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Ventricle assist device

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https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#1
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28532240/ventricular-assist-devices-for-the-failing-univentricular-circulation
#2
Edward Buratto, William Y Shi, Xin Tao Ye, Igor E Konstantinov
Improved survival following single ventricle palliation has led to a large population of patients with a Fontan circulation, many of whom will eventually develop Fontan failure. Many of these patients will require heart transplantation. However, more than half of these patients have Fontan failure despite preserved ventricular function. Increasing experience with ventricular assist devices (VAD) in children has paved the way for VAD support in those with failing univentricular circulation. Areas covered: The use of VADs to support the failing univentricular circulation is a relatively new concept...
May 22, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28530132/development-of-a-high-fidelity-pressurized-porcine-beating-heart-simulator-for-cardiac-surgery-training
#3
Igo B Ribeiro, Janet M C Ngu, Gurinder Gill, Fraser D Rubens
BACKGROUND: Development of a high-fidelity cardiac surgery simulator (CSS) requires integration of a heart model with a mock cardiopulmonary bypass (CPB) circuit that can provide feedback to mimic the pathophysiology of cardiac surgery. However, the cost of commercially available simulators precludes regular use. We describe steps in the construction of a high-fidelity CSS that integrates a pulsatile paracorporeal ventricular-assist device (Pulse-VAD) and a commercially available CPB simulator...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28527962/resolution-of-mitral-regurgitation-with-left-ventricular-assist-device-support
#4
Matthew Goodwin, Hassan W Nemeh, Jamil Borgi, Gaetano Paone, Jeffrey A Morgan
BACKGROUND: Cardiac valve disease is common in patients with end-stage heart failure undergoing left ventricular assist device implantation (LVAD). The aim of this study was to determine if preoperative mitral regurgitation (MR) affects outcomes and hemodynamics in patients after LVAD implantation. METHODS: From March 2006 through May 2015, 238 consecutive patients underwent LVAD implantation. Patient cohorts included less than moderate to severe MR (< moderate-severe, n = 195) and greater than or equal to moderate to severe MR (≥ moderate-severe, n = 43)...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28524449/technical-feasibility-and-safety-of-image-guided-parieto-occipital-ventricular-catheter-placement-with-the-assistance-of-a-wearable-head-up-display
#5
Jang W Yoon, Robert E Chen, Karim ReFaey, Roberto J Diaz, Ronald Reimer, Ricardo J Komotar, Alfredo Quinones-Hinojosa, Benjamin L Brown, Robert E Wharen
BACKGROUND: Wearable technology is growing in popularity as a result of its ability to interface with normal human movement and function. METHODS: Using proprietary hardware and software, neuronavigation images were captured and transferred wirelessly via a password-encrypted network to the head-up display. The operating surgeon wore a loupe-mounted wearable head-up display during image-guided parieto-occipital ventriculoperitoneal shunt placement in two patients...
May 19, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28522783/splenic-abcesses-as-infectious-complication-following-127-implantation-of-left-ventricular-asssist-device-case-report
#6
Sławomir Gajda, Anna M Szczepanik, Grzegorz Religa, Andrzej Misiak, Andrzej B Szczepanik
Left ventricular assist device (LVAD) is one of the modern management therapies in patients with advanced heart failure, and it serves as a bridge to heart transplantation or even as destination therapy. However, it is burdened with a high risk of thromboembolic, hemorrhagic, and infectious complications despite prophylactic management. Splenic abscesses, as septic complications following implantation of mechanical ventricular support, have not yet been described in the literature. We report of a patient with severe left ventricular insufficiency (NYHA II/III), pulmonary hypertension, and arrhythmia who underwent implantation of the Heart Ware® pump for left ventricular support with simultaneous tricuspidvalvoplasty, as a bridge therapy to heart transplantation...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28512702/an-intracardiac-soft-robotic-device-for-augmentation-of-blood-ejection-from-the-failing-right-ventricle
#7
Markus A Horvath, Isaac Wamala, Eric Rytkin, Elizabeth Doyle, Christopher J Payne, Thomas Thalhofer, Ignacio Berra, Anna Solovyeva, Mossab Saeed, Sara Hendren, Ellen T Roche, Pedro J Del Nido, Conor J Walsh, Nikolay V Vasilyev
We introduce an implantable intracardiac soft robotic right ventricular ejection device (RVED) for dynamic approximation of the right ventricular (RV) free wall and the interventricular septum (IVS) in synchrony with the cardiac cycle to augment blood ejection in right heart failure (RHF). The RVED is designed for safe and effective intracardiac operation and consists of an anchoring system deployed across the IVS, an RV free wall anchor, and a pneumatic artificial muscle linear actuator that spans the RV chamber between the two anchors...
May 16, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28512680/a-novel-idea-to-improve-cardiac-output-of-mechanical-circulatory-support-devices-by-optimizing-kinetic-energy-transfer-available-in-forward-moving-aortic-blood-flow
#8
Muhammad B Qureshi, Jacob Glower, Daniel L Ewert, Steven C Koenig
Mechanical circulatory support devices (MCSDs) have gained widespread clinical acceptance as an effective heart failure (HF) therapy. The concept of harnessing the kinetic energy (KE) available in the forward aortic flow (AOF) is proposed as a novel control strategy to further increase the cardiac output (CO) provided by MCSDs. A complete mathematical development of the proposed theory and its application to an example MCSDs (two-segment extra-aortic cuff) are presented. To achieve improved device performance and physiologic benefit, the example MCSD timing is regulated to maximize the forward AOF KE and minimize retrograde flow...
May 16, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28509676/isolated-right-ventricular-mechanical-support-outcomes-and-prognosis
#9
Teresa A Mulaikal, Laura H Bell, Boyangzi Li, Gebhard Wagener, Hiroo Takayama
Right ventricular (RV) failure that necessitates isolated mechanical support is extremely rare. Outcomes have not been described and are limited to case reports. We sought to evaluate this select group of patients and determine their 30 day and 1 year survival. We retrospectively reviewed the Mechanical Assist Device Database at Columbia University from 2007 to 2015. Inclusion criteria consisted of patients who received isolated RV assist devices (RVADs) without mechanical support of the left ventricle. We evaluated survival, duration of support, intensive care unit (ICU) length of stay, and adverse events...
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
#10
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/28479938/statistical-shape-modeling-for-cavopulmonary-assist-device-development-variability-of-vascular-graft-geometry-and-implications-for-hemodynamics
#11
Jan L Bruse, Giuliano Giusti, Catriona Baker, Elena Cervi, Tain-Yen Hsia, Andrew M Taylor, Silvia Schievano
Patients born with a single functional ventricle typically undergo three-staged surgical palliation in the first years of life, with the last stage realizing a cross-like total cavopulmonary connection (TCPC) of superior and inferior vena cavas (SVC and IVC) with both left and right pulmonary arteries, allowing all deoxygenated blood to flow passively back to the lungs (Fontan circulation). Even though within the past decades more patients survive into adulthood, the connection comes at the prize of deficiencies such as chronic systemic venous hypertension and low cardiac output, which ultimately may lead to Fontan failure...
June 2017: Journal of Medical Devices
https://www.readbyqxmd.com/read/28473116/elevated-mitral-valve-pressure-gradient-after-mitraclip-implantation-deteriorates-long-term-outcome-in-patients-with-severe-mitral-regurgitation-and-severe%C3%A2-heart-failure
#12
Michael Neuss, Thomas Schau, Akihiro Isotani, Markus Pilz, Maren Schöpp, Christian Butter
OBJECTIVES: This single-center study was performed to analyze the effect of an increased transvalvular gradient after the MitraClip (MC) (Abbott Laboratories, Abbott Park, Illinois) procedure on patient outcome during follow-up. BACKGROUND: Percutaneous transcatheter repair of the mitral valve with the MC device has been established as a novel technique for patients with severe mitral regurgitation and high surgical risk. This study investigated the influence of an increased pressure gradient after MC implantation on the long-term outcome of patients...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28471885/extracorporeal-membrane-oxygenation-for-acute-decompensated-heart-failure
#13
Laurence Dangers, Nicholas Bréchot, Matthieu Schmidt, Guillaume Lebreton, Guillaume Hékimian, Ania Nieszkowska, Sébastien Besset, Jean-Louis Trouillet, Jean Chastre, Pascal Leprince, Alain Combes, Charles-Edouard Luyt
OBJECTIVE: Long-term outcomes of patients treated with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure (i.e., cardiogenic shock complicating chronic cardiomyopathy) have not yet been reported. This study was undertaken to describe their outcomes and determine mortality-associated factors. DESIGN: Retrospective analysis of data prospectively collected. SETTING: Twenty-six-bed tertiary hospital ICU. PATIENTS: One hundred five patients implanted with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure...
May 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28470925/modalities-and-effects-of-left-ventricle-unloading-on-extracorporeal-life-support-a-review-of-the-current-literature
#14
Paolo Meani, Sandro Gelsomino, Eshan Natour, Daniel M Johnson, Hans-Peter Brunner La Rocca, Federico Pappalardo, Elham Bidar, Maged Makhoul, Giuseppe Raffa, Samuel Heuts, Pieter Lozekoot, Suzanne Kats, Niels Sluijpers, Rick Schreurs, Thijs Delnoij, Alice Montalti, Jan Willem Sels, Marcel van de Poll, Paul Roekaerts, Thomas Poels, Eric Korver, Zaheer Babar, Jos Maessen, Roberto Lorusso
INTRODUCTION/AIM: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support is increasingly used in refractory cardiogenic shock and cardiac arrest, but is characterized by a rise in afterload of the left ventricle (LV) which may ultimately either further impair or delay cardiac contractility improvement. The aim of this study was to provide a comprehensive overview regarding the different LV venting techniques and results currently available in the literature. METHODS: A systematic literature search was performed in the PubMed database: 207 articles published between 1993 and 2016 were included...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28467129/heartware-hvad-for-end-stage-heart-failure-a-review-of-clinical-experiences-with-%C3%A2-50-patients
#15
Luca Botta, Benedetta De Chiara, Francesca Macera, Aldo Cannata, Alessandro Costetti, Alessandra Voltolini, Antonella Moreo, Manlio Cipriani, Maria Frigerio, Claudio Francesco Russo
Despite the improvements in medical and surgical treatments, the incidence of end-stage heart failure (ESHF) continues to increase. Different mechanical systems have been adopted to support failing left ventricles. Among continuous-flow devices, the HeartWare-HVAD was the first to use a centrifugal pump rather than an axial one. Areas covered: In this review article, we provide an overview of the HeartWare-HVAD as a ventricular assist device for ESHF, discussing indications, echocardiographic assessment, surgical techniques, outcomes, concerns and controversies...
May 3, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28442147/troubleshooter-in-electrical-storm-mechanical-unloading-leads-to-heart-rhythm-stabilization
#16
Johannes Mierke, Tobias Loehn, Christian Pfluecke, Karim Ibrahim
The electrical storm is a life-threatening situation which causes a complex antiarrhythmic treatment. We firstly report a rhythmological stabilization through mechanical unloading of the left ventricle in a health patient who developed electrical storm after endo- and epicardiac re-ablation and who previously underwent 27 unsuccessful defibrillations. No evidence for a specific etiology of the rhythm disturbances was found. After implantation of a percutaneous left ventricular assist device (pLVAD) a single additional defibrillation was needed to terminate ventricular fibrillation...
April 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28439697/heart-transplantation-for-adults-with-congenital-heart-disease-current-status-and-future-prospects
#17
REVIEW
Hikaru Matsuda, Hajime Ichikawa, Takayoshi Ueno, Yoshiki Sawa
Increased survival rates after corrective or palliative surgery for complex congenital heart disease (CHD) in infancy and childhood are now being coupled with increased numbers of patients who survive to adulthood with various residual lesions or sequelae. These patients are likely to deteriorate in cardiac function or end-organ function, eventually requiring lifesaving treatment including heart transplantation. Although early and late outcomes of heart transplantation have been improving for adult survivors of CHD, outcomes and pretransplant management could still be improved...
April 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28416103/a-new-twist-on-right-heart-failure-with-left-ventricular-assist-systems
#18
EDITORIAL
Brian A Houston, Keyur B Shah, Mandeep R Mehra, Ryan J Tedford
Despite significant efforts to predict and prevent right heart failure, it remains a leading cause of morbidity and mortality after implantation of left ventricular assist systems (LVAS). In this Perspective, we review the underappreciated anatomic and physiologic principles that govern the relationship between left and right heart function and contribute to this phenomenon. This includes the importance of considering the right ventricle (RV) and pulmonary arterial circuit as a coupled system; the contribution of the left ventricle (LV) to RV contractile function and the potential negative impact of acutely unloading the LV; the influence of the pericardium and ventricular twist on septal function; the role of RV deformation in reduced mechanical efficiency after device placement; and the potential of ongoing stressors of an elevated right-sided preload...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28412431/3d-morphological-changes-in-lv-and-rv-during-lvad-ramp-studies
#19
Karima Addetia, Nir Uriel, Francesco Maffessanti, Gabriel Sayer, Sirtaz Adatya, Gene H Kim, Nitasha Sarswat, Savitri Fedson, Diego Medvedofsky, Eric Kruse, Keith Collins, Daniel Rodgers, Takayoshi Ota, Valluvan Jeevanandam, Victor Mor-Avi, Daniel Burkhoff, Roberto M Lang
OBJECTIVES: The purpose of this study was to investigate the differential impact of the 2 most commonly available left ventricular assist device (LVAD) types on the right (RV) and left (LV) ventricles using 3-dimensional (3D) echocardiography-based analysis of ventricular morphology. BACKGROUND: LVADs have emerged as common therapy for advanced heart failure. Recent data suggest that the heart responds differently to speed settings in the 2 main devices available (HeartMate II [HMII], St Jude Medical, Pleasanton, California, and HVAD, HeartWare International, Framingham, Massachusetts)...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28375841/a-mock-heart-engineered-with-helical-aramid-fibers-for-in-vitro-cardiovascular-device-testing
#20
So-Hyun Jansen-Park, Po-Lin Hsu, Indra Müller, Ulrich Steinseifer, Dirk Abel, Rüdiger Autschbach, Rolf Rossaint, Thomas Schmitz-Rode
Mock heart circulation loops (MHCLs) serve as in-vitro platforms to investigate the physiological interaction between circulatory systems and cardiovascular devices. A mock heart (MH) engineered with silicone walls and helical aramid fibers, to mimic the complex contraction of a natural heart, has been developed to advance the MHCL previously developed in our group. A mock aorta with an anatomical shape enables the evaluation of a cannulation method for ventricular assist devices (VADs) and investigation of the usage of clinical measurement systems like pressure-volume catheters...
April 1, 2017: Biomedizinische Technik. Biomedical Engineering
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