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https://www.readbyqxmd.com/read/28092289/the-impact-of-obesity-on-heart-failure
#1
Alexander B Zhai, Haissam Haddad
PURPOSE OF REVIEW: Obesity, a growing global health problem, contributes to the development of heart failure. However, increased BMI seems protective for those with established disease, a phenomenon known as the 'obesity paradox'. In this review, we outline the mechanism through which obesity can contribute to the development of heart failure, explore the concept of obesity paradox, and highlight the challenges that obesity presents for advanced heart failure therapy. RECENT FINDINGS: Although the mechanism underlying the obesity paradox is complex, meta-analysis shows that intentional weight loss through bariatric surgery can indeed improve cardiac structure and function...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28089072/the-role-of-implantable-cardioverter-defibrillators-in-patients-bridged-to-transplantation-with-a-continuous-flow-left-ventricular-assist-device-a-propensity-score-matched-analysis
#2
Kevin J Clerkin, Veli K Topkara, Donna M Mancini, Melana Yuzefpolskaya, Ryan T Demmer, Jose M Dizon, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, A Reshad Garan
BACKGROUND: Implantable cardioverter defibrillators (ICDs) provide a significant mortality benefit for appropriately selected patients with advanced heart failure. ICDs are associated with a mortality benefit when used in patients with a pulsatile left ventricular assist device (LVAD). It is unclear whether patients with a continuous-flow LVAD (CF-LVAD) derive the same benefit. We sought to determine if the presence of an ICD provided a mortality benefit during CF-LVAD support as a bridge to transplantation...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#3
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
January 15, 2017: Journal of Cardiac Surgery
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
#4
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/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#5
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28076895/implantation-of-left-ventricular-assist-device-in-a-patient-with-left-ventricular-non-compaction
#6
Keki R Balsara, Andrew Bierhals, Justin Vader, Michael K Pasque, Aki Itoh
Left ventricular noncompaction (LVNC) may result in systolic left ventricular (LV) failure resulting in the need for heart transplantation. LV assist devices (LVAD) have been used to bridge these patients to transplantation; however, the extensive trabeculations found in these patients predispose them to thromboembolic events and pump thrombosis. We describe a patient with LVNC in whom an aggressive surgical approach was used to debride the LV cavity of trabeculations to successfully implant an LVAD.
January 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28073849/caregivers-of-patients-with-left-ventricular-assist-devices-possible-impacts-on-patients-mortality-and-interagency-registry-for-mechanically-assisted-circulatory-support-defined-morbidity-events
#7
Courtenay R Bruce, Charles G Minard, L A Wilhelms, Mackenzie Abraham, Javier Amione-Guerra, Linda Pham, Sherry D Grogan, Barry Trachtenberg, Martin L Smith, Brian A Bruckner, Jerry D Estep, Kristin M Kostick
BACKGROUND: How caregivers contribute to positive or negative outcomes for left ventricular assist device (LVAD) patients remains unclear. Our primary study objectives were to (1) identify caregiver support attributes through a retrospective chart review of social workers' psychosocial assessments for LVAD patients and (2) determine how these attributes associated with patients' post-LVAD placement mortality and Interagency Registry for Mechanically Assisted Circulatory Support-defined morbidity events...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28073805/sheet-like-remodeling-of-the-transverse-tubular-system-in-human-heart-failure-impairs-excitation-contraction-coupling-and-functional-recovery-by-mechanical-unloading
#8
Thomas Seidel, Sutip Navankasattusas, Azmi A Ahmad, Nikolaos A Diakos, Weining D Xu, Martin Tristani-Firouzi, Michael Bonios, Iosif Taleb, Dean Y Li, Craig H Selzman, Stavros G Drakos, Frank B Sachse
BACKGROUND: -Cardiac recovery in response to mechanical unloading by left ventricular assist devices (LVADs) has been demonstrated in subgroups of chronic heart failure (HF) patients. Hallmarks of HF are depletion and disorganization of the transverse tubular system (t-system) in cardiomyocytes. Here, we investigated remodeling of the t-system in human end-stage HF and its role in cardiac recovery. METHODS: -Left ventricular biopsies were obtained from 5 donors (CTRL) and 26 chronic HF patients undergoing implantation of LVADs...
January 10, 2017: Circulation
https://www.readbyqxmd.com/read/28073804/hemodynamic-support-with-a-micro-axial-percutaneous-left-ventricular-assist-device-impella%C3%A2-protects-against-acute-kidney-injury-in-patients-undergoing-high-risk-percutaneous-coronary-intervention
#9
Michael P Flaherty, Sadip Pant, Samir V Patel, Tyler Kilgore, Sujith Dassanayaka, John Loughran, Wasiq Rawasia, Buddhadeb Dawn, Allen Cheng, Carlo R Bartoli
RATIONALE: Acute kidney injury (AKI) is common during high-risk percutaneous coronary intervention (PCI) particularly in those with severely reduced left ventricular (LV) ejection fraction (EF). The impact of partial hemodynamic support with a micro-axial percutaneous LV assist device (pLVAD) on renal function following high-risk PCI remains unknown. OBJECTIVE: We tested the hypothesis that partial hemodynamic support with the Impella 2.5 micro-axial pLVAD during high-risk PCI protected against AKI...
January 10, 2017: Circulation Research
https://www.readbyqxmd.com/read/28073659/serotonin-norepinephrine-re-uptake-inhibitor-snri-selective-norepinephrine-reuptake-inhibitor-s-nri-and-exogenously-administered-norepinephrine-induced-takotsubo-syndrome-analysis-of-published-cases
#10
Shams Y-Hassan
BACKGROUND: Takotsubo syndrome (TS) may be triggered by numerous physical stress factors including exogenous Norepinephrine administration. The aim of this study is to report on the clinical features and outcome of serotonin-norepinephrine reuptake inhibitor (SNRI)-, selective NRI (S-NRI)-, and exogenously administered norepinephrine-induced TS in a largest possible cohort of published cases. METHODS: A computer assisted search of the electronic data base Pubmed was performed from 1990 to August 2016...
December 30, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28070902/a-modified-lvad-technique-to-augment-caval-and-pulmonary-arterial-blood-flow-in-the-failing-fontan-circulation
#11
Michael F Swartz, Louis DiVincenti, Karen Smith, Robin Westcott, Kevin Belmont, William Harris, Francisco Gensini, George M Alfieris
BACKGROUND: There are minimal circulatory support options for patients with a failing Fontan. The Heartmate II (HMII) left ventricular assist device (Thoratec, Bedford, MA) in its packaged state cannot augment caval/pulmonary arterial blood flow. AIM: We hypothesized that a modified HMII pump could augment caval and pulmonary arterial blood flow. METHODS: A bifurcated ringed Gore-Tex graft (W. L. Gore & Associates, Flagstaff, AZ) was sewn to the HMII inflow, and the outflow graft transected and tapered from 16 mm to 8 mm in diameter...
January 9, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28070866/finite-element-analysis-of-patient-specific-mitral-valve-with-mitral-regurgitation
#12
Thuy Pham, Fanwei Kong, Caitlin Martin, Qian Wang, Charles Primiano, Raymond McKay, John Elefteriades, Wei Sun
Functional mitral regurgitation (FMR) is a significant complication of left ventricular dysfunction and strongly associated with a poor prognosis. In this study, we developed a patient-specific finite element (FE) model of the mitral apparatus in a FMR patient which included: both leaflets with thickness, annulus, chordae tendineae, and chordae insertions on the leaflets and origins on the papillary muscles. The FE model incorporated human age- and gender-matched anisotropic hyperelastic material properties, and MV closure at systole was simulated...
January 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28070237/to-ventricular-assist-devices-or-not-when-is-implantation-of-a-ventricular-assist-device-appropriate-in-advanced-ambulatory-heart-failure
#13
EDITORIAL
Emily Cerier, Brent C Lampert, Arman Kilic, Asia McDavid, Salil V Deo, Ahmet Kilic
Advanced heart failure has been traditionally treated via either heart transplantation, continuous inotropes, consideration for hospice and more recently via left ventricular assist devices (LVAD). Heart transplantation has been limited by organ availability and the futility of other options has thrust LVAD therapy into the mainstream of therapy for end stage heart failure. Improvements in technology and survival combined with improvements in the quality of life have made LVADs a viable option for many patients suffering from heart failure...
December 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/28066992/native-arteriovenous-fistula-placement-in-three-patients-after-implantation-of-a-left-ventricular-assist-device-with-non-pulsatile-blood-flow
#14
Johannes F Schaefers, Christian Ertmer
Patients with left ventricular assist device have an increased risk for postoperative acute kidney injury and long-term requirement of dialysis. As a chronic access for dialysis, native arteriovenous fistulae are uncommon options due to suspected maturation failure. We present three patients who received successful arteriovenous fistulae placement after left ventricular assist device implantation with assisted long term patency.
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28066578/angiopoietin-2-marker-or-mediator-of-angiogenesis-in-continuous-flow-left-ventricular-assist-device-patients
#15
EDITORIAL
Lauren K Truby, Veli K Topkara
No abstract text is available yet for this article.
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#16
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28058956/neuromuscular-blockade-and-inspiratory-breath-hold-during-stereotactic-body-radiation-therapy-for-treatment-of-heart-base-tumors-in-four-dogs
#17
Krista L Kelsey, Lyndsay N Kubicek, Nicholas J Bacon, Terry Torres, Sheilah A Robertson
CASE DESCRIPTION 4 dogs were examined because of pleural effusion and ventricular tachycardia, coughing and supraventricular tachycardia, appendicular osteosarcoma, and syncopal episodes. CLINICAL FINDINGS In all 4 dogs, a heart base tumor was identified by means of thoracic CT. TREATMENT AND OUTCOME In all 4 dogs, the heart base tumors were treated by means of stereotactic body radiation therapy. Dogs were anesthetized, and neuromuscular blockade was achieved with atracurium or vecuronium. A circle rebreathing system with 15 m (50 feet) of anesthetic tubing coursing through the vault wall was used to connect the patient to the anesthesia machine, which was located in the control room...
January 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28058856/effective-treatment-with-a-new-protocol-using-tissue-type-plasminogen-activator-thrombolysis-for-pump-thrombosis-with-the-hvad-device
#18
Benedikt Schrage, Hanno Grahn, Florian M Wagner, Alexander Bernhardt, Meike Rybczynski, Stefan Blankenberg, Hermann Reichenspurner, Markus J Barten
BACKGROUND: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis. METHODS: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28058699/international-coordinator-survey-results-on-the-outpatient-management-of-patients-with-the-heartware%C3%A2-ventricular-assist-system
#19
Thomas Schlöglhofer, Desiree Robson, Jayne Bancroft, Gro Sørensen, Friedrich Kaufmann, Leslie Sweet, Neil Wrightson
PURPOSE: While the HeartWare® Ventricular Assist System (HVAS) is a successful therapy for end-stage heart failure, outpatient management methods can vary significantly and require further investigation. METHODS: A survey to assess the long-term HVAS patient management and monitoring strategies was completed by 36 international heart centers that currently have over 1,450 patients on VAD support either at home or in the hospital. Multiple choice questions examined VAD program characteristics, anticoagulation management, driveline exit-site dressing and showering recommendations, blood pressure and pump parameter monitoring, and patient discharge protocols...
December 26, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28057337/caregiver-status-and-outcomes-after-durable-left-ventricular-assist-device-implantation
#20
Michael Koeckert, Patrick Vining, Alex Reyentovich, Stuart D Katz, Abe DeAnda, Stefanie Philipson, Leora B Balsam
OBJECTIVES: To determine the relationship between caregiver status and outcomes after durable left ventricular assist device (LVAD) implantation. BACKGROUND: The absence of a caregiver is a relative contraindication to durable LVAD support. METHODS: Forty-three patients that underwent primary LVAD implantation were divided into three groups: those with caregivers that retained their roles for the duration of LVAD support (CG group), those with caregivers that resigned their roles (CG-QUIT group), and those implanted without an assigned caregiver (No-CG group)...
January 2, 2017: Heart & Lung: the Journal of Critical Care
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