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https://www.readbyqxmd.com/read/28645834/left-ventricular-assist-device-therapy-for-destination-therapy-is-less-invasive-surgery-a-safe-alternative
#1
Sebastian V Rojas, Jasmin S Hanke, Murat Avsar, Philipp R Ahrens, Ove Deutschmann, Kirstin A Tümler, Aitor Uribarri, Sara Rojas-Hernández, Pedro L Sánchez, José M González-Santos, Axel Haverich, Jan D Schmitto
INTRODUCTION AND OBJECTIVES: The number of older patients with congestive heart failure has dramatically increased. Because of stagnating cardiac transplantation, there is a need for an alternative therapy, which would solve the problem of insufficient donor organ supply. Left ventricular assist devices (LVADs) have recently become more commonly used as destination therapy (DT). Assuming that older patients show a higher risk-profile for LVAD surgery, it is expected that the increasing use of less invasive surgery (LIS) LVAD implantation will improve postoperative outcomes...
June 20, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28634001/the-effect-of-preoperative-cognitive-behavior-and-exercise-therapy-for-patient-with-implanted-lvad-in-korea-case-presentation
#2
Yong Gon Seo, Won Hah Park, Eun Seok Jeon, Ji Dong Sung, Mi Ja Jang
Left ventricular assist devices (LVADs) are used in patients with progressive heart failure symptoms to provide circulatory support. Patients with LVADs are referred to inpatient cardiac rehabilitation to prevent postoperative complications and improve aerobic capacity and quality of life (QOL). Preoperative exercise therapy for cardiac patients is an emerging treatment modality, and several studies have reported that it improves postoperative outcomes such as length of hospital stay and postoperative complications...
June 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28633256/successful-delivery-in-a-patient%C3%A2-with-left-ventricular-assist-device-and-unplanned-pregnancy
#3
George Makdisi, M Y Jan, Lauren Dungy-Poythress, I-Wen Wang, Marco A Caccamo
We report the case of a woman supported by a left ventricular assist device (LVAD) who presented at 20 weeks of gestation and decided against recommendations to continue with her pregnancy. This was managed with well-developed plan for a multidisciplinary team approach. With close and regular follow-up and regular adjustment of the patient's medications and LVAD parameters, successful delivery and outcome for both the mother and the newborn were achieved.
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28623639/anemia-after-continuous-flow-left-ventricular-assist-device-implantation-characteristics-and-implications
#4
Javier Amione-Guerra, Ana S Cruz-Solbes, Arvind Bhimaraj, Barry H Trachtenberg, Sai R Pingali, Jerry D Estep, Myung H Park, Ashrith Guha
BACKGROUND: Anemia is common in patients with heart failure and is associated with adverse outcomes. Management of anemia in CF-LVAD patients is not well studied. Our purpose is to characterize and identify the etiology of anemia in CF-LVAD patients. Secondary objectives are to describe the effect of CF-LVAD on pre-existing anemia and assess its impact after CF-LVAD support. METHODS: Cross-sectional study from January to July 2015 of ambulatory patients supported with a CF-LVAD for at least 6-months that presented with hemoglobin <12 g/dL and no recent gastrointestinal bleeding...
June 14, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28621882/exercise-capacity-and-functional-performance-in-heart-failure-patients-supported-by-a-left-ventricular-assist-device-at-discharge-from-inpatient-rehabilitation
#5
Thomas Schmidt, Birna Bjarnason-Wehrens, Petra Bartsch, Ezin Deniz, Jan Schmitto, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Adequate physical and functional performance is an important prerequisite for renewed participation and integration in self-determined private and (where appropriate) professional lives following left ventricular assist device (LVAD) implantation. During cardiac rehabilitation (CR), individually adapted exercise programs aim to increase exercise capacity and functional performance. A retrospective analysis of cardiopulmonary exercise capacity and functional performance in LVAD patients at discharge from a cardiac rehabilitation program was conducted...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28621816/control-of-a-pediatric-pulsatile-ventricular-assist-device-a-hybrid-cardiovascular-model-study
#6
Gianfranco Ferrari, Arianna Di Molfetta, Krzysztof Zieliński, Libera Fresiello, Krystyna Górczyńska, Krzysztof Jakub Pałko, Marek Darowski, Antonio Amodeo, Maciej Kozarski
The aim of this work is to study pediatric pneumatic ventricle (PVAD) performance, versus VAD rate (VADR) and native heart rate (HR) ratio Rr (VADR/HR). The study uses a hybrid model of the cardiovascular system (HCS). HCS consists of a computational part (a lumped parameter model including left and right ventricles, systemic and pulmonary arterial and venous circulation) interfaced to a physical part. This permits the connection of a VAD (15 mL PVAD). Echocardiographic and hemodynamic data of a pediatric patient (average weight 14...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28621461/the-use-of-eptifibatide-alone-or-in-combination-with-heparin-or-argatroban-for-suspected-thrombosis-in-patients-with-left-ventricular-assist-devices
#7
Abbas Bitar, Rajakrishnan Vijayakrishnan, Andrew Lenneman, Emma Birks, Todd Massey, Mark Slaughter, Dmitry Abramov
Pump thrombosis and hemolysis in patients with left ventricular assist devices (LVADs) are associated with significant morbidity and mortality. Intensification of anticoagulation has been suggested as potential therapy, with mixed results. The aim of this study is to assess the safety and efficacy of adding eptifibatide with or without an anticoagulation agent in managing patients with LVAD presenting with hemolysis and suspected pump thrombosis. This retrospective single center study included all patients who presented with their first episode of suspected pump thrombosis and were treated with eptifibatide with or without an anticoagulant between March 1, 2011 and July 30, 2015...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28616303/stop-the-lvad-bleeding
#8
EDITORIAL
Antigone Koliopoulou, Craig H Selzman
No abstract text is available yet for this article.
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28611860/renal-function-and-outcomes-with-use-of-left-ventricular-assist-device-implantation-and-inotropes-in-end-stage-heart-failure-a-retrospective-single-center-study
#9
Sean Verma, Emmanuel Bassily, Shane Leighton, Rahul Mhaskar, Igor Sunjic, Angel Martin, Nancy Rihana, Tambi Jarmi, Claude Bassil
BACKGROUND: Left ventricular assist device (LVAD) and inotrope therapy serve as a bridge to transplant (BTT) or as destination therapy in patients who are not heart transplant candidates. End-stage heart failure patients often have impaired renal function, and renal outcomes after LVAD therapy versus inotrope therapy have not been evaluated. METHODS: In this study, 169 patients with continuous flow LVAD therapy and 20 patients with continuous intravenous inotrope therapy were analyzed...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28611126/patient-reported-health-related-quality-of-life-is-a-predictor-of-outcomes-in-ambulatory-heart-failure-patients-treated-with-left-ventricular-assist-device-compared-with-medical-management-results-from-the-roadmap-study-risk-assessment-and-comparative-effectiveness
#10
Josef Stehlik, Jerry D Estep, Craig H Selzman, Joseph G Rogers, John A Spertus, Keyur B Shah, Joyce Chuang, David J Farrar, Randall C Starling
BACKGROUND: The prospective observational ROADMAP study (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management) demonstrated that ambulatory advanced heart failure patients selected for left ventricular assist device (LVAD) were more likely to be alive at 1 year on original therapy with ≥75-m improvement in 6-minute walk distance compared with patients assigned to optimal medical management. Whether baseline health-related quality of life (hrQoL) resulted in a heterogeneity of this treatment benefit is unknown...
June 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28604571/hvad-waveform-analysis-as-a-noninvasive-marker-of-pulmonary-capillary-wedge-pressure-a-first-step-toward-the-development-of-a-smart-left-ventricular-assist-device-pump
#11
Jonathan Grinstein, Daniel Rodgers, Sara Kalantari, Gabriel Sayer, Gene H Kim, Nitasha Sarswat, Sirtaz Adatya, Takeyoshi Ota, Valluvan Jeevanandam, Daniel Burkhoff, Nir Uriel
Flow waveforms are an important feature of the HVAD left ventricular assist device (LVAD) that provides information about HVAD function and patient hemodynamics. We assessed the properties of one specific aspect of the waveform, the slope of the ventricular filling phase (VFP), and its correlation with pulmonary capillary wedge pressure (PCWP). A total of 101 screenshots from the HVAD monitor and simultaneous hemodynamic measurements were obtained simultaneously during sequential stages of invasive hemodynamic ramp studies...
June 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28602376/left-ventricular-assist-device-in-older-adults
#12
REVIEW
Chris Caraang, Gregg M Lanier, Alan Gass, Wilbert S Aronow, Chhaya Aggarwal Gupta
Left ventricular assist devices (LVADs) are an effective therapy for a growing and aging population in the background of limited donor supply. Selecting the proper patient involves assessment of indications, risk factors, scores for overall outcomes, assessment for right ventricular failure, and optimal timing of implantation. LVAD complications have a 5% to 10% perioperative mortality and complications of bleeding, thrombosis, stroke, infection, right ventricular failure, and device failure. As LVAD engineering technology evolves, so will the risk-prediction scores...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28601303/device-specific-evaluation-of-intraventricular-left-ventricular-assist-device-position-by-quantitative-coaxiality-analysis
#13
Amedeo Anselmi, Sophie Collin, Pascal Haigron, Jean-Philippe Verhoye, Erwan Flecher
BACKGROUND: Patient-specific anatomy may influence the final intraventricular positioning of inflow cannula in left ventricular assist device (LVAD) recipients. An association exists between such positioning and clinical outcomes (specifically, orientation toward the interventricular septum has negative prognostic implications). Alternative commercially available LVADs are characterized by markedly different design, with potential consequences on intrathoracic fitting among individual patients...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28595702/left-ventricular-assist-devices-for-lifelong%C3%A2-support
#14
REVIEW
Sean P Pinney, Anelechi C Anyanwu, Anuradha Lala, Jeffrey J Teuteberg, Nir Uriel, Mandeep R Mehra
Continuous-flow left ventricular assist devices (LVADs) have revolutionized advanced heart failure care. These compact, fully implantable heart pumps are capable of providing meaningful increases in survival, functional capacity, and quality of life. Implantation volumes continue to grow, but several challenges remain to be overcome before LVADs will be considered as the therapy of choice for all patients with advanced heart failure. They must be able to consistently extend survival for the long term (7 to 10 years), rather than the midterm (3 to 5 years) more typical of contemporary devices; they must incorporate design elements that reduce shear stress and avoid stasis to reduce the frequent adverse events of bleeding, stroke, and pump thrombosis; and they must become more cost-effective...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28591005/implant-strategy-specific-changes-in-symptoms-in-response-to-left-ventricular-assist-devices
#15
Christopher S Lee, Jill M Gelow, Christopher V Chien, Shirin O Hiatt, Julie T Bidwell, Quin E Denfeld, Kathleen L Grady, James O Mudd
BACKGROUND: Although we know that the quality of life generally improves after left ventricular assist device (LVAD) implantation, we know little about how symptoms change in response to LVAD. METHODS: The purpose of this study was to compare the changes in symptoms between bridge and destination therapy patients as part of a prospective cohort study. Physical (dyspnea and wake disturbances) and affective symptoms (depression and anxiety) were measured before LVAD and at 1, 3, and 6 months after LVAD...
June 7, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28586149/comparative-analysis-of-von-willebrand-factor-profiles-after-implantation-of-left-ventricular-assist-device-and-total-artificial-heart
#16
H J Reich, J Morgan, F Arabia, L Czer, J Moriguchi, D Ramzy, F Esmailian, L Lam, J Dunhill, O Volod
BACKGROUND: Bleeding remains a challenge during mechanical circulatory support and underlying mechanisms are incompletely understood. Functional von Willebrand Factor (VWF) impairment due to loss of high molecular weight multimers (MWM) produces acquired von Willebrand Disease (VWD) after left ventricular assist device (LVAD). Little is known about VWF multimers with total artificial hearts (TAHs). Here, VWF profiles with LVADs and TAHs are compared using a VWD panel. METHODS: VWD evaluations for patients with LVAD or TAH (2013-14) were retrospectively analyzed and included: VWF activity (Ristocetin Cofactor, VWF:RCo), VWF antigen (VWF:Ag), ratio of VWF:RCo to VWF:Ag, and quantitative VWF multimeric analysis...
June 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28582920/optimization-of-a-passively-suspended-injection-impeller-for-left-ventricular-assist-device
#17
Liangfan Zhu, Xi Yang, Yue Wu, Minghui Wang, Yun Luo
BACKGROUND: A rotary blood pump with a passively levitated impeller and a large bearing gap between housing and impeller in the range of 0.6 mm has been developed for Left ventricular assist device (LVAD). OBJECTIVE: The purpose of the present study is to determine the optimal injection angle of the impeller to improve its radial stability by increasing the radial suspension force. MTEHODS: Since the radial and axial suspension forces generated by an injection channel were equal, the axial suspension force obtained from numerical simulation was chosen as the evaluation parameter...
May 26, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28580527/non-occlusive-mesenteric-ischemia-in-a-patient-with-left-ventricular-assist-device-implantation
#18
Takaaki Samura, Koichi Toda, Daisuke Yoshioka, Hidekazu Takahashi, Shigeru Miyagawa, Yasushi Yoshikawa, Shunsuke Saito, Keitaro Domae, Yoshiki Sawa
Non-occlusive mesenteric ischemia (NOMI) is a devastating complication after cardiac surgery. Once patients develop NOMI, intra-mesenteric infusion of vasodilators and/or emergent laparotomy is usually required, but the mortality is extraordinarily high even with intensive treatment. We present a case of salvage of a patient with NOMI complicated with severe right ventricular dysfunction after left ventricular assist device (LVAD) implantation using maximum treatment with emergent laparotomy and temporary right ventricular assist device implantation...
June 3, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28579115/bleeding-and-thrombosis-associated-with-ventricular-assist-device-therapy
#19
Palak Shah, Udaya S Tantry, Kevin P Bliden, Paul A Gurbel
Over the past decade, continuous-flow rotary pumps have dramatically improved survival for patients with advanced systolic heart failure. Bleeding and thrombosis, however, continue to be the Achilles heel of left ventricular assist device (LVAD) therapy. There is a dynamic and complex interaction between the patient and pump. The net effect of a variety of hematologic derangements, such as hemolysis, high-molecular-weight von Willebrand degradation, platelet activation and diminished pulsatility, is poorly understood...
May 11, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28567658/left-ventricular-assist-devices-challenges-toward-sustaining-long-term-patient-care
#20
REVIEW
Marianne Schmid Daners, Friedrich Kaufmann, Raffael Amacher, Gregor Ochsner, Markus J Wilhelm, Aldo Ferrari, Edoardo Mazza, Dimos Poulikakos, Mirko Meboldt, Volkmar Falk
Over the last few decades, the left ventricular assist device (LVAD) technology has been tremendously improved transitioning from large and noisy paracorporeal volume displacement pumps to small implantable turbodynamic devices with only a single transcutaneous element, the driveline. Nevertheless, there remains a great demand for further improvements to meet the challenge of having a robust and safe device for long-term therapy. Here, we review the state of the art and highlight four key areas of needed improvement targeting long-term, sustainable LVAD function: (1) LVADs available today still have a high risk of thromboembolic and bleeding events that could be addressed by the rational fabrication of novel surface structures and endothelialization approaches aiming at improving the device hemocompatibility...
May 31, 2017: Annals of Biomedical Engineering
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