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https://www.readbyqxmd.com/read/29141856/impact-of-diabetes-mellitus-on-outcomes-in-patients-supported-with-left-ventricular-assist-devices-a-single-institutional-9-year-experience
#1
Rabea Asleh, Alexandros Briasoulis, Sarah D Schettle, Vakhtang Tchantchaleishvili, Naveen L Pereira, Brooks S Edwards, Alfredo L Clavell, Simon Maltais, David L Joyce, Lyle D Joyce, Richard C Daly, Sudhir S Kushwaha, John M Stulak
BACKGROUND: Diabetes mellitus (DM) is a risk factor for morbidity and mortality in patients with heart failure. The effect of DM on post-left ventricular assist device (LVAD) implantation outcomes is unclear. This study sought to investigate whether patients with DM had worse outcomes than patients without DM after LVAD implantation and whether LVAD support resulted in a better control of DM. METHODS AND RESULTS: We retrospectively reviewed 341 consecutive adults who underwent implantation of LVAD from 2007 to 2016...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29141690/resternotomy-does-not-adversely-affect-outcome-after-left-ventricular-assist-device-implantation
#2
Maria Papathanasiou, Loukas Tsourelis, Nikolaus Pizanis, Achim Koch, Markus Kamler, Tienush Rassaf, Peter Luedike
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients...
November 15, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29136649/discordance-between-actual-and-scheduled-check-in-times-at-a-heart-failure-clinic
#3
Eiran Z Gorodeski, Emer Joyce, Benjamin T Gandesbery, Eugene H Blackstone, David O Taylor, W H Wilson Tang, Randall C Starling, Rory Hachamovitch
INTRODUCTION: A 2015 Institute Of Medicine statement "Transforming Health Care Scheduling and Access: Getting to Now", has increased concerns regarding patient wait times. Although waiting times have been widely studied, little attention has been paid to the role of patient arrival times as a component of this phenomenon. To this end, we investigated patterns of patient arrival at scheduled ambulatory heart failure (HF) clinic appointments and studied its predictors. We hypothesized that patients are more likely to arrive later than scheduled, with progressively later arrivals later in the day...
2017: PloS One
https://www.readbyqxmd.com/read/29130648/emergent-percutaneous-therapy-for-left-ventricular-assist-device-retrograde-flow
#4
Ryan E Wilson, John C Gurley, Navin Rajagopalan, Thomas A Tribble
With the number of heart transplants being performed each year stagnating due to lack of donors the left ventricular assist device (LVAD) patient population will continue to grow. As more and more patients are living longer with LVADs, either as a bridge to transplant or destination therapy, we will continue to see an increased number of complications related to assist device therapy. One of the common challenges physicians face are patients who suffer from both bleeding and thrombotic complications. When bleeding complications occur anticoagulation is usually reduced or discontinued and then the thrombosis risk increases...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29129497/frailty-and-clinical-outcomes-in-advanced-heart-failure-patients-undergoing-left-ventricular-assist-device-implantation-a-systematic-review-and-meta-analysis
#5
Gary Tse, Mengqi Gong, Sunny Hei Wong, William K K Wu, George Bazoukis, Konstantinos Lampropoulos, Wing Tak Wong, Yunlong Xia, Martin C S Wong, Tong Liu, Jean Woo
BACKGROUND: Frailty has been identified as a risk factor for adverse clinical outcomes after cardiac intervention or surgery. However, whether it increases the risk of adverse outcomes in patients undergoing left ventricular assist device (LVAD) therapy has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and clinical outcomes of length of stay and mortality in this setting. METHODS: PubMed and Embase were searched until September 11, 2017, for studies evaluating the association between frailty and clinical outcomes in advanced heart failure patients undergoing LVAD implantation...
November 9, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29129374/the-jarvik-2000-left-ventricular-assist-device-as-a-bridge-to-transplantation-japanese-registry-for-mechanically-assisted-circulatory-support
#6
Hiroki Kohno, Goro Matsumiya, Yoshiki Sawa, Minoru Ono, Yoshikatsu Saiki, Akira Shiose, Kenji Yamazaki, Yoshiro Matsui, Hiroshi Niinami, Hikaru Matsuda, Soichiro Kitamura, Takeshi Nakatani, Shunei Kyo
BACKGROUND: The Jarvik 2000 ventricular assist device features a miniaturized intraventricular pump and an intermittent low-speed function that facilitates aortic valve opening. Despite its long history, little is known about the Jarvik device with regard to post-implantation outcomes. METHODS: Prospectively collected data from 13 participating hospitals were extracted from the Japanese Registry for Mechanically Assisted Circulatory Support database to analyze mortality, morbidity and de-novo aortic regurgitation...
October 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29127102/algorithms-to-guide-ambulance-clinicians-in-the-management-of-emergencies-in-patients-with-implanted-rotary-left-ventricular-assist-devices
#7
REVIEW
Christopher T Bowles, Rachel Hards, Neil Wrightson, Paul Lincoln, Shishir Kore, Laura Marley, Jonathan R Dalzell, Binu Raj, Tracey A Baker, Diane Goodwin, Petra Carroll, Jane Pateman, John J M Black, Paul Kattenhorn, Mark Faulkner, Jayan Parameshwar, Charles Butcher, Mark Mason, Alexander Rosenberg, Ian McGovern, Alexander Weymann, Carl Gwinnutt, Nicholas R Banner, Stephan Schueler, Andre R Simon, David W Pitcher
Advances in left ventricular assist device (LVAD) therapy have resulted in increasing numbers of adult LVAD recipients in the community. However, device failure, stroke, bleeding, LVAD thrombosis and systemic infection can be life-threatening emergencies. Currently, four LVAD systems are implanted in six UK transplant centres, each of which provides device-specific information to local emergency services. This has resulted in inconsistent availability and content of information with the risks of delayed or inappropriate decision-making...
November 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29118868/efficacy-of-video-capsule-endoscopy-in-the-management-of-suspected-small-bowel-bleeding-in-patients-with-continuous-flow-left-ventricular-assist-devices
#8
Thomas A Zikos, Jennifer Pan, Berkeley Limketkai, Dipanjan Banerjee, Nielsen Fernandez-Becker
Background: Continuous flow left ventricular assist device (CF-LVAD) patients have a high prevalence of gastrointestinal bleeding from the small bowel. Video capsule endoscopy (VCE) is often used for diagnosis in these patients, but efficacy has yet to be determined. In this study, we evaluated the efficacy of VCE in the management of CF-LVAD patients with suspected small bowel bleeding by comparing to a non-VCE CF-LVAD control group. Methods: We retrospectively reviewed the charts of all patients with CF-LVADs implanted at Stanford Hospital from January 2010 to October 2015...
October 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29117041/repeated-ramp-tests-on-stable-lvad-patients-reveal-patient-specific-hemodynamic-fingerprint
#9
Teruhiko Imamura, Daniel Burkhoff, Daniel Rodgers, Sirtaz Adatya, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, Colleen Juricek, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
Hemodynamic speed ramp tests are used in left ventricular assist device (LVAD) patients to guide speed adjustment and medical therapies. However, the reproducibility of these tests is unknown. In this prospective study, clinically stable LVAD patients underwent echocardiography and right heart catheterization ramp tests followed by a repeat test within 2 years as per institutional protocol. Sixteen patients (61.8 ± 10.5 years old, 50% male, eight with HeartMate II and eight with HVAD) underwent repeated ramp testing...
November 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29112021/heartmate-iii-replacement-for-recurring-left-ventricular-assist-device-pump-thrombosis
#10
Yaron D Barac, Jacob N Schroder, Mani A Daneshmand, Chetan B Patel, Carmelo A Milano
Left ventricular assist devices (LVADs) are being used widely to support patients with advanced systolic heart failure. Some of these patients will need more than one LVAD replacement due to pump thrombosis. The Heartmate III LVAD (Abbott Inc, Chicago, IL) recently has been shown to have a very low incidence of pump thrombosis. In this article, we describe cases of patients with multiple pump thrombosis events, who were successfully replaced with the Heartmate III.
November 3, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29109001/physician-decision-making-in-the-setting-of-advanced-illness-an-examination-of-patient-disposition-and-physician-religiousness
#11
Benjamin W Frush, Simon G Brauer, John D Yoon, Farr A Curlin
CONTEXT: Little is known about patient and physician factors that affect decisions to pursue more or less aggressive treatment courses for patients with advanced illness. OBJECTIVES: This study sought to determine how patient age, patient disposition, and physician religiousness affect physician recommendations in the context of advanced illness. METHODS: A survey was mailed to a stratified random sample of US physicians, which included three vignettes depicting advanced illness scenarios: 1) cancer, 2) heart failure, and 3) dementia with acute infection...
November 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29106559/outcome-of-heart-transplantation-after-bridge-to-transplant-strategy-using-various-mechanical-circulatory-support-devices
#12
Daisuke Yoshioka, Boyangzi Li, Hiroo Takayama, Reshad A Garan, Veli K Topkara, Jiho Han, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
OBJECTIVES: Orthotopic heart transplantation (OHT) is limited by a chronic shortage of donors. With the evolution of technology, more patients have been bridged to transplant (BTT) through various pathways using various types of mechanical circulatory support. We compared short- and long-term outcomes among these various strategies of BTT. METHODS: We retrospectively reviewed 410 patients who had OHT between January 2009 and April 2015. Patients were divided into 4 groups according to BTT status: primary OHT without bridging (Group A, n  = 246); bridge with implantable continuous-flow left ventricular assist device (CF-LVAD) (Group B, n  = 130); bridge with short-term mechanical circulatory support (Group C, n  = 16) and bridge with multiple mechanical circulatory supports, including short-term mechanical circulatory support and CF-LVAD (Group D, n  = 18)...
July 4, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29103855/right-ventricular-longitudinal-strain-in-left-ventricular-assist-device-surgery-a-retrospective-cohort-study
#13
Daniel R Beck, Lisa Foley, Jackson R Rowe, Angela F D Moss, Nathaen S Weitzel, T Brett Reece, David A Fullerton, Joseph C Cleveland, Karsten Bartels
OBJECTIVES: Right ventricular (RV) failure is common after left ventricular assist device (LVAD) surgery and is associated with higher mortality. Measurement of longitudinal RV strain using speckle-tracking technology is a novel approach to quantify RV function. The authors hypothesized that depressed peak longitudinal RV strain measured by intraoperative transesophageal echocardiography (TEE) examinations would be associated with adverse outcomes after LVAD surgery. DESIGN: Retrospective cohort study...
July 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29099540/depression-and-anxiety-in-patients-undergoing-left-ventricular-assist-device-implantation
#14
Scott Lundgren, Cecilia Y M Poon, Ahmed Selim, Brian D Lowes, Ronald Zolty, Adam Burdorf, Yael Potashnik-Peled, Michael J Moulton, John Y Um, Eugenia Raichlin
BACKGROUND: Depression and anxiety are associated with a worse prognosis in heart failure patients. The aim of this study was to identify the prevalence of depression and anxiety in left ventricular assist device (LVAD) candidates and assess their effect on post-LVAD outcomes. METHODS: Based on the pre-LVAD psychological assessment, the total cohort of 246 patients were divided into 4 groups: 1) no depression or anxiety (NDep&Anx group, n = 138); 2) isolated depression (Dep group, n = 42); 3) isolated anxiety (Anx group, n = 32), and 4) combined depression and anxiety (Dep&Anx group, n = 34)...
November 1, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29098712/flap-coverage-for-the-treatment-of-exposed-left-ventricular-assist-device-lvad-hardware-and-intractable-lvad-infections
#15
Adam Jacoby, John T Stranix, Oriana Cohen, Eddie Louie, Leora B Balsam, Jamie P Levine
BACKGROUND: Left ventricular assist devices (LVADs) have become useful adjuncts in the treatment of patients with end-stage heart failure. LVAD implantation is associated with a unique set of problems; one such problem is device infection. We report our experience with flap salvage of infected and/or exposed LVAD hardware. METHODS: Between 2011 and 2016, 49 patients underwent LVAD implantation at our institution. Patients were then categorized by infectious status: systemic infection not directly involving the LVAD device, hardware infection responsive to antibiotics, and exposure of LVAD hardware or device infection refractory to antibiotics requiring debridement and flap coverage...
November 3, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29098548/influence-of-lvad-function-on-mechanical-unloading-and-electromechanical-delay-a-simulation-study
#16
Aulia Khamas Heikhmakhtiar, Ah Jin Ryu, Eun Bo Shim, Kwang-Soup Song, Natalia A Trayanova, Ki Moo Lim
This study hypothesized that a left ventricular assist device (LVAD) shortens the electromechanical delay (EMD) by mechanical unloading. The goal of this study is to examine, by computational modeling, the influence of LVAD on EMD for four heart failure (HF) cases ranging from mild HF to severe HF. We constructed an integrated model of an LVAD-implanted cardiovascular system, then we altered the Ca(2+) transient magnitude, with scaling factors 1, 0.9, 0.8, and 0.7 representing HF1, HF2, HF3, and HF4, respectively, in order of increasing HF severity...
November 3, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29095736/outcomes-with-the-tandem-protek-duo-dual-lumen-percutaneous-right-ventricular-assist-device
#17
Ashwin K Ravichandran, David A Baran, Kelly Stelling, Jennifer A Cowger, Christopher T Salerno
Recently, a percutaneous right ventricular assist device (RVAD) called the TandemLife Protek Duo (TPD; TandemLife, Pittsburgh, PA) has been introduced. The Protek Duo (TPD) is a temporary RVAD placed via the right internal jugular vein, capable of providing up to 4.5 L of flow. We report a two-center experience using the TPD in 17 patients with right ventricular (RV) failure, 12 of whom were post-left ventricular assist device (LVAD) implantation.
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29095735/single-versus-multidrug-regimen-for-surgical-infection-prophylaxis-in-left-ventricular-assist-device-implantation
#18
Nana Aburjania, Brennan M Ertmer, Saira Farid, Melody Berg, Juhsien J C Nienaber, Vakhtang Tchantchaleishvili, John M Stulak, Muhammad R Sohail
Infection is a serious complication of left ventricular assist device (LVAD) therapy. However, an optimal antimicrobial surgical infection prophylaxis (SIP) regimen for LVAD implantation is not well established. We retrospectively reviewed all adults who underwent continuous-flow LVAD implantation from February 2007 to March 2015 at Mayo Clinic Rochester. Left ventricular assist device infection (LVADI) was defined using criteria published by the International Society for Heart and Lung Transplant. Patients excluded from the analysis included those who did not have HeartMate II or HeartWare device, patients with incomplete documentation of SIP, and those with an actively treated infection at the time of LVAD implantation...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29095733/left-lateral-thoracotomy-for-centrifugal-continuous-flow-left-ventricular-assist-device-placement-an-analysis-from-the-mechanical-circulatory-support-research-network
#19
Simon Maltais, Lucman A Anwer, Vakhtang Tchantchaleishvili, Nicholas A Haglund, Shannon M Dunlay, Keith D Aaronson, Francis D Pagani, Jennifer Cowger, Christopher T Salerno, Palak Shah, Zain Khalpey, Jan Schmitto, John M Stulak
Continuous-flow left ventricular assist devices (CF-LVADs) have revolutionized the management of patients with advanced heart failure. Alternative implant strategies are increasingly used for device placement. We reviewed our experience from the Mechanical Circulatory Support Research Network registry with the HeartWare centrifugal CF-LVAD (HVAD). From May 2004 to August 2015, 1,150 patients underwent primary CF-LVAD implantation at our institutions. Within this group, a total of 283 patients (25%) were implanted with the HVAD...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29095732/left-ventricular-assist-device-infections-a-systematic-review
#20
John C O'Horo, Omar M Abu Saleh, John M Stulak, Mark P Wilhelm, Larry M Baddour, M Rizwan Sohail
Left ventricular assist devices (LVADs) are becoming a more frequent life-support intervention. Gaining an understanding of risk factors for infection and management strategies is important for treating these patients. We conducted a systematic review and meta-analysis of studies describing infections in continuous-flow LVADs. We evaluated incidence, risk factors, associated microorganisms, and outcomes by type of device and patient characteristics. Our search identified 90 distinct studies that reported LVAD infections and outcomes...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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