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https://www.readbyqxmd.com/read/28547176/metabolic-volume-performs-better-than-suvmax-in-the-detection-of-left-ventricular-assist-device-driveline-infection
#1
Nemanja Avramovic, Angelo Maria Dell'Aquila, Matthias Weckesser, Danka Milankovic, Alexis Vrachimis, Jürgen R Sindermann, Christian Wenning
PURPOSE: A continuous-flow left ventricular assist device (LVAD) is a new and highly promising therapy in supporting end-stage heart failure patients, either bridging them to heart transplantation or as a destination therapy. Infection is one of the major complications associated with LVAD implants. (18)F-FDG PET/CT has already been shown to be useful in the detection of LVAD infection. The goal of this study was to compare the diagnostic accuracy of different PET analysis techniques (visual grading versus SUVmax and metabolic volume)...
May 25, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28546755/pediatric-ventricular-assist-devices-current-challenges-and-future-prospects
#2
REVIEW
Sarah Burki, Iki Adachi
The field of mechanical circulatory support has made great strides in the preceding 2 decades. Although pediatric mechanical circulatory support has lagged behind that of adults, the gap between them is expected to close soon. The only device currently approved by the US Food and Drug Administration for use in children is the Berlin Heart EXCOR ventricular assist device (VAD). The prospective Berlin Heart Investigational Device Exemption Trial demonstrated good outcomes, such as bridge to transplantation or recovery, in ~90% of children supported with this device...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28544381/biventricular-impella-placement-via-complete-venous-access
#3
Norihiko Kamioka, Ateet Patel, Michael A Burke, Adam Greenbaum, Vasilis Babaliaros
Impella (Abiomed, Danvers, MA) is an effective option for emergent treatment of critical refractory cardiogenic shock. However, in patients who have inadequate peripheral arterial access, Impella for left ventricular support sometimes requires surgical access, leading to disadvantages for emergent procedures or invasiveness for very sick patients. In addition, Impella for right ventricular support was recently reported to contribute to the management of severe biventricular dysfunction. In this report, we describe a case of refractory cardiogenic shock in a patient with inadequate vascular access who was treated with biventricular Impella via venous and caval-aortic access under conscious sedation...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28543813/inhaled-pulmonary-vasodilator-therapy-for-management-of-right-ventricular-dysfunction-after-left-ventricular-assist-device-placement-and-cardiac-transplantation
#4
Leah A Sabato, David M Salerno, Jeremy D Moretz, Douglas L Jennings
Right ventricular failure (RVF) after cardiac transplant (CTX) or implantation of a continuous-flow left ventricular assist device (CF-LVAD) is associated with significant post-operative morbidity and mortality. A variety of modalities have been used to treat post-operative RVF, including management of volume status, intravenous inotropes and vasodilators, and right-sided mechanical support. Inhaled vasodilator agents are a unique treatment option aimed at minimizing systemic absorption by delivering therapy directly to the pulmonary vasculature...
May 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28542177/mycophenolate-mofetil-for-scleroderma-related-interstitial-lung-disease-a-real-world-experience
#5
Misbah Baqir, Ashima Makol, Thomas G Osborn, Brian J Bartholmai, Jay H Ryu
BACKGROUND AND OBJECTIVE: Interstitial lung disease (ILD) remains the number one cause of mortality in scleroderma (SSc). Our goal was to determine the effectiveness of mycophenolate mofetil (MMF) in treating SSc-ILD in a retrospective study. METHODS: A retrospective, computer-assisted search was performed to identify patients with SSc-ILD treated with MMF from 1997 through 2014. We used a novel software tool, Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER), to quantify parenchymal lung abnormalities on high-resolution computed tomography...
2017: PloS One
https://www.readbyqxmd.com/read/28542076/comparative-analysis-of-perioperative-and-mid-term-results-of-tecab-and-midcab-for-revascularization-of-anterior-wall
#6
Markus Kofler, Thomas Schachner, Sebastian J Reinstadler, Lukas Stastny, Julia Dumfarth, Dominik Wiedemann, Gudrun Feuchtner, Guy Friedrich, Johannes Bonatti, Nikolaos Bonaros
OBJECTIVE: Totally endoscopic coronary artery bypass (TECAB) and minimally invasive direct coronary artery bypass (MIDCAB) grafting through minithoracotomy are currently the two minimally invasive surgical techniques of left ventricular anterior wall revascularization. We aimed to compare both techniques in terms of perioperative and mid-term results. METHODS: Arrested heart TECAB was carried out in 204 patients with a median (range) age of 60 (53-76) years and a median (range) EuroSCORE I of 2 (0-3)...
May 24, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28539566/traumatic-tricuspid-regurgitation
#7
Yan Cheng, Lei Yao, Shengjun Wu
Traumatic tricuspid regurgitation is a rare and progressive disease. Early diagnosis and surgical valve repair are very important. A 57-year-old male was referred to our hospital with a history of blunt chest trauma. Three-dimensional echocardiography showed severe tricuspid regurgitation and demonstrated two main anterior leaflet chordaes of the tricuspid valve rupture and the whole anterior leaflet prolapsed. The diagnosis was severe tricuspid regurgitation due to leaflet chordae rupture secondary to blunt chest trauma...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28536661/successful-use-of-extracorporeal-membrane-oxygenation-for-the-treatment-of-cardiogenic-shock-due-to-scorpion-envenomation
#8
Amine Tarmiz, Imene Mgarrech, Chokri Kortas, Sofiane Jerbi
Introduction. The occurrence of a cardiogenic shock is a rare presentation after scorpion envenomation. The treatment includes classically the use of inotropes and specific vasodilators. Case Presentation. We report a case of an 11-year-old boy presenting with cardiogenic shock and pulmonary edema after a scorpion sting. Despite adequate management at the emergency department and intensive care unit, the patient's hemodynamic status worsened rapidly, justifying his transfer to our department for ventricular mechanical assistance by venoarterial extracorporeal membrane oxygenation...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28536530/the-total-artificial-heart-in-end-stage-congenital-heart-disease
#9
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/28536224/impella-percutaneous-left-ventricular-assist-device-for-severe-acute-ischaemic-mitral-regurgitation-as-a-bridge-to-surgery
#10
Bilal Jalil, Karim El-Kersh, Jarrod Frizzell, Shozab Ahmed
Ischaemic papillary muscle rupture causing acute severe mitral regurgitation (MR) has a dramatic presentation and a very high mortality. Emergent surgical repair improves outcomes, which necessitates robust preoperative stabilisation. Here we discuss a patient with cardiogenic shock with an acute severe MR that was deemed very high risk for emergent valve replacement due to haemodynamic instability and respiratory failure. A percutaneous left ventricular assist device Impella 2.5 (Abiomed, Danvers, MA) drastically improved clinical status, and the patient underwent a successful surgical mitral valve replacement soon after placement of the temporary assist device...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28536222/giant-cell-myocarditis-presenting-with-acute-heart-failure
#11
Ioannis Kasouridis, Joaquim Majo, Guy MacGowan, Andrew L Clark
Idiopathic giant cell myocarditis (GCM) is a rare and rapidly progressing form of myocarditis predominantly affecting younger people. We report a case of a 23-year-old athletic patient who presented with features of acute heart failure due to GCM and discuss his management that included a left ventricular assist device as a bridge to transplant. He died immediately following the transplant.We also review the literature on this rare disease, highlighting the advances in the management of the disease including immunosuppressive therapy, ventricular assist devices and heart transplantation...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535190/concomitant-repair-for-mild-aortic-insufficiency-and-continuous-flow-left-ventricular-assist-devices
#12
Shinichi Fukuhara, Hirohisa Ikegami, Antonio R Polanco, Jeremy J Song, Jiho Han, Koji Takeda, Paul A Kurlansky, Hiroo Takayama, Yoshifumi Naka
OBJECTIVES: Aortic insufficiency (AI) after continuous-flow left ventricular assist device (CF-LVAD) implantation has become a highly relevant subject. However, management of pre-existing mild AI is unknown. We examined the fate of pre-existing mild AI during CF-LVAD support. METHODS: From March 2004 to October 2015, 446 consecutive patients received CF-LVAD. Of these, 56 (12.6%) patients with pre-existing mild AI were identified. Outcomes were compared between patients who underwent repair [ n  = 41 (73...
May 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28533303/cardiopulmonary-resuscitation-in-adults-and-children-with-mechanical-circulatory-support-a-scientific-statement-from-the-american-heart-association
#13
REVIEW
Mary Ann Peberdy, Jason A Gluck, Joseph P Ornato, Christian A Bermudez, Russell E Griffin, Vigneshwar Kasirajan, Richard E Kerber, Eldrin F Lewis, Mark S Link, Corinne Miller, Jeffrey J Teuteberg, Ravi Thiagarajan, Robert M Weiss, Brian O'Neil
Cardiac arrest in patients on mechanical support is a new phenomenon brought about by the increased use of this therapy in patients with end-stage heart failure. This American Heart Association scientific statement highlights the recognition and treatment of cardiovascular collapse or cardiopulmonary arrest in an adult or pediatric patient who has a ventricular assist device or total artificial heart. Specific, expert consensus recommendations are provided for the role of external chest compressions in such patients...
May 22, 2017: Circulation
https://www.readbyqxmd.com/read/28532781/usefulness-of-left-atrial-emptying-fraction-to-predict-ventricular-arrhythmias-in-patients-with-implantable-cardioverter-defibrillators
#14
Mischa T Rijnierse, Mehran Kamali Sadeghian, Sophie Schuurmans Stekhoven, P Stefan Biesbroek, Anne-Lotte C van der Lingen, Peter M van de Ven, Albert C van Rossum, Robin Nijveldt, Cornelis P Allaart
Impaired left atrial emptying fraction (LAEF) is an important predictor of mortality in patients with heart failure. As it may reflect increased LV wall stress, it might predict ventricular arrhythmia (VA) specifically. This study evaluated the predictive value of LAEF assessed with cardiovascular magnetic resonance (CMR) imaging with respect to appropriate device therapy (ADT) for VA and compared its role with CMR assessed scar size and other risk factors. In total, 229 patients (68% male, 63 ± 10 years, 61% ischemic cardiomyopathy) with LV ejection fraction ≤35% who underwent CMR and implantable cardioverter defibrillator (ICD) implantation for primary prevention in 2005 to 2012 were included...
April 27, 2017: American Journal of Cardiology
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
#15
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
#16
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
#17
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/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#18
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28528048/real-time-autofluorescence-imaging-to-diagnose-lvad-driveline-infections
#19
Jack B Keenan, Taufiek Konrad Rajab, David G Armstrong, Zain Khalpey
A 64-year-old man experienced a driveline infection that was treated with serial debridements and antibiotics. When the wound clinically appeared ready for closure, a handheld fluorescence imaging device still revealed a margin of red fluorescence around the wound edges consistent with a subclinical infection. Therefore, a wider margin was made and additional specimens for wound culture were taken, which demonstrated a vancomycin-resistant enterococcal infection. The autofluorescence signals of common bacteria can be detected with a fluorescence camera in subclinical wound infections without clinical signs...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28528026/implantation-of-a-durable-left-ventricular-assist-device-how-i-teach-it
#20
EDITORIAL
John M Stulak, Ashraf Abou El Ela, Francis D Pagani
No abstract text is available yet for this article.
June 2017: Annals of Thoracic Surgery
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