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https://www.readbyqxmd.com/read/28528048/real-time-autofluorescence-imaging-to-diagnose-lvad-driveline-infections
#1
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/28508806/telemonitoring-and-medical-care-of-heart-failure-patients-supported-by-left-ventricular-assist-devices-the-medolution-project
#2
Nils Reiss, Thomas Schmidt, Frerk Müller-von Aschwege, Wolfgang Thronicke, Jan-Dirk Hoffmann, Jenny Inge Röbesaat, Ezin Deniz, Andreas Hein, Heiko Krumm, Franz-Josef Stewing, Detlev Willemsen, Jan Dieter Schmitto, Christina Feldmann
Long-term survival after left ventricular assist device (LVAD) implantation in heart failure patients is mainly determined by a sophisticated after-care. Ambulatory visits only take place every 12 weeks. In case of life-threatening complications (pump thrombosis, driveline infection) this might lead to delayed diagnosis and delayed intervention. It is the intention of the international project Medolution (Medical care evolution) to develop new approaches in order to create best structures for telemonitoring of LVAD patients...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28430300/left-ventricular-assist-pump-pocket-infection-conservative-treatment-strategy-for-destination-therapy-candidates
#3
Elie Haddad, François-Xavier Lescure, Walid Ghodhbane, Laurent Lepage, Camille D'humieres, William Vindrios, Yazdan Yazdanpanah, Patrick Nataf, Matthias Kirsch
BACKGROUND: Heart failure is a major cause of mortality and morbidity, particularly among patients with advanced disease and no access to cardiac transplantation. LVAD implantation is not only a bridge-to-transplantation option for patients awaiting a heart donor, but is often used as bridge-to-destination therapy in patients unsuited for transplantation for various reasons. LVAD infection is considered the second-most common cause of death in patients who survive the initial 6 months on LVAD support...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28430297/stopping-conventional-showering-decreases-pseudomonas-infections-in-left-ventricular-assist-device-patients
#4
Nana Aburjania, Saadia Sherazi, Vakhtang Tchantchaleishvili, Jeffrey D Alexis, Christine M Hay
BACKGROUND: Left ventricular assist device (LVAD) exit-site infections represent a major challenge in the era of modern LVADs. Infections caused by Pseudomonas are particularly difficult to treat due to limited antibiotic susceptibility. We hypothesized that keeping the LVAD exit site dry while bathing could result in reduced incidence of Pseudomonas infections. METHODS: Starting in April 2013, all patients who underwent placement of HeartMate II (HM II) LVAD were instructed not to take conventional showers and to keep the exit site dry while bathing...
April 18, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28376837/heartmate-3-fully-magnetically-levitated-left-ventricular-assist-device-for-the-treatment-of-advanced-heart-failure-1%C3%A2-year-results-from-the-ce-mark-trial
#5
Thomas Krabatsch, Ivan Netuka, Jan D Schmitto, Daniel Zimpfer, Jens Garbade, Vivek Rao, Michiel Morshuis, Friedhelm Beyersdorf, Silvana Marasco, Laura Damme, Yuriy Pya
BACKGROUND: The HeartMate 3 Left Ventricular Assist System (LVAS) (St. Jude Medical Inc., St Paul, MN) with full magnetic levitation allows for wide and consistent blood flow paths and an artificial pulse designed for enhanced hemocompatibility. The HeartMate 3 received market approval in the European Union in 2015 following completion of a multicenter study. After reaching the 6-month study endpoint, patients continue to be followed for 2 years with the 1-year results presented herein...
April 4, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28323195/left-ventricular-assist-device-related-infections-a-multicentric-study
#6
S Siméon, E Flécher, M Revest, M Niculescu, J-C Roussel, M Michel, P Leprince, P Tattevin
OBJECTIVES: Implantable left ventricular assist device (LVAD) is a major therapeutic progress for end-stage heart failure in selected patients. As their use is expanding, infectious complications are emerging, with limited data available to guide their management. We aimed to better characterize LVAD-related infections. METHODS: We enrolled all consecutive patients diagnosed with LVAD-related infections in 3 referral centers in France, using standardized definition of infections in patients with LVAD...
March 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28125466/comparison-of-hemodynamic-performance-and-clinical-results-with-evaheart-versus-heartmate-ii
#7
Yorihiko Matsumoto, Tomoyuki Fujita, Satsuki Fukushima, Hiroki Hata, Yusuke Shimahara, Yuta Kume, Kizuku Yamashita, Kensuke Kuroda, Seiko Nakajima, Takuma Sato, Osamu Seguchi, Masanobu Yanase, Norihide Fukushima, Hideyuki Shimizu, Junjiro Kobayashi
This study aimed to compare the hemodynamic performance and clinical results of the EVAHEART and HeartMate II left ventricular assist devices (LVADs). From 2007 to 2016, 14 patients received EVAHEART and 28 received HeartMate II at our center. Early survival, driveline infection and neurological events were evaluated. Hemodynamic performance was evaluated with transthoracic echocardiography and right heart catheterization. Mean follow-up was 35.5 ± 14.8 months for EVAHEART, and 29.8 ± 6.5 months for HeartMate II...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28114194/myocardial-recovery-strategy-with-decommissioning-for-the-heartware-left-ventricular-assist-device
#8
Guy A MacGowan, Neil Wrightson, Nicola Robinson-Smith, Andrew Woods, Gareth Parry, Kate Gould, Stephan Schueler
To manage myocardial recovery in patients with the HeartWare left ventricular assist device (HVAD), we describe a minimally invasive approach (decommissioning) that involves disconnecting the driveline and occluding the outflow tract through a small left thoracotomy incision, leaving the device in situ, in conjunction with optimal medical therapies and comprehensive assessment of left ventricular recovery. Nine patients (all male, 37 ± 12 years, all nonischemic dilated cardiomyopathy) had an HVAD implanted for 766 ± 343 days...
May 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28104118/cerebrovascular-accident-rate-is-different-between-centrifugal-and-axial-flow-pumps-but-survival-and-driveline-infection-rates-are-similar
#9
M Kimura, K Nawata, O Kinoshita, H Yamauchi, Y Itoda, T Imamura, M Hatano, K Kinugawa, M Ono
OBJECTIVES: We analyzed the outcome of patients with implantable left ventricular assist devices (LVADs) at the University of Tokyo Hospital to compare those with centrifugal pumps (CE group: Duraheart and Evaheart) and those with axial-flow pumps (AX group: Heartmate II and Jarvik 2000). METHODS: A total of 68 patients who underwent implantation of LVADs (Duraheart: n = 15; Evaheart: n = 23; Heartmate II: n = 22; Jarvik 2000: n = 8) as a bridge to transplantation at our institution from May 2011 to April 2015 were retrospectively reviewed...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#10
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27986679/prevention-and-infection-management-in-mechanical-circulatory-support-device-recipients
#11
Shimon Kusne, Linda Staley, Francisco Arabia
There are currently no guidelines for the management of infection and its prevention in mechanical circulatory support (MCS) device recipients. The International Society of Heart and Lung Transplantation (ISHLT) has initiated a multidisciplinary collaboration for the creation of a consensus document to guide clinicians in infection prevention and management in MCS patients. Most medical centers use local protocols that are based on expert opinion. MCS recipients are debilitated and have some immunological dysfunction...
January 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27931587/do-prior-driveline-infections-increase-the-risk-of-infection-in-heart-transplant-patients-treated-with-rabbit-antithymocyte-globulin-induction-therapy
#12
D Arman, D Kuraitis, J Moriguchi, M Hamilton, F Liou, S Siddiqui, M Luu, P Zakowski, F Arabia, J Kobashigawa
BACKGROUND: The use of mechanical circulatory support devices (MCSDs) has been increasing over the past several years. Driveline infections (DLIs) are one of the most common complications seen in these patients; reportedly, up to 50% of patients with MCSDs can develop this complication. It is believed that the removal of the driveline results in treatment of the localized infection area. MCSD patients are also known to develop circulating antibodies. These circulating antibodies have been associated with poor outcomes after heart transplantation...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27903010/heartmate-ii-left-ventricular-assist-device-pump-exchange-a-single-institution-experience
#13
Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
November 30, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27878511/new-challenges-in-the-treatment-of-patients-with-left-ventricular-support-lvad-thrombosis
#14
REVIEW
Ann B Nguyen, Nir Uriel, Sirtaz Adatya
Mechanical circulatory support has revolutionized the treatment of heart failure, affording patients significantly improved survival and quality of life. However, further advancements in this technology have been hindered by adverse events, particularly gastrointestinal bleeding, driveline infection, stroke, and device thrombosis. Recently, there has been a renewed focus on device thrombosis as the reported incidence has increased. This review focuses on an update on the diagnostic modalities and current treatment algorithms of this serious complication...
December 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27833783/the-role-of-computed-tomography-in-predicting-left-ventricular-assist-device-infectious-complications
#15
Carrie K Gomez, Scott R Schiffman, Susan K Hobbs
OBJECTIVE: The purpose of this study is to identify early computed tomography findings around the driveline which would predict mediastinal or left ventricular assist device (LVAD) pocket abscess formation. MATERIALS AND METHODS: A retrospective analysis was performed on 128 LVAD recipients between January 2007 and December 2011. Infectious complications were subdivided into those affecting the driveline and those resulting in abscess formation either around the LVAD pump or mediastinum...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/27828806/mechanical-circulatory-support-heart-failure-therapy-in-motion
#16
REVIEW
Stephan M Ensminger, Gino Gerosa, Jan F Gummert, Volkmar Falk
Because the first generation of pulsatile-flow devices was primarily used to bridge the sickest patients to transplantation (bridge-to-transplant therapy), the current generation of continuous-flow ventricular assist devices qualifies for destination therapy for patients with advanced heart failure who are ineligible for transplantation. The first-generation devices were associated with frequent adverse events, limited mechanical durability, and patient discomfort due device size. In contrast, second-generation continuous-flow devices are smaller, more quiet, and durable, thus resulting in less complications and significantly improved survival rates...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27816511/does-small-size-matter-with-continuous%C3%A2-flow-devices-analysis-of-the-intermacs-database-of-adults-with-bsa%C3%A2-%C3%A2-1-5-m-2
#17
Farhan Zafar, Chet R Villa, David L Morales, Elizabeth D Blume, David N Rosenthal, James K Kirklin, Angela Lorts
OBJECTIVES: This study investigated how small patient size affects clinical outcomes in patients implanted with a continuous flow left ventricular assist device (CFLVAD). BACKGROUND: The development of smaller CFLVADs has allowed ventricular assist device (VAD) use in anatomically smaller patients; however, limited outcome data exist regarding CFLVAD use in patients with a body surface area (BSA) ≤1.5 m(2). METHODS: All CFLVAD patients entered in the Interagency Registry for Mechanically Assisted Circulatory Support registry April 2008 to September 2013 and with BSA data were included...
October 27, 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27774264/initial-3-year-outcomes-with-left-ventricular-assist-devices-in-a-country-with-a-nascent-heart-transplantation-program
#18
Yuriy Pya, Makhabbat Bekbossynova, Saltanat Jetybayeva, Serik Bekbossynov, Saltanat Andossova, Roman Salov, Assel Medressova, Svetlana Novikova, Muradym Murzagaliyev
AIMS: The need for the left ventricular assist devices (LVAD) in patients with end-stage heart failure is well established, but prior to 2011, this was not available to patients in Kazakhstan. We describe the development of the sole LVAD programme in the context of a nascent heart transplantation programme and clinical outcomes for the first three years. METHODS AND RESULTS: From November 2011 to November 2014, 146 patients underwent implantation of 152 VADs (approximately 50 devices implanted per year)...
March 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27766677/surgical-management-of-driveline-infections-in-patients-with-left-ventricular-assist-devices
#19
Marina Pieri, Anna Mara Scandroglio, Marcus Müller, Panagiotis Pergantis, Alexandra Kretzschmar, Friedrich Kaufmann, Volkmar Falk, Thomas Krabatsch, Georg Arlt, Evgenij Potapov, Marian Kukucka
BACKGROUND AND AIM OF THE STUDY: Driveline infections in patients with implantable left ventricular assist devices (VAD) carry increasing risk for pump infection, thromboembolic events, decreased quality of life, and increased hospitalization. We report our experience with a surgical technique for refractory driveline infections without mediastinitis consisting of translocation and wrapping of the driveline with greater omentum tissue. METHODS: We retrospectively reviewed data of VAD patients who underwent surgical treatment by translocation and wrapping with omentum for severe chronic driveline infection...
December 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27702831/reduction-of-incor%C3%A2-driveline-infection-rate-with-silicone-at-the-driveline-exit-site
#20
Daniele Camboni, Matthaeus Zerdzitzki, Stephan Hirt, René Tandler, Michael Weyand, Christof Schmid
OBJECTIVES: A silicone interface at skin level of left ventricular assist device (LVAD) may reduce the risk of driveline (DL) exit site infections when compared with other materials (e.g. velour). The purpose of this study was to evaluate the rate of DL exit site infection according to the presence of silicone or velour at the exit site with the redesigned INCOR, facilitating the positioning of silicone at the exit site. METHODS: The rate of DL exit site infection and overall survival were compared between the two groups (silicone group, n = 16/velour group, n = 24) with 1-year follow-up postimplantation...
October 4, 2016: Interactive Cardiovascular and Thoracic Surgery
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