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https://www.readbyqxmd.com/read/28441157/new-role-of-mechanical-assist-device-as-bridge-to-transplant-usa-perspective
#1
Ambreen Mohamed, Natasha Mehta, Howard J Eisen
PURPOSE OF REVIEW: Cardiac transplant remains the gold standard of care for patients with end-stage heart failure. Unfortunately, due to the limited availability of donor hearts in the United States, not all eligible candidates are able to be transplanted. Since the introduction of mechanical assist devices for the treatment of advanced heart failure, patients gain a significant survival benefit while awaiting transplant. With rapidly evolving technology, it is important to appreciate the advances in the current use of mechanical assist devices...
April 24, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28435003/the-hemodynamic-effects-of-aortic-insufficiency-in-patients-supported-with-continuous-flow-left-ventricular-assist-devices
#2
Gabriel Sayer, Nitasha Sarswat, Gene H Kim, Sirtaz Adatya, Diego Medvedofsky, Daniel Rodgers, Eric Kruse, Takeyoshi Ota, Valluvan Jeevanandam, Roberto Lang, Nir Uriel
BACKGROUND: The impact of aortic insufficiency (AI) on the morbidity and mortality of left ventricular assist device (LVAD) patients remains controversial. This study's aim is to assess the hemodynamics of LVAD patients with at least mild AI, at baseline and in response to device speed changes. METHODS: Asymptomatic LVAD patients were prospectively enrolled and underwent a hemodynamic and echocardiographic ramp study. Hemodynamics at rest and in response to device speed changes were compared between patients with at least mild AI at their baseline speed and patients without AI...
April 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#3
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28431980/shear-stress-alterations-in-the-celiac-trunk-of-patients-with-a-continuous-flow-left-ventricular-assist-device-as-shown-by-in-silico-and-in-vitro-flow-analyses
#4
Francesco Scardulla, Salvatore Pasta, Leonardo D'Acquisto, Sergio Sciacca, Valentina Agnese, Christian Vergara, Alfio Quarteroni, Francesco Clemenza, Diego Bellavia, Michele Pilato
BACKGROUND: The use of left ventricular assist devices (LVADs) to treat advanced cardiac heart failure is constantly increasing, although this device leads to high risk for gastrointestinal bleeding. METHODS: Using in-silico flow analysis, we quantified hemodynamic alterations due to continuous-flow LVAD (HeartWare, Inc., Framingham, MA) in the celiac trunk and major branches of the abdominal aorta, and then explored the relationship between wall shear stress (WSS) and celiac trunk orientation...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28430303/echocardiographic-outflow-pump-ramp-test-in-centrifugal-flow-left-ventricular-assist-device
#5
Attilio Iacovoni, Claudia Vittori, Alessandra Fontana, Alessandra Carobbio, Carlo Fino, Emilia D'Elia, Amedeo Terzi, Michele Senni
This study sought to develop a novel echocardiogram outflow ramp test to detect device malfunctions in centrifugal-flow left ventricular assist devices (LVADs). This new ramp pump test is based on the direct analyses of systolic and diastolic ratio (S/D) Doppler velocity in the outflow cannula in the HeartWare LVAD during progressive increases in speed. The results showed that in patients with normal pump function, the Doppler velocity S/D ratio gradually decreased during LVAD speed increases. This test is easily performed and seems promising to detect normal pump function in patients assisted by a centrifugal flow LVAD...
April 18, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28430300/left-ventricular-assist-pump-pocket-infection-conservative-treatment-strategy-for-destination-therapy-candidates
#6
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
#7
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/28429120/the-influence-of-pump-rotation-speed-on-hemodynamics-and-myocardial-oxygen-metabolism-in-left-ventricular-assist-device-support-with-aortic-valve-regurgitation
#8
Kei Iizuka, Tomohiro Nishinaka, Yoshiaki Takewa, Kenji Yamazaki, Eisuke Tatsumi
Aortic valve regurgitation (AR) is a serious complication under left ventricular assist device (LVAD) support. AR causes LVAD-left ventricular (LV) recirculation, which makes it difficult to continue LVAD support. However, the hemodynamics and myocardial oxygen metabolism of LVAD support with AR have not been clarified, especially, how pump rotation speed influences them. An animal model of LVAD with AR was newly developed, and how pump rotation speed influences hemodynamics and myocardial oxygen metabolism was examined in acute animal experiments...
April 20, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28420862/clinical-characteristics-treatment-and-prognosis-of-patients-with-acute-severe-heart-failure-of-ischemic-and-non-ischemic-etiology-analysis-from-the-commit-ahf-registry
#9
Mateusz Ostręga, Marek J Gierlotka, Grzegorz Słonka, Paweł Nadziakiewicz, Mariusz Gąsior
INTRODUCTION    There are limited data on the impact of ischemic etiology on clinical status and long-term prognosis among patients with acute severe heart failure (ASHF) not associated with acute coronary syndrome (ACS).  OBJECTIVES    To assess clinical characteristics, treatment and the 12-month mortality of patients with no-ACS ASHF according to etiology.  PATIENTS AND METHODS    The data from 112 patients with ASHF that was not associated with ACS were analyzed: 61 with ischemic (IASHF) and 51 with non-ischemic (NIASHF) etiology...
April 18, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28412437/3d-echocardiography-and-ventricular-unloading-with-continuous-flow-lvad-potential-advantages-to-optimize-patient-outcome
#10
EDITORIAL
Jerry D Estep
No abstract text is available yet for this article.
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412431/3d-morphological-changes-in-lv-and-rv-during-lvad-ramp-studies
#11
Karima Addetia, Nir Uriel, Francesco Maffessanti, Gabriel Sayer, Sirtaz Adatya, Gene H Kim, Nitasha Sarswat, Savitri Fedson, Diego Medvedofsky, Eric Kruse, Keith Collins, Daniel Rodgers, Takayoshi Ota, Valluvan Jeevanandam, Victor Mor-Avi, Daniel Burkhoff, Roberto M Lang
OBJECTIVES: The purpose of this study was to investigate the differential impact of the 2 most commonly available left ventricular assist device (LVAD) types on the right (RV) and left (LV) ventricles using 3-dimensional (3D) echocardiography-based analysis of ventricular morphology. BACKGROUND: LVADs have emerged as common therapy for advanced heart failure. Recent data suggest that the heart responds differently to speed settings in the 2 main devices available (HeartMate II [HMII], St Jude Medical, Pleasanton, California, and HVAD, HeartWare International, Framingham, Massachusetts)...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28408037/reduced-anxiety-and-depression-in-patients-with-advanced-heart-failure-after-left-ventricular-assist-device-implantation
#12
Gardner Yost, Geetha Bhat, Edward Mahoney, Antone Tatooles
BACKGROUND: Despite the high prevalence of depression and anxiety in patients with advanced heart failure, the effects of left ventricular assist device (LVAD) implantation on these critically important aspects of mental health are not well understood. OBJECTIVE: We sought to assess changes in depression and anxiety following LVAD implantation. METHODS: The Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) were administered to 54 patients by a clinical psychologist at a mean of 12 days before LVAD implantation and 251 days after implantation...
February 12, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28408022/left-ventricular-assist-device-as-a-bridge%C3%A2-to-recovery-for-patients-with-advanced-heart-failure
#13
Djordje G Jakovljevic, Magdi H Yacoub, Stephan Schueler, Guy A MacGowan, Lazar Velicki, Petar M Seferovic, Sandeep Hothi, Bing-Hsiean Tzeng, David A Brodie, Emma Birks, Lip-Bun Tan
BACKGROUND: Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, as destination therapy, or in some patients, as a bridge to recovery. OBJECTIVES: This study evaluated whether patients undergoing an LVAD bridge-to-recovery protocol can achieve cardiac and physical functional capacities equivalent to those of healthy controls. METHODS: Fifty-eight male patients-18 implanted with a continuous-flow LVAD, 16 patients with LVAD explanted (recovered patients), and 24 heart transplant candidates (HTx)-and 97 healthy controls performed a maximal graded cardiopulmonary exercise test with continuous measurements of respiratory gas exchange and noninvasive (rebreathing) hemodynamic data...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28396088/erythrocyte-aging-as-a-mechanism-of-anemia-and-a-biomarker-of-device-thrombosis-in-continuous-flow-left-ventricular-assist-devices
#14
Ziad Taimeh, Ryan J Koene, Julie Furne, Ashish Singal, Peter M Eckman, Michael D Levitt, Marc R Pritzker
BACKGROUND: Blood trauma caused by continuous-flow left ventricular assist devices (CF-LVADs) has been associated with device thrombosis and anemia. Accurate in vivo quantification of erythrocyte turnover and its contribution to CF-LVAD complications have yet to be elucidated. METHODS: We investigated the age (lifespan) of circulating erythrocytes in subjects with CF-LVAD. Erythrocyte lifespan is a quantitative indicator of in vivo erythrocyte turnover that can be accurately derived from measurement of the exhaled carbon monoxide (CO) level...
February 9, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28396040/risk-assessment-and-comparative-effectiveness-of-left-ventricular-assist-device-and-medical-management-in-ambulatory-heart-failure-patients-the-roadmap-study-2-year-results
#15
Randall C Starling, Jerry D Estep, Douglas A Horstmanshof, Carmelo A Milano, Josef Stehlik, Keyur B Shah, Brian A Bruckner, Sangjin Lee, James W Long, Craig H Selzman, Vigneshwar Kasirajan, Donald C Haas, Andrew J Boyle, Joyce Chuang, David J Farrar, Joseph G Rogers
OBJECTIVES: The authors sought to provide the pre-specified primary endpoint of the ROADMAP (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients) trial at 2 years. BACKGROUND: The ROADMAP trial was a prospective nonrandomized observational study of 200 patients (97 with a left ventricular assist device [LVAD], 103 on optimal medical management [OMM]) that showed that survival with improved functional status at 1 year was better with LVADs compared with OMM in a patient population of ambulatory New York Heart Association functional class IIIb/IV patients...
March 30, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28386491/multidrug-resistant-pseudomonas-mycotic-pseudoaneurysm-following-cardiac-transplant-bridged-by-ventricular-assistant-device
#16
C Aye, M Williams, R Horvath
Mycotic pseudoaneurysm of aorta following cardiac surgery is rare but is highly fatal if it is unrecognized and untreated. Here, we report a case of a 45-year-old male patient who presented with rapidly progressive multiple pseudoaneurysms of the ascending aorta infected with multidrug resistant (MDR) Pseudomonas aeruginosa at 5 weeks after cardiac transplantation, on a background of prior bridging therapy with left ventricular assistant device (LVAD). The patient was successfully treated with the newer cephalosporin, Ceftolozane/Tazobactam, in combination with surgery...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28380632/evaluation-of-right-ventricular-function-using-liver-stiffness-in-patients-with-left-ventricular-assist-device%C3%A2
#17
Noriyuki Kashiyama, Koichi Toda, Teruya Nakamura, Shigeru Miyagawa, Hiroyuki Nishi, Yasushi Yoshikawa, Satsuki Fukushima, Shunsuke Saito, Daisuke Yoshioka, Yoshiki Sawa
OBJECTIVES: Although right ventricular failure (RVF) is a major concern after left ventricular assist device (LVAD) implantation, methodologies to evaluate RV function remain limited. Liver stiffness (LS), which is closely related to right-sided filling pressure and may indicate RVF severity, could be non-invasively and repeatedly assessed using transient elastography. Here we investigated the suitability of LS as a parameter of RV function in pre- and post-LVAD periods. METHODS: The study included 55 patients with LVAD implantation as a bridge to transplantation between 2011 and 2015 whose LS was assessed using transient elastography...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28371221/prediction-of-right-ventricular-failure-after-ventricular-assist-device-implant-systematic-review-and-meta-analysis-of-observational-studies
#18
REVIEW
Diego Bellavia, Attilio Iacovoni, Cesare Scardulla, Lorenzo Moja, Michele Pilato, Sudhir S Kushwaha, Michele Senni, Francesco Clemenza, Valentina Agnese, Calogero Falletta, Giuseppe Romano, Joseph Maalouf, Michael Dandel
Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is associated with increased morbidity and mortality, but the identification of LVAD candidates at risk for RVF remains challenging. We undertook a systematic review and meta-analysis of observational studies of risk factors associated with RVF after LVAD implant. Thirty-six studies published between 1 January 1995 and 30 April 2015, comprising 995 RVF patients out of a pooled final population of 4428 patients, were identified...
March 31, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28365215/mean-arterial-pressure-to-central-venous-pressure-ratio-a-novel-marker-for-right-ventricular-failure-after-left-ventricular-assist-device-placement
#19
Burhan Mohamedali, Rami Doukky, Kelly Karavalos, Elizabeth Avery, Geetha Bhat
BACKGROUND: Early right ventricular failure (RVF) is common after left ventricular assist device (LVAD) implantation and often leads to increased morbidity and mortality. It is difficult to predict early RVF on the basis of clinical and hemodynamic parameters. We investigated the utility of mean arterial pressure (MAP) to central venous pressure (CVP) ratio in predicting early RVF. METHOD: We analyzed a retrospective cohort of 212 consecutive patients who underwent hemodynamic assessment prior to destination therapy LVAD implantation...
March 29, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28365175/outcomes-following-implantation-of-mechanical-circulatory-support-in-adults-with-congenital-heart-disease-an-analysis-of-the-interagency-registry-for-mechanically-assisted-circulatory-support-intermacs
#20
Christina J VanderPluym, Ari Cedars, Pirooz Eghtesady, Bryan G Maxwell, Jill M Gelow, Luke J Burchill, Simon Maltais, Devin A Koehl, Ryan S Cantor, Elizabeth D Blume
BACKGROUND: Adults with congenital heart disease represent an expanding and unique population of patients with heart failure (HF) in whom the use of mechanical circulatory support (MCS) has not been characterized. We sought to describe overall use, patient characteristics, and outcomes of MCS in adult congenital heart disease (ACHD). METHODS: All patients entered into the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) between June 23, 2006, and December 31, 2015, were included...
March 7, 2017: Journal of Heart and Lung Transplantation
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