implantation
#7
Hayah Kassis, Krishna Cherukuri, Richa Agarwal, Manreet Kanwar, Subbarao Elapavaluru, George G Sokos, Robert J Moraca, Stephen H Bailey, Srinivas Murali, Raymond L Benza, Amresh Raina
OBJECTIVES: This study hypothesized that the presence of residual mitral regurgitation (MR) post-continuous flow (CF) left ventricular assist device (LVAD) implantation based on quantitative assessment would be negatively associated with right ventricular (RV) size and function and clinical outcomes. BACKGROUND: MR is associated with elevated left atrial pressure, secondary pulmonary hypertension and RV dysfunction. Implantation of a LVAD leads to mechanical unloading of the left ventricle and generally improves MR...
November 30, 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/28009715/impact-of-lvad-implantation-site-on-ventricular-blood-stagnation
#8
Anthony R Prisco, Alberto Aliseda, Jennifer A Beckman, Nahush A Mokadam, Claudius Mahr, Guilherme J M Garcia
Treatment of end-stage heart failure includes cardiac transplantation or ventricular assist device (VAD) therapy. While increasingly prevalent, current VAD therapy has inherent complications, including thrombosis. Studies have demonstrated that VAD implantation alters intra-cardiac blood flow, creating areas of stagnation that predispose to thrombus formation. Two potential surgical configurations exist for VAD implantation: through the apical or diaphragmatic surfaces of the heart. We hypothesized that diaphragmatic implantation causes more stagnation than apical implantation...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28009041/left-ventricle-assist-device-supported-rotational-atherectomy-of-the-highly-calcified-last-remaining-vessel-in-a-patient-with-acute-myocardial-infarction-and-reduced-left-ventricular-function
#9
Brunon Tomasiewicz, Mirosław Ferenc, Wojciech Zimoch, Piotr Kübler, Krzysztof Reczuch
No abstract text is available yet for this article.
2016: Kardiologia Polska
https://www.readbyqxmd.com/read/28007060/mechanical-circulatory-support-of-the-fontan-patient
#10
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/27987352/design-of-a-right-ventricular-mock-circulation-loop-as-a-test-bench-for-right-ventricular-assist-devices
#11
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/27938487/conceptual-design-and-procedure-for-an-autonomous-intramyocardial-injection-catheter
#12
Weyland Cheng, Peter Law
This article discusses existing catheter systems and proposes a conceptual design and procedure for an autonomous cellinjection catheter for the purpose of transferring committed myogenic or undifferentiated stem cells into the infarct boundary zones of the left ventricle. Operation of existing catheters used for cell delivery is far from optimal. Commercial injection catheters available are hand-held devices operated manually by means of tip deflection and torque capabilities. Interventionists require a hefty learning curve and often encounter difficulties in catheter stabilization and infarct detection, resulting in lengthy operation times and non-precise injections...
7, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27925225/preclinical-study-of-anticoagulation-regimens-in-sheep-after-implantation-of-ch-vad-blood-pump
#13
Chuangye Xu, Guanghui Wu, Xiujian Liu, Yuna He, Xiaotong Hou, Haiyang Li, Chen Chen, Peng Yang, Changyan Lin
Effective anticoagulation regimens are needed to reduce risks of thrombosis and bleeding in animal models of ventricular assist device to verify its hemocompatibility, biologic safety and reliability. This study is to develop a validated anticoagulation procedure for a sheep model to test the newly developed CH-VAD. CH-VAD models were established in six healthy sheep by constructing blood bypass of left ventricle → ventricular assist device → descending aorta. Heparin infusion was used during operation and in the prior 4 days to maintain activated clotting time 1...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27873344/impact-of-residual-mitral-regurgitation-on-right-ventricular-systolic-function-after-left-ventricular-assist-device-implantation
#14
Serkan Ertugay, Hatice S Kemal, Umit Kahraman, Catagay Engin, Sanem Nalbantgil, Tahir Yagdi, Mustafa Ozbaran
Significant mitral regurgitation (MR) is thought to decrease after left ventricular assist device (LVAD) implantation, and therefore repair of mitral valve is not indicated in current practice. However, residual moderate and severe MR leads to pulmonary artery pressure increase, thereby resulting in right ventricular (RV) dysfunction during follow-up. We examined the impact of residual MR on systolic function of the right ventricle by echocardiography after LVAD implantation. This study included 90 patients (mean age: 51...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27855113/comparison-of-novel-physiological-load-adaptive-control-strategies-for-ventricular-assist-devices
#15
Moriz Habigt, Maike Ketelhut, Jonas Gesenhues, Frank Schrödel, Marc Hein, Mare Mechelinck, Thomas Schmitz-Rode, Dirk Abel, Rolf Rossaint
Terminal heart failure (HF) is the most prevalent cause of death in the Western world and the implantation of a left ventricular assist device (LVAD) has become the gold standard therapy today. Most of the actually implanted devices are driven at a constant speed (CS) regardless of the patient's physiological demand. A new physiological controller [power ratio (PR) controller], which keeps a constant ratio between LVAD power and left ventricular power, a previous concept [preload responsive speed (PRS) controller], which adds a variable LVAD power to reach a defined stroke work, and a CS controller were compared with an unimpaired ventricle in a full heart computer simulation model...
November 17, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27807535/rat-heterotopic-heart-transplantation-model-to-investigate-unloading-induced-myocardial-remodeling
#16
REVIEW
Xuebin Fu, Adrian Segiser, Thierry P Carrel, Hendrik T Tevaearai Stahel, Henriette Most
Unloading of the failing left ventricle in order to achieve myocardial reverse remodeling and improvement of contractile function has been developed as a strategy with the increasing frequency of implantation of left ventricular assist devices in clinical practice. But, reverse remodeling remains an elusive target, with high variability and exact mechanisms still largely unclear. The small animal model of heterotopic heart transplantation (hHTX) in rodents has been widely implemented to study the effects of complete and partial unloading on cardiac failing and non-failing tissue to better understand the structural and molecular changes that underlie myocardial recovery...
2016: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27777298/management-of-systemic-right-ventricular-failure-in-patients-with-congenitally-corrected-transposition-of-the-great-arteries
#17
Aleksei A Filippov, Pedro J Del Nido, Nikolay V Vasilyev
In recent decades, significant progress has been made in the diagnosis and management of congenitally corrected transposition of the great arteries (ccTGA). Nevertheless, gradual dysfunction and failure of the right ventricle (RV) in the systemic circulation remain the main contributors to mortality and disability for patients with ccTGA, especially after adolescence. Anatomic repair of ccTGA effectively resolves the problem of failure of the systemic RV and has good early and midterm results. However, this strategy is applicable primarily in infants and children up to their teens and has associated risks and limitations, and new challenges can arise in the late postoperative period...
October 25, 2016: Circulation
https://www.readbyqxmd.com/read/27743468/a-monolithic-3d-0d-coupled-closed-loop-model-of-the-heart-and-the-vascular-system-experiment-based-parameter-estimation-for-patient-specific-cardiac-mechanics
#18
M Hirschvogel, M Bassilious, L Jagschies, S M Wildhirt, M W Gee
A model for patient-specific cardiac mechanics simulation is introduced, incorporating a 3-dimensional finite element model of the ventricular part of the heart which is coupled to a reduced-order 0-dimensional closed-loop vascular system, heart valve and atrial chamber model.The ventricles are modeled by a nonlinear orthotropic passive material law. The electrical activation is mimicked by a prescribed parametrized active stress acting along a generic muscle fiber orientation. Our activation function is constructed such that the start of ventricular contraction and relaxation as well as the active stress curve's slope are parameterized...
October 15, 2016: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/27692763/a-transapical-to-aorta-double-lumen-cannula-based-neonate-left-ventricular-assist-device-efficiently-unloads-the-left-ventricle-in-neonate-lambs
#19
Cheng Zhou, Dongfang Wang, Cherry Ballard-Croft, Guangfeng Zhao, Hassan K Reda, Stephen Topaz, Joseph Zwischenberger
OBJECTIVE: We are developing a transapical-to-aorta double lumen cannula (TAA DLC) for a less-invasive/more dependable neonatal left ventricular assist device. METHODS: The 18-Fr TAA DLC prototypes were bench tested and evaluated for 6 hours in neonate lambs (n = 6, 7.7-10 kg). The cardiac apex was exposed through a left anterolateral thoracotomy through the sixth intercostal space. The TAA DLC was inserted through a mattress stitch on apex, passing LV-aortic valve, into the ascending aorta with insertion/deployment guided by pressure waveform...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27660015/a-fully-integrated-electrochemical-biosensor-platform-fabrication-process-for-cytokines-detection
#20
Abdoullatif Baraket, Michael Lee, Nadia Zine, Monique Sigaud, Joan Bausells, Abdelhamid Errachid
Interleukin-1b (IL-1b) and interleukin-10 (IL-10) biomarkers are one of many antigens that are secreted in acute stages of inflammation after left ventricle assisted device (LVAD) implantation for patients suffering from heart failure (HF). In the present study, we have developed a fully integrated electrochemical biosensor platform for cytokine detection at minute concentrations. Using eight gold working microelectrodes (WEs) the design will increase the sensitivity of detection, decrease the time of measurements, and allow a simultaneous detection of varying cytokine biomarkers...
September 9, 2016: Biosensors & Bioelectronics
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