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Assist device

Justin M Vader, Daniel H Cooper, Praveen Rao
No abstract text is available yet for this article.
June 15, 2018: Journal of the American Heart Association
Rakesh Gopinathannair, Henri Roukoz, Adarsh Bhan, Ashwin Ravichandran, Mustafa M Ahmed, Dmitry Familtsev, Geetha Bhat, Jennifer Cowger, Munazzah Abdullah, Chirag Sandesara, Rahul Dhawan, Emma J Birks, Jaimin R Trivedi, Mark S Slaughter
BACKGROUND: Many patients with heart failure continue cardiac resynchronization therapy (CRT) after continuous flow left ventricular assist device (CF-LVAD) implant. We report the first multicenter study to assess the impact of CRT on clinical outcomes in CF-LVAD patients. METHODS AND RESULTS: Analysis was performed on 488 patients (58±13 years, 81% male) with an implantable cardioverter defibrillator (ICD) (n=223) or CRT-D (n=265) who underwent CF-LVAD implantation at 5 centers from 2007 to 2015...
June 15, 2018: Journal of the American Heart Association
David Ouyang, Gunsagar Gulati, Richard Ha, Dipanjan Banerjee
BACKGROUND: Proposed changes to the United Network for Organ Sharing heart transplant allocation protocol will prioritize patients receiving temporary mechanical circulatory support (tMCS), including extracorporeal membrane oxygenation (ECMO), percutaneous ventricular assist devices (PVADs), and intra-aortic balloon pumps (IABPs). We sought to evaluate contemporary trends in the incidence and outcomes of patients who required tMCS during the hospitalization before heart transplantation...
April 26, 2018: Journal of Heart and Lung Transplantation
Srinivas Murali
No abstract text is available yet for this article.
July 2018: Critical Care Clinics
Manreet K Kanwar, Stephen Bailey, Srinivas Murali
The clinical use of left ventricular assist devices (LVADs) in the growing epidemic of heart failure has improved quality of life and long-term survival for this otherwise devastating disease. The current generation of commercially available devices offers a smaller profile that simplifies surgical implantation, a design that optimizes blood flow characteristics, with less adverse events and improved durability than their predecessors. Despite this, the risk for adverse events remains significant, as do burdens for patients and their caregivers...
July 2018: Critical Care Clinics
Sitaramesh Emani
Heart failure patients on durable left ventricular assist device support experience improved survival, quality of life, and exercise capacity. The complication rate, however, remains unacceptably high, although it has declined with improvements in pump design, better patient selection, and greater understanding of the pump physiology and flow dynamics. Most complications are categorized as those related to the pump-patient interface or those related to patient physiology. It is hoped that further engineering progress, and better patient selection through risk stratification, will allow for left ventricular assist device to be totally biocompatible and perform effectively, without affecting biology and homeostasis of the different organ systems...
July 2018: Critical Care Clinics
Inna Tchoukina, Melissa C Smallfield, Keyur B Shah
The authors discuss principles of continuous flow left ventricular assist device (LVAD) operation, basic differences between the axial and centrifugal flow designs and hemodynamic performance, normal LVAD physiology, and device interaction with the heart. Systematic interpretation of LVAD parameters and recognition of abnormal patterns of flow and pulsatility on the device interrogation are necessary for clinical assessment of the patient. Optimization of pump flow using LVAD parameters and echocardiographic and hemodynamics guidance are reviewed...
July 2018: Critical Care Clinics
Amresh Raina, Maria Patarroyo-Aponte
Left ventricular assist devices (LVAD) are increasingly used for the treatment of end-stage heart failure. Right ventricular (RV) failure after LVAD implantation is an increasingly common clinical problem, occurring in patients early after continuous flow LVAD implant. RV failure is associated with a substantial increase in post-LVAD morbidity and mortality. RV failure can be predicted using preoperative hemodynamic, clinical, and echocardiographic variables and a variety of risk prediction algorithms. However, RV failure may also develop due to unanticipated intraoperative or perioperative factors...
July 2018: Critical Care Clinics
S Benacchio, O Doutres, A Le Troter, A Varoquaux, E Wagnac, V Callot, F Sgard
Passive and active in-ear devices (IED) occluding the ear canal are commonly used to (i) protect people from high noise levels (earplugs), (ii) assist people suffering from hearing impairment (hearing aids) or (iii) help people in listening from their sound systems (earbuds). However, the usability and/or efficiency of IEDs can be greatly affected by several discomfort components (physical, acoustical and functional). The mechanical pressure exerted by the IED onto the ear canal walls is greatly suspected to affect the aforementioned comfort components...
June 2, 2018: Hearing Research
James H Tabibian, Daniel P Rhoades, Kimberly A Forde, Rhondalyn C McLean, Vinay Chandrasekhara
BACKGROUND & AIMS: Continuous-flow left ventricular assist devices (LVADs) for advanced heart failure have been associated with gastrointestinal bleeding (GIB). We examined the association between time of GIB after LVAD implantation and bleeding location (determined by endoscopy), etiology, and patient outcomes. METHODS: We performed a retrospective study of consecutive patients who underwent implantation of continuous-flow LVADs from 2008 through 2015. We analyzed data on anatomic location of GIB, etiology, length of hospital stay, transfusion requirement, time to endoscopy, and rate of readmission within 30 days...
June 12, 2018: Clinical Gastroenterology and Hepatology
Jun Xiao, Hanyu Zhu, Ying Wang, Wei Feng, Yunxia Hu, Arvind Dasgupta, Yimo Han, Yuan Wang, David A Muller, Lane W Martin, PingAn Hu, Xiang Zhang
Out-of-plane ferroelectricity with a high transition temperature in ultrathin films is important for the exploration of new domain physics and scaling down of memory devices. However, depolarizing electrostatic fields and interfacial chemical bonds can destroy this long-range polar order at two-dimensional (2D) limit. Here we report the experimental discovery of the locking between out-of-plane dipoles and in-plane lattice asymmetry in atomically thin In_{2}Se_{3} crystals, a new stabilization mechanism leading to our observation of intrinsic 2D out-of-plane ferroelectricity...
June 1, 2018: Physical Review Letters
Sarah Streeter Hutcheson, Victoria Phillips, Rachel Patzer, Andrew Smith, J David Vega, Alanna A Morris
BACKGROUND: Medicaid insurance in Georgia provides limited reimbursement for heart transplant (HT) and left ventricular assist devices (LVAD). We examined whether insurance type affects eligibility for and survival after receipt of HT or LVAD. METHODS AND RESULTS: We retrospectively identified patients evaluated for HT/LVAD from 2012 to 2016. We used multivariable logistic and Cox proportional hazards regression to examine the association of insurance type on treatment eligibility and one year survival...
June 15, 2018: Clinical Transplantation
Prashant N Mohite, Anton Sabashnikov, Achim Koch, Raj Binu, Ashok Padukone, Sundip Kaul, Olaf Maunz, Diana García-Sáez, Bartlomiej Zych, Mubassher Husain, Fabio De Robertis, Aron-Frederik Popov, André R Simon
OBJECTIVES: Post-cardiotomy cardiogenic shock (PCCS) results in substantial morbidity and mortality, whereas refractory cases require mechanical circulatory support (MCS). The aim of the study was to compare extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VADs) utilized in the management of PCCS. METHODS: In total, 56 consecutive patients who developed PCCS from 2005 to 2014 required MCS as a bridge to decision-24 were supported with a VAD and 32 with an ECMO...
June 13, 2018: Interactive Cardiovascular and Thoracic Surgery
Roxana Moayedifar, Andreas Zuckermann, Arezu Aliabadi-Zuckermann, Julia Riebandt, Philipp Angleitner, Kamen Dimitrov, Thomas Schloeglhofer, Angela Rajek, Guenther Laufer, Daniel Zimpfer
OBJECTIVES: Fixed pulmonary hypertension (fPH) is a contraindication for heart transplantation (HTX). Left ventricular assist device (LVAD) implantation as a bridge to candidacy can reverse fPH in patients with terminal heart failure by chronic left ventricular unloading. We report our institutional experience with terminal heart failure patients and fPH that were successfully bridged to candidacy and underwent subsequent HTX. METHODS: We retrospectively reviewed the data of 79 patients with terminal heart failure and fPH who were successfully bridged to candidacy for HTX with 6 different LVAD devices at our centre from October 1998 to September 2016 (Novacor n = 4, MicroMed DeBakey n = 29, DuraHeart n = 2, HeartMate II n = 14, HVAD n = 29 and MVAD n = 1)...
June 13, 2018: European Journal of Cardio-thoracic Surgery
Zhengli Han, Seigo Ohno, Yu Tokizane, Kouji Nawata, Takashi Notake, Yuma Takida, Hiroaki Minamide
This Letter describes a novel metamaterial design by employing off-resonance and in-resonance excitation for a high-transmission terahertz-wave quarter-wave plate (QWP). The device is demonstrated with a thin film metamaterial with double-layer split ring resonators (SRRs). Different from a usual resonant metamaterial device, here we design the work frequency off from the inductor-capacitor (LC) resonance for the TE mode, while in a dipole resonance for the TM mode to obtain the artificial birefringence. Rectangular SRRs in this Letter provide a choice to optimize the off-resonance and in-resonance excitation, to assist the double-layer design for high transmission...
June 15, 2018: Optics Letters
Yingchang Jiang, Zeyi Wu, Le Jiang, Zhichang Pan, Peiyu Yang, Wenchao Tian, Linfeng Hu
The integration of high flexibility, high energy density and wide voltage window for solid-state supercapacitors remains a big challenge to date. Herein, ultrathin CoSeO3·H2O nanoribbons (thickness: ∼14 nm) with typical pseudocapacitive behavior were synthesized in a high yield by a solution-based refluxing process. Freestanding CoSeO3·H2O ribbon/hydroxylated multi-walled carbon nanotube (HWCNT) paper could be fabricated through a vacuum-assisted filtration strategy owing to its ultrathin nature, ribbon-like morphology and inherent flexibility...
June 15, 2018: Nanoscale
Ao Liu, Huihui Zhu, Huabin Sun, Yong Xu, Yong-Young Noh
The electronic functionalities of metal oxides comprise conductors, semiconductors, and insulators. Metal oxides have attracted great interest for construction of large-area electronics, particularly thin-film transistors (TFTs), for their high optical transparency, excellent chemical and thermal stability, and mechanical tolerance. High-permittivity (κ) oxide dielectrics are a key component for achieving low-voltage and high-performance TFTs. With the expanding integration of complementary metal oxide semiconductor transistors, the replacement of SiO2 with high-κ oxide dielectrics has become urgently required, because their provided thicker layers suppress quantum mechanical tunneling...
June 14, 2018: Advanced Materials
Suneet N Purohit, William K Cornwell, Jay D Pal, JoAnn Lindenfeld, Amrut V Ambardekar
Pulsatility seems to have a teleological role because evolutionary hierarchy favors higher ordered animals with more complex, multichamber circulatory systems that generate higher pulse pressure compared with lower ordered animals. Yet despite years of such natural selection, the modern generation of continuous-flow left ventricular assist devices (CF-LVADs) that have been increasingly used for the last decade have created a unique physiology characterized by a nonpulsatile, nonlaminar blood flow profile with the absence of the usual large elastic artery Windkessel effect during diastole...
June 2018: Circulation. Heart Failure
Harry Magunia, Clemens Dietrich, Harald F Langer, David Schibilsky, Christian Schlensak, Peter Rosenberger, Martina Nowak-Machen
BACKGROUND: Right heart failure remains a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Multiple 2D echocardiography derived parameters are associated with right ventricular failure (RV failure), but none of them has been proven to be a reliable predictor to date. We hypothesized that novel 3D-echocardiography (3DE) based parameters are associated with RV failure and predict long term outcome in patients undergoing LVAD implantation. METHODS: This single-center study retrospectively enrolled 26 patients undergoing continuous-flow LVAD implantation...
June 8, 2018: International Journal of Cardiology
Andreas Triantafyllidis, Dimitris Filos, Roselien Buys, Jomme Claes, Véronique Cornelissen, Evangelia Kouidi, Anargyros Chatzitofis, Dimitris Zarpalas, Petros Daras, Deirdre Walsh, Catherine Woods, Kieran Moran, Nicos Maglaveras, Ioanna Chouvarda
BACKGROUND: Exercise-based rehabilitation plays a key role in improving the health and quality of life of patients with Cardiovascular Disease (CVD). Home-based computer-assisted rehabilitation programs have the potential to facilitate and support physical activity interventions and improve health outcomes. OBJECTIVES: We present the development and evaluation of a computerized Decision Support System (DSS) for unsupervised exercise rehabilitation at home, aiming to show the feasibility and potential of such systems toward maximizing the benefits of rehabilitation programs...
August 2018: Computer Methods and Programs in Biomedicine
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