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https://www.readbyqxmd.com/read/28790277/-management-of-right-heart-failure-after-cardiac-surgery
#1
Takeo Fujino, Akira Shiose
Perioperative right heart failure(RHF) is an important problem, especially in the field of heart failure surgery. Right ventricular performance is determined by the combination of preload, contractility, heart rate, rhythm and afterload. Many factors influence on these parameters in the perioperative period, and the deterioration of one of them can cause RHF. Recently, we often encounter perioperative RHF after left ventricular assist device (LVAD) implantation, and prompt LVAD pump speed optimization and treatment for RHF is required to avoid complications and hemodynamic deterioration...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28765741/experience-with-mechanical-circulatory-support-for-medically-intractable-low-cardiac-output-in-a-pediatric-intensive-care-unit
#2
Jung Bin Park, Jae Gun Kwak, Hong-Gook Lim, Woong-Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: Mechanical circulatory support with extracorporeal membrane oxygenation (ECMO) and ventricular assist device has always been the optimal choice for treating the majority of medically intractable low cardiac output case. We retrospectively investigated our institution's outcomes and variables associated with a high risk of mortality. SUBJECTS AND METHODS: From 1999 to 2014, 86 patients who were of pediatric age or had grown-up congenital heart disease underwent mechanical circulatory support for medically intractable low cardiac output in our pediatric intensive care unit...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28760462/histone-modification-is-correlated-with-reverse-lv-remodeling-in-nonischemic-dilated-cardiomyopathy
#3
Emiko Ito, Shigeru Miyagawa, Satsuki Fukushima, Yasushi Yoshikawa, Shunsuke Saito, Tetsuya Saito, Akima Harada, Maki Takeda, Noriyuki Kashiyama, Yuki Nakamura, Motoko Shiozaki, Koichi Toda, Yoshiki Sawa
BACKGROUND: Although implantation of a left ventricular assist device (LVAD) induces reverse remodeling of the left ventricle in end-stage nonischemic dilated cardiomyopathy (DCM), the underlying mechanism is not fully understood. It has been shown that epigenetic modification, such as methylation or acetylation of the histone, is one of the most important upstream signals in cardiac failure. This study hypothesized that histone profiles may be modified by LVAD implantation for end-stage nonischemic DCM, in association with reverse left ventricular remodeling...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28746083/novel-cardiac-coordinate-modeling-system-for-three-dimensional-quantification-of-inflow-cannula-malposition-of-heartmate-ii-lvads
#4
Brian Lima, Onur Dur, Joyce Chuang, Themistokles Chamogeorgakis, David J Farrar, Kartik S Sundareswaran, Joost Felius, Susan M Joseph, Shelley A Hall, Gonzalo V Gonzalez-Stawinski
Optimal function of left ventricular assist devices (LVADs) depends on proper alignment of the inflow cannula (IC). Quantitative guidelines for IC angulation are lacking because of variation in cardiac geometry and difficulty in analyzing three-dimensional (3D) cannula orientation relative to the left ventricle (LV). Based on contrast-enhanced computed tomography images from five normal and five clinically malpositioned IC cases in patients with HeartMate II LVADs, we developed a method for 3D quantification of IC malpositioning...
July 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28742532/pulmonary-pressure-assessment-with-the-total-artificial-heart
#5
David L Joyce, Margaret M Redfield, Sudhir S Kushwaha, Atta Behfar, Barry A Borlaug, Richard C Daly, Gurpreet S Sandhu, Lyle D Joyce
Reversal of pulmonary hypertension has been observed in patients during a bridge to transplant with a left ventricular assist device. Total artificial heart (TAH) implant prevents subsequent right heart catheterization. Consequently, controversy exists over whether the prosthetic right ventricle improves or exacerbates pulmonary hypertension. A pulmonary artery (PA) pressure monitor was placed in two patients undergoing TAH implant, as a bridge to transplant. One patient had pulmonary hypertension at implant; the other had normal pulmonary pressures...
July 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28741664/in-vitro-evaluation-of-an-immediate-response-starling-like-controller-for-dual-rotary-blood-pumps
#6
Andrew F Stephens, Michael C Stevens, Shaun D Gregory, Matthias Kleinheyer, Robert F Salamonsen
Rotary ventricular assist devices (VADs) are used to provide mechanical circulatory support. However, their lack of preload sensitivity in constant speed control mode (CSC) may result in ventricular suction or venous congestion. This is particularly true of biventricular support, where the native flow-balancing Starling response of both ventricles is diminished. It is possible to model the Starling response of the ventricles using cardiac output and venous return curves. With this model, we can create a Starling-like physiological controller (SLC) for VADs which can automatically balance cardiac output in the presence of perturbations to the circulation...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28738087/exercise-physiology-with-a-left-ventricular-assist-device-analysis-of-heart-pump-interaction-with-a-computational-simulator
#7
Libera Fresiello, Frank Rademakers, Piet Claus, Gianfranco Ferrari, Arianna Di Molfetta, Bart Meyns
Patients with a Ventricular Assist Device (VAD) are hemodynamically stable but show an impaired exercise capacity. Aim of this work is to identify and to describe the limiting factors of exercise physiology with a VAD. We searched for data concerning exercise in heart failure condition and after VAD implantation from the literature. Data were analyzed by using a cardiorespiratory simulator that worked as a collector of inputs coming from different papers. As a preliminary step the simulator was used to reproduce the evolution of hemodynamics from rest to peak exercise (ergometer cycling) in heart failure condition...
2017: PloS One
https://www.readbyqxmd.com/read/28734437/two-pumps-for-single-ventricle-mechanical-support-for-establishment-of-biventricular-circulation
#8
Stanislav Ovroutski, Oliver Miera, Thomas Krabatsch, Felix Berger, Joachim Photiadis, Evgenii Potapov
A 31-year-old patient with a univentricular heart and double-inlet left ventricle, moderate pulmonary stenosis, and severe mitral valve regurgitation experienced irreversible heart failure after mitral valve replacement. "Biventricular" mechanical circulatory support was initiated. The systemic circulation was supported using the HeartWare ventricular assist device (HVAD) (HeartWare, Framingham, MA) pump in the usual manner. The second pump was inserted into the right atrium and connected to the pulmonary artery after closure of the pulmonary valve and atrial separation...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28708210/particle-image-velocimetry-tests-on-pediatric-45-cc-and-30-cc-ventricle-assist-devices-effects-of-heart-rate-on-vad-operation
#9
Dariusz Witkowski, Damian Obidowski, Piotr Reorowicz, Daniel Jodko, Krzysztof Jozwik
BACKGROUND: This study investigated flow analysis inside pediatric ventricle assist devices (VADs) designed and manufactured at the Foundation for Cardiac Surgery Development (FRK), Zabrze, Poland. The main goal of the experiment was to define the minimal heart rate admissible in clinical practice. METHODS: The flow was directed by mechanical, single-disc valves developed at the Lodz University of Technology, Institute of Turbomachinery in Lodz, Poland. VAD operation conditions under different heart rates were analyzed...
July 8, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28692527/sildenafil-in-left-ventricular-assist-device-is-safe-and-well-tolerated
#10
Ashwin K Ravichandran, Shane J LaRue, Eric Novak, Susan A Joseph, Joel D Schilling
Right heart failure is a potentially devastating complication of mechanical circulatory support, occurring at a rate of 0.49 events per 100 patient-months. Pulmonary vasodilators such as phosphodiesterase-5 inhibitors (PDE5i) have been frequently used to unload the right ventricle in left ventricular assist device (LVAD) patients, but there is scant evidence to support this practice. The purpose of this analysis is to provide additional data regarding the safety and efficacy of the PDE5i sildenafil in a real world population of patients supported with LVADs at Washington University in St...
July 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28661912/favorable-effects-on-pulmonary-vascular-hemodynamics-with-continuous-flow-left-ventricular-assist-devices-are-sustained-5-years-after-heart-transplantation
#11
Abdulfattah Saidi, Craig H Selzman, Abdulmohsin Ahmadjee, Mohammad Al-Sarie, Gregory L Snow, Omar Wever-Pinzon, Rami A Alharethi, Bruce Reid, Josef Stehlik, Abdallah G Kfoury, Feras Bader
It is unclear whether pulmonary hemodynamics improvement with left ventricle unloading with left ventricular assist devices (LVADs) is sustained long term after heart transplant (HT). We sought to assess the effects on pulmonary vascular hemodynamics during continuous-flow (CF-LVAD) and pulsatile flow (PF-LVAD) support up to 5 years after HT. Invasive hemodynamics were evaluated before LVAD, before HT, and at 3 months, 1, and 3-5 years posttransplant. Thirty-eight patients were included in the study and divided into two groups according to the type of LVAD support...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28661911/pump-in-parallel-mechanical-assistance-of-partial-cavopulmonary-circulation-using-a-conventional-ventricular-assist-device
#12
Pranava Sinha, Nina Deutsch, Kanishka Ratnayaka, Dingchao He, Murfad Peer, Mustafa Kurkluoglu, Mark Nuszkowski, Erin Montague, Gerald Mikesell, David Zurakowski, Richard Jonas
Mechanical assistance of systemic single ventricle is effective in pulling blood through a cavopulmonary circuit. In patients with superior cavopulmonary connection, this strategy can lead to arterial desaturation secondary to increased inferior caval flow. We hypothesized that overall augmentation in cardiac output with mechanical assistance compensates for the drop in oxygen saturation thereby maintaining tissue oxygen delivery (DO2). Bidirectional Glenn (BDG) was established in seven swine (25 kg) after a common atrium had been established by balloon septostomy...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28651485/intraoperative-left-atrium-inversion-after-implantation-of-heartmate-iii-ventricular-assist-device
#13
Ayşegül Ozgök, Z Asli Demir, Gökçe Sert, Doğan Sert, Zehra Gölbaşı, Umit Kervan
We report here a case of left atrium inversion after implanting HeartMate III LVAD, which is known to be the first in literature. LVAD can be functional only if there is adequate inflow to the device. Parameters and filling of left ventricle can be assessed by TEE. In our case, initial examination with TEE showed thrombus like images. HeartMate III has a reliable algorithm that automatically reduces pump speed if 'suction effect' is detected. HeartMate III demonstrates clean flow properties and good surface wash...
June 27, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28649147/multiblock-high-order-large-eddy-simulation-of-powered-fontan-hemodynamics-towards-computational-surgery
#14
Yann T Delorme, Mark D Rodefeld, Steven H Frankel
Children born with only one functional ventricle must typically undergo a series of three surgeries to obtain the so-called Fontan circulation in which the blood coming from the body passively flows from the Vena Cavae (VCs) to the Pulmonary Arteries (PAs) through the Total Cavopulmonary Connection (TCPC). The circulation is inherently inefficient due to the lack of a subpulmonary ventricle. Survivors face the risk of circulatory sequelae and eventual failure for the duration of their lives. Current efforts are focused on improving the outcomes of Fontan palliation, either passively by optimizing the TCPC, or actively by using mechanical support...
January 17, 2017: Computers & Fluids
https://www.readbyqxmd.com/read/28621816/control-of-a-pediatric-pulsatile-ventricular-assist-device-a-hybrid-cardiovascular-model-study
#15
Gianfranco Ferrari, Arianna Di Molfetta, Krzysztof Zieliński, Libera Fresiello, Krystyna Górczyńska, Krzysztof Jakub Pałko, Marek Darowski, Antonio Amodeo, Maciej Kozarski
The aim of this work is to study pediatric pneumatic ventricle (PVAD) performance, versus VAD rate (VADR) and native heart rate (HR) ratio Rr (VADR/HR). The study uses a hybrid model of the cardiovascular system (HCS). HCS consists of a computational part (a lumped parameter model including left and right ventricles, systemic and pulmonary arterial and venous circulation) interfaced to a physical part. This permits the connection of a VAD (15 mL PVAD). Echocardiographic and hemodynamic data of a pediatric patient (average weight 14...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28593869/a-mock-heart-engineered-with-helical-aramid-fibers-for-in-vitro-cardiovascular-device-testing
#16
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 4, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28536530/the-total-artificial-heart-in-end-stage-congenital-heart-disease
#17
REVIEW
Chet R Villa, David L S Morales
The development of durable ventricular assist devices (VADs) has improved mortality rates and quality of life in patients with end stage heart failure. While the use of VADs has increased dramatically in recent years, there is limited experience with VAD implantation in patients with complex congenital heart disease (CHD), despite the fact that the number of patients with end stage CHD has grown due to improvements in surgical and medical care. VAD use has been limited in patients with CHD and end stage heart failure due to anatomic (systemic right ventricle, single ventricle, surgically altered anatomy, valve dysfunction, etc...
2017: Frontiers in Physiology
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
#18
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
#19
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 univentricular circulation, many of whom develop heart failure. 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. Most studies have focused on supporting patients with the failing systemic ventricle...
June 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
#20
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
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