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Ventricle assist device

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https://www.readbyqxmd.com/read/29784052/the-effect-of-heart-failure-and-left-ventricular-assist-device-treatment-on-right-ventricular-mechanics-a-computational-study
#1
Jun I K Park, Aulia Khamas Heikhmakhtiar, Chang Hyun Kim, Yoo Seok Kim, Seong Wook Choi, Kwang Soup Song, Ki Moo Lim
BACKGROUND AND AIMS: Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model...
May 22, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29758970/effects-of-an-intra-ventricular-assist-device-on-the-stroke-volume-of-failing-ventricle-analysis-of-a-mock-circulatory-system
#2
Shidong Zhu, Lin Luo, Bibo Yang, Kai Ni, Qian Zhou, Xinghui Li, Xiaohao Wang
BACKGROUND: A novel intra-ventricular assist device (iVAD) was established as a new pulsatile assist device to address various disadvantages, such as bulky configuration and reduced arterial pulsatility, observed in conventional ventricular assist devices. OBJECTIVE: Analyzed the native left ventricular stroke volume (SV) after iVAD support in vitro. METHODS: The SV of iVAD was examined in a home-designed mock circulatory system (MCS) at different heart rates and drive pressures and the SV of a failure ventricle was examined with iVAD at 75, 90, 120 bpm and 120-180 mmHg drive pressure after iVAD support...
May 4, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29757760/cannula-tip-with-integrated-volume-sensor-for-rotary-blood-pump-control-early-stage-development
#3
Joshua Cysyk, Ray Newswanger, Eric Popjes, Walter Pae, Choon-Sik Jhun, Jenelle Izer, William Weiss, Gerson Rosenberg
The lack of direct measurement of left ventricular unloading is a significant impediment to the development of an automatic speed control system for continuous-flow left ventricular assist devices (cf-LVADs). We have developed an inlet cannula tip for cf-LVADs with integrated electrodes for volume sensing based on conductance. Four platinum-iridium ring electrodes were installed into grooves on a cannula body constructed from polyetheretherketone (PEEK). A sinusoidal current excitation waveform (250 μA pk-pk, 50 kHz) was applied across one pair of electrodes, and the conductance-dependent voltage was sensed across the second pair of electrodes...
May 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29757759/mechanical-circulatory-support-of-the-right-ventricle-for-adult-and-pediatric-patients-with-heart-failure
#4
Steven G Chopski, Nohra M Murad, Carson S Fox, Randy M Stevens, Amy L Throckmorton
The clinical implementation of mechanical circulatory assistance for a significantly dysfunctional or failing left ventricle as a bridge-to-transplant or bridge-to-recovery is on the rise. Thousands of patients with left-sided heart failure are readily benefitting from these life-saving technologies, and left ventricular failure often leads to severe right ventricular dysfunction or failure. Right ventricular failure (RVF) has a high rate of mortality caused by the risk of multisystem organ failure and prolonged hospitalization for patients after treatment...
May 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29752919/first-use-of-heartmate-3-tm-in-a-failing-fontan-circulation
#5
Angela Lorts, Chet Villa, Kyle W Riggs, John Broderick, David Ls Morales
The failing Fontan circulation can be challenging to support with ventricular assist devices (VAD) mostly due to the variety of causes of failure, some of which cannot be addressed by VAD therapy alone. A new VAD, the HeartMate 3TM , was recently approved for use in adults in the United States and is now widely available with excellent survival in two-ventricle patients. We report the first successful implantation of the HeartMate 3 in a 22-year-old male with a failing Fontan circulation and the possible benefits it may have in supporting this ever-growing population of young adults with single ventricles...
May 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29751959/if-i-only-had-a-heart-the-trials-and-tribulations-of-ventricular-assist-device-support-when-missing-a-ventricle
#6
EDITORIAL
Chet R Villa, David L S Morales
No abstract text is available yet for this article.
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29750405/heartmate-3-implantation-via-left-antero-lateral-thoracotomy-to-avoid-resternotomy-in-high-risk-patients
#7
Raymond Pfister, Piergiorgio Tozzi, Roger Hullin, Patrick Yerly, Fritz-Patrick Jahns, René Prêtre, Matthias Kirsch
Left ventricular assist devices (LVADs) are currently the best alternative to cardiac transplantation for patients with end-stage heart failure (HF) as a bridge to transplant or to decision, or as destination therapy. Full median sternotomy or minimally invasive techniques are the more standard approaches used at present.  LVADs are usually implanted between the left ventricle apex and the ascending aorta. An implantation through a left thoracotomy with an outflow graft connected to the descending aorta is much less performed nowadays due to the longer times to extubation, higher incidence of postoperative pain, and poorer hemodynamics in the ascending aorta, which may lead to thrombosis...
April 25, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29746312/calculation-of-the-alma-risk-of-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#8
Antonio Loforte, Andrea Montalto, Francesco Musumeci, Cristiano Amarelli, Carlo Mariani, Vincenzo Polizzi, Paola Lilla Della Monica, Francesco Grigioni, Roberto Di Bartolomeo, Giuseppe Marinelli
Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88)...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29743195/isovolumic-loading-of-the-failing-heart-by-intraventricular-placement-of-a-spring-expander-attenuates-cardiac-atrophy-after-heterotopic-heart-transplantation
#9
Martin Pokorný, Iveta Mrázová, Jan Šochman, Vojtěch Melenovský, Jiří Malý, Jan Pirk, Lenka Červenková, Janusz Sadowski, Zdeněk Čermák, Karel Volenec, Šárka Vacková, Hana Maxová, Luděk Červenka, Ivan Netuka
Cardiac atrophy is the most common complication of prolonged application of the left ventricle assist device in patients with advanced heart failure. Our aim was to evaluate the course of unloading-induced cardiac atrophy in rats with failing hearts, and to examine if increased isovolumic loading obtained by intraventricular implantation of an especially designed spring expander would attenuate this process. Heterotopic abdominal heart transplantation (HTx ) was used as a rat model of heart unloading. Heart failure (HF) was induced by volume overload achieved by creation of the aorto-caval fistula...
May 9, 2018: Bioscience Reports
https://www.readbyqxmd.com/read/29715362/characterizing-the-heartmate-ii-left-ventricular-assist-device-outflow-using-particle-image-velocimetry
#10
Grant W Rowlands, Bryan C Good, Steven Deutsch, Keefe B Manning
Ventricular assist devices (VADs) are implanted in patients with a diseased ventricle to maintain peripheral perfusion as a bridge-to-transplant or as destination therapy. However, some patients with continuous flow VADs (e.g., HeartMate II (HMII)) have experienced gastrointestinal (GI) bleeding, in part caused by the proteolytic cleavage or mechanical destruction of von Willebrand factor (vWF), a clotting glycoprotein. in vitro studies were performed to measure the flow located within the HMII outlet cannula under both steady and physiological conditions using particle image velocimetry (PIV)...
July 1, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#11
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29700783/modeling-right-ventricle-failure-after-continuous-flow-left-ventricular-assist-device-a-biventricular-finite-element-and-lumped-parameter-analysis
#12
Francesco Scardulla, Valentina Agnese, Giuseppe Romano, Gabriele Di Gesaro, Sergio Sciacca, Diego Bellavia, Francesco Clemenza, Michele Pilato, Salvatore Pasta
The risk of right ventricle (RV) failure remains a major contraindication for continuous-flow left ventricular assist device (CF-LVAD) implantation in patients with heart failure. It is therefore critical to identify the patients who will benefit from early intervention to avoid adverse outcomes. We sought to advance the computational modeling description of the mechanisms underlying RV failure in LVAD-supported patients. RV failure was studied by computational modeling of hemodynamic and cardiac mechanics using lumped-parameter and biventricular finite element (FE) analysis...
April 26, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29681957/mechanical-circulatory-support-is-effective-to-treat-pulmonary-hypertension-in-heart-transplant-candidates-disqualified-due-to-unacceptable-pulmonary-vascular-resistance
#13
Michał Zakliczyński, Jerzy Pacholewicz, Izabela Copik, Marcin Maruszewski, Tomasz Hrapkowicz, Roman Przybylski, Marian Zembala
Introduction: High pulmonary vascular resistance (PVR) in orthotopic heart transplantation (OHT) candidates is a risk factor of right ventricle failure after the procedure. However, the increase of PVR may be a consequence of the life-threatening deterioration of the left ventricle function. The use of mechanical circulatory support (MCS) seems to be the best solution, but it is reimbursed only in active OHT candidates. Aim: We performed a retrospective analysis of MCS effectiveness in maintaining PVR at values accepted for OHT...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29677212/pulsatile-operation-of-a-continuous-flow-right-ventricular-assist-device-rvad-to-improve-vascular-pulsatility
#14
Boon C Ng, Matthias Kleinheyer, Peter A Smith, Daniel Timms, William E Cohn, Einly Lim
Despite the widespread acceptance of rotary blood pump (RBP) in clinical use over the past decades, the diminished flow pulsatility generated by a fixed speed RBP has been regarded as a potential factor that may lead to adverse events such as vasculature stiffening and hemorrhagic strokes. In this study, we investigate the feasibility of generating physiological pulse pressure in the pulmonary circulation by modulating the speed of a right ventricular assist device (RVAD) in a mock circulation loop. A rectangular pulse profile with predetermined pulse width has been implemented as the pump speed pattern with two different phase shifts (0% and 50%) with respect to the ventricular contraction...
2018: PloS One
https://www.readbyqxmd.com/read/29666072/left-ventricular-assist-device-inflow-cannula-angle-and-thrombosis-risk
#15
Venkat Keshav Chivukula, Jennifer A Beckman, Anthony R Prisco, Todd Dardas, Shin Lin, Jason W Smith, Nahush A Mokadam, Alberto Aliseda, Claudius Mahr
BACKGROUND: As heart failure prevalence continues to increase in the setting of a static donor supply, left ventricular assist device (LVAD) therapy for end-stage heart failure continues to grow. Anecdotal evidence suggests that malalignment of the LVAD inflow cannula may increase thrombosis risk, but this effect has not been explored mechanistically or quantified statistically. Our objective is to elucidate the impact of surgical angulation of the inflow cannula on thrombogenicity. METHODS AND RESULTS: Unsteady computational fluid dynamics is used in conjunction with computational modeling and virtual surgery to model flow through the left ventricle for 5 different inflow cannula angulations...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29666009/in-vitro-validation-of-a-self-driving-aortic-turbine-venous-assist-device-for-fontan-patients
#16
Kerem Pekkan, Ibrahim Basar Aka, Ece Tutsak, Erhan Ermek, Haldun Balim, Ismail Lazoglu, Riza Turkoz
BACKGROUND: Palliative repair of single ventricle defects involve a series of open-heart surgeries where a single-ventricle (Fontan) circulation is established. As the patient ages, this paradoxical circulation gradually fails, because of its high venous pressure levels. Reversal of the Fontan paradox requires an extra subpulmonic energy that can be provided through mechanical assist devices. The objective of this study was to evaluate the hemodynamic performance of a totally implantable integrated aortic-turbine venous-assist (iATVA) system, which does not need an external drive power and maintains low venous pressure chronically, for the Fontan circulation...
March 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29663123/creation-of-a-restrictive-atrial-communication-in-heart-failure-with-preserved-and-mid-range-ejection-fraction-effective-palliation-of-left-atrial-hypertension-and-pulmonary-congestion
#17
Anna Bauer, Markus Khalil, Monika Lüdemann, Jürgen Bauer, Anoosh Esmaeili, Roberta De-Rosa, Norbert F Voelkel, Hakan Akintuerk, Dietmar Schranz
BACKGROUND: Left atrial decompression is considered in patients with symptomatic heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the feasibility and efficacy of transcatheter generation of a restrictive atrial septum communication to manage HFpEF from infancy to adulthood with cardiomyopathy and congenital heart defect. METHODS AND RESULTS: From June 2009 to December 2016, 24 patients (50% with an age less than 16 years) with HFpEF were palliated; NYHA-/Ross class IV (n = 10); median systemic ventricular ejection fraction 64 (range 35-78) %...
April 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29651826/new-percutaneous-interventions-in-heart-failure
#18
Elisabetta Moscarella, Salvatore Brugaletta, Manel Sabaté
Chronic heart failure (HF) is one of the main causes of mortality and morbidity worldwide and represents a growing challenge in interventional cardiology. Its prevalence is recently increasing due to the improvements in cardiac care with subsequent significant reduction in the HF acute mortality. HF may occur with either a reduced left ventricular ejection fraction (LVEF) (LVEF<40%, HFrEF) or a preserved EF (typically LVEF≥50%, HFpEF) indicative of diastolic dysfunction. Despite recent advances in drug therapies as well as in nonpharmacological strategies, including defibrillators, cardiac resynchronization therapy, LV assist devices (LVAD), mortality in HF remains high...
April 12, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29629994/the-achilles-heel-of-left-ventricular-assist-device-therapy-right-ventricle
#19
Neel K Ranganath, Deane E Smith, Nader Moazami
PURPOSE OF REVIEW: Many patients suffer from either persistent right ventricular failure (RVF) at the time of left ventricular assist device (LVAD) or have ongoing symptoms consistent with RVF during chronic mechanical circulatory support. The lack of long-term right ventricular assist devices (RVADs) has limited the impact that mechanical circulatory support can provide to patients with biventricular failure. We aim to review the entire spectrum of RVF in patients receiving LVADs and reflect on why this entity remains the Achilles' heel of LVAD therapy...
April 7, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29623530/novel-insights-and-treatment-strategies-for-right-heart-failure
#20
REVIEW
Weiqin Lin, Ai-Ling Poh, W H Wilson Tang
PURPOSE OF REVIEW: The function of the right ventricle (RV) is intimately linked to its preload (systemic volume status) and afterload (pulmonary vasculature). In this review, we explore current knowledge in RV physiology, RV function assessment, causes of right heart failure (RHF), and specific treatment strategies for RHF. RECENT FINDINGS: We examine the evidence behind new pharmacological therapies available, such as macitentan and riociguat in the treatment of specific etiologies of RHF...
April 6, 2018: Current Heart Failure Reports
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