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https://www.readbyqxmd.com/read/29332919/high-intensity-interval-training-for-severe-left-ventricular-dysfunction-treated-with-left-ventricular-assist-device
#1
Yusuke Ugata, Hiroshi Wada, Kenichi Sakakura, Tatsuro Ibe, Miyuki Ito, Nahoko Ikeda, Hideo Fujita, Shin-Ichi Momomura
Aerobic training based on anaerobic threshold (AT) is well-known to improve cardiac function, exercise capacity, and long-term outcomes of patients with heart failure. Recent reports suggested that high-intensity interval training (HIIT) for patients with cardiovascular disease may improve cardiopulmonary exercise capacity. We present a 61-year-old male patient of severe left ventricular dysfunction with left ventricular assisted device (LVAD). Following HIIT for 8 weeks, exercise capacity and muscle strength have improved without worsening left ventricular function...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29330824/colonic-fistula-caused-by-remaining-inflow-cannula-14%C3%A2-years-after-left-ventricular-assist-device-explantation
#2
Shunsuke Saito, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Keitaro Domae, Ryohei Matsuura, Yoshiki Sawa
Intestinal complication associated with left ventricular assist device (LVAD) implantation is not rare, and sometimes results in serious condition of patients, if occurred. We report a rare case in which remaining foreign body after LVAD explantation resulted in colonic fistula 14 years after LVAD explantation.
January 12, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29325978/management-of-cardiac-implantable-electronic-devices-in-the-presence-of-left-ventricular-assist-devices
#3
Valay Parikh, Andrew Sauer, Paul Friedman, Seth H Sheldon
Left ventricular assist devices (LVAD) are increasingly utilized in the management of patients with advanced heart failure. Many of these patients have or will be considered for cardiac implantable electronic devices (CIEDs) such as an implantable cardioverter-defibrillator or cardiac resynchronization therapy device. Frequent interplay is often encountered due to complexity of these devices and the underlying disease states. Proactive management strategies and an awareness of interactions may help reduce adverse events...
January 8, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29325227/soluble-st2-in-end-stage-heart-failure-before-and-after-support-with-a-left-ventricular-assist-device
#4
C C S Tseng, M M H Huibers, L H Gaykema, E Siera-de Koning, F Z Ramjankhan, A S Maisel, N de Jonge
BACKGROUND: The interleukin-33 (IL-33)/supressor of tumorigenicity 2 (ST2) pathway is suggested to play an important role in fibrosis, remodeling and the progression of heart failure (HF). Increased soluble (sST2) levels are associated with adverse outcome in the average HF population. Less is known about sST2 levels in end-stage HF. Therefore, we studied sST2 levels in end-stage HF and the effect of unloading by left ventricular assist device (LVAD) support on sST2 levels. METHOD AND RESULTS: Serial plasma measurements of sST2 were performed pre-implantation and 1, 3 and 6 months after (LVAD) implantation in 38 patients...
January 11, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29321132/intersection-of-pulmonary-hypertension-and-right-ventricular-dysfunction-in-patients-on-left-ventricular-assist-device-support-is-there-a-role-for-pulmonary-vasodilators
#5
Christopher T Sparrow, Shane J LaRue, Joel D Schilling
Left ventricular assist devices (LVADs) improve survival and quality of life in patients with advanced heart failure. Despite these benefits, combined post- and precapillary pulmonary hypertension can be particularly problematic in patients on LVAD support, often exacerbating right ventricular (RV) dysfunction. Both persistently elevated pulmonary vascular resistance and RV dysfunction are associated with adverse outcomes, including death after LVAD. These observations have led to significant interest in the use of pulmonary vasodilators to treat pulmonary hypertension and preserve RV function among LVAD-supported patients...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29319565/left-ventricular-assist-device-as-destination-therapy-for-end-stage-heart-failure-the-right-time-for-the-right-patients
#6
Naoto Fukunaga, Vivek Rao
PURPOSE OF REVIEW: Cardiac transplantation is the gold standard treatment for patients with end-stage heart failure. Unfortunately, the demand for donor organs far outstrips the number of available hearts. Therefore, not all patients who can benefit from this therapy are even listed for transplant. Once destination therapy was approved for the long-term support of nontransplant eligible patients, it was felt that the number of durable ventricular assist device (VAD) implants would increase...
January 9, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29315424/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#7
Ammar M Killu, Jae-Yoon Park, Jaskanwal D Sara, David O Hodge, Bernard J Gersh, Rick A Nishimura, Samuel J Asirvatham, Christopher J McLeod
Aims: A dilated/end-stage phase of hypertrophic cardiomyopathy (HCM) is rare but well-recognized. The role for cardiac resynchronization therapy (CRT) in this subset of patients remains unexplored. We aimed to clarify the impact of bi-ventricular pacing CRT in dilated/end-stage HCM. Methods and results: The Mayo Clinic HCM database was interrogated to identify patients with ejection fraction (EF) <50% and CRT. Control subjects were identified in 1:1 manner...
January 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29307849/implementing-routine-palliative-care-consultation-prior-to-lvad-implantation-a-single-center-experience
#8
Say Salomon, Hilary Frankel, Elizabeth Chuang, Serife Eti, Peter Selwyn
CONTEXT: Left-ventricular assist devices (LVADs) are increasingly used to improve quality of life for end-stage heart failure patients. The Joint Commission now requires pre-implantation palliative care assessment, however many palliative care teams have little experience providing this service. OBJECTIVE: To describe the integration of palliative services at one Center of Excellence for Heart and Vascular Care. METHODS: This is a retrospective chart review of all patients receiving LVADs at a single urban academic medical center from 1/2015 to 9/2016...
January 4, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29301460/inert-gas-rebreathing-helpful-tool-in-the-management-of-left-ventricular-assist-device-patients
#9
Nils Reiss, Thomas Schmidt, Stephanie Mommertz, Christina Feldmann, Jan Dieter Schmitto
In patients with left ventricular assist devices (LVAD), exercise capacity is a decisive factor regarding the quality of life. When evaluating exercise capacity, precise information about the total cardiac output generated is crucial. To date, complex measurements using a right-heart catheter were necessary in order to determine total cardiac output. The inert gas rebreathing method facilitates non-invasive, direct and valid measurement of total cardiac output as well as associated parameters, like the difference in arteriovenous oxygen saturation, both at rest and during exercise...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29300199/recent-advances-in-heart-failure
#10
Mahwash Kassi, Bashar Hannawi, Barry Trachtenberg
PURPOSE OF REVIEW: Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)...
January 2, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29290308/continuous-flow-left-ventricular-assist-device-implantation-in-patients-with-a-small-left-ventricle
#11
Masashi Kawabori, Chitaru Kurihara, Tadahisa Sugiura, William E Cohn, Andrew B Civitello, O Howard Frazier, Jeffrey A Morgan
BACKGROUND: Having a preoperative small left ventricle (LV) has been associated with higher complication and mortality rates after left ventricular assist device (LVAD) implantation; however, the outcomes after continuous-flow LVAD implantation have not been well studied. This is the first large-scale analysis of long-term survival after continuous-flow LVAD implantation in patients with a preoperative small LV. METHODS: Our cohort comprised 511 patients who underwent primary implantation of a HeartMate II (n = 393 [Thoratec, Pleasanton, CA]) or HeartWare HVAD (n = 118 [HeartWare International, Framingham, MA]) at our institution between November 2003 and March 2016...
December 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29287808/clinical-implications-of-hemodynamic-assessment-during-left-ventricular-assist-device-therapy
#12
REVIEW
Teruhiko Imamura, Ben Chung, Ann Nguyen, Gabriel Sayer, Nir Uriel
Left ventricular assist devices (LVADs) significantly improve outcomes of advanced heart failure patients. However, patients continue to have high readmission rates due to complications ranging from bleeding, thrombosis, heart failure, and infection. Considering that the hallmark benefit of LVAD therapy is improvement in hemodynamics (cardiac unloading and increased cardiac output), hemodynamic assessment on LVAD support is key to better understand these difficult complications and may serve as a tool to resolving them...
December 26, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29282819/platelet-activation-is-a-preoperative-risk-factor-for-the-development-of-thromboembolic-complications-in-patients-with-continuous-flow-left-ventricular-assist-device
#13
Filippo Consolo, Giulia Sferrazza, Giulia Motolone, Rachele Contri, Lorenzo Valerio, Rosalba Lembo, Loris Pozzi, Patrizia Della Valle, Michele De Bonis, Alberto Zangrillo, Gianfranco B Fiore, Alberto Redaelli, Marvin J Slepian, Federico Pappalardo
AIMS: To correlate the dynamics of platelet activation with the development of thromboembolic events in patients with continuous-flow left ventricular assist device (cf-LVAD). METHODS AND RESULTS: The platelet activity state (PAS) assay was utilized to evaluate platelet activation in 68 cf-LVAD patients implanted with the HeartMate II (n = 15, 22%), HeartMate 3 (n = 15, 22%), or HeartWare HVAD (n = 38, 56%). PAS was measured preoperatively, early post-implant, and at long-term follow-up (1, 3, 6, 12, 18, and 24 months post-implant)...
December 28, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29279816/when-ablation-is-not-the-answer-acute-left-main-thrombosis-causing-incessant-ventricular-tachycardia-following-left-ventricular-assist-device-implant
#14
Mohammad K Mojadidi, Ahmed N Mahmoud, Akram Y Elgendy, R David Anderson
Ventricular arrhythmia from aortic cusp thrombosis and coronary embolization is a rare complication of left ventricular assist device (LVAD) implantation. In this report, we present a case of acute left main and left anterior descending artery occlusion from embolic aortic cusp thrombi after LVAD implant. The patient presented with chest pain and incessant ventricular tachycardia post-LVAD implant. This was successfully treated by intracoronary thrombolysis, aspiration thrombectomy, and rheolytic thrombectomy...
October 21, 2017: Curēus
https://www.readbyqxmd.com/read/29279533/the-incidence-risk-factors-and-outcomes-of-hyperlactatemia-after-heart-transplantation
#15
Yasuhiro Hoshino, Osamu Kinoshita, Minoru Ono
Hyperlactatemia (HL) is associated with tissue hypoperfusion during cardiac surgery, which results in postoperative morbidity and mortality among patients undergoing cardiopulmonary bypass surgery. The aim of this study was to determine the incidence, risk factors, and outcome of HL after heart transplantation (HTx) in one of the largest Japanese single-center cohorts. We retrospectively studied the lactate levels in 49 patients who underwent HTx at the University of Tokyo Hospital from August 1, 2010 to November 30, 2015...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29277303/modified-tricuspid-annular-plane-systolic-excursion-using-transesophageal-echocardiography-and-its-utility-to-predict-postoperative-course-in-heart-transplantation-and-left-ventricular-assist-device-implantation
#16
Yoshihisa Morita, Tura Lencho, Sharadhadevi Gunasekaran, Raj Modak
OBJECTIVES: Perioperative right ventricular (RV) function is important for determining the postoperative course in heart transplantation (HT) and left ventricular assist device (LVAD) implantation. The authors describe a modified tricuspid annular plane systolic excursion (m-TAPSE) using transesophageal echocardiography and assessed its clinical utility in HT and LVAD. DESIGN: Retrospective medical record review. SETTING: A single tertiary-care medical center...
November 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29275844/left-ventricular-assist-devices-versus-medical-management-in-ambulatory-heart-failure-patients-an-analysis-of-intermacs-profiles-4-and-5-to-7-from-the-roadmap-study
#17
Keyur B Shah, Randall C Starling, Joseph G Rogers, Douglas A Horstmanshof, James W Long, Vigneshwar Kasirajan, Josef Stehlik, Joyce Chuang, David J Farrar, Jerry D Estep
BACKGROUND: The ROADMAP study showed survival with improved functional status was better with left ventricular assist device (LVAD) therapy compared with optimal medical management (OMM) in ambulatory, non-inotrope-dependent (INTERMACS [IM] Profile 4 to 7) patients. To study more balanced cohorts and better define which patients may benefit from implantation of an LVAD, we re-evaluated the patients enrolled in ROADMAP when stratified by INTERMACS profile (Profile 4 and Profiles 5 to 7)...
December 7, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29274911/selective-implantation-of-durable-left-ventricular-assist-devices-as-primary-therapy-for-refractory-cardiogenic-shock
#18
Amit Pawale, Yosef Schwartz, Shinobu Itagaki, Sean Pinney, David H Adams, Anelechi C Anyanwu
OBJECTIVE: Surgical therapy for refractory primary cardiogenic shock is largely based on emergent placement of extracorporeal membrane oxygenation or short-term ventricular assist devices. We have adopted a strategy of routine implantation of durable left ventricular assist devices (LVAD) as initial therapy for refractory cardiogenic shock, in patients who are potential candidates for heart transplantation, and report our experience. METHODS: Retrospective review of 43 consecutive patients with refractory shock caused by acute myocardial infarction (n = 21) or acute decompensated heart failure (n = 22) who were treated with primary implantation of a durable LVAD in a single institution...
November 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29274191/acquired-coagulopathy-in-patients-with-left-ventricular-assist-devices
#19
REVIEW
R Muslem, K Caliskan, F W G Leebeek
Chronic heart failure (HF) is a major emerging health care problem, associated with a high morbidity and mortality. Left ventricular assist devices (LVADs) have emerged as a successful treatment option for patients with end-stage HF. Despite its great benefit, the use of LVAD is associated with a high risk for complications. Bleeding, pump thrombosis, and thrombo-embolic events are frequently observed complications, with bleeding complications occurring in over a third of the patients. Although the design of the third generation LVAD has improved greatly, these hemostatic complications still occur...
December 23, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29273909/emergency-department-visits-among-patients-with-left-ventricular-assist-devices
#20
Christopher R Tainter, Oscar Ö Braun, Felipe Teran, Albert P Nguyen, Kimberly Robbins, Edward O O'Brien, Zeb M McMillan, Ulrich Schmidt, Angela Meier, Mat Goebel, Victor Pretorius, Michela Brambatti, Eric D Adler, Raghu Seethala
Continuous-flow left ventricular assist devices (LVADs) are increasingly implanted to support patients with end-stage heart failure. These patients are at high risk for complications, many of which necessitate emergency care. While rehospitalization rates have been described, there is little data regarding emergency department (ED) visits. We hypothesize that ED visits are frequent and often require admission after LVAD implantation. We performed a retrospective review of patients in our health-care system followed by the advanced heart failure service for LVAD management after implantation between January 2011 and July 2015...
December 22, 2017: Internal and Emergency Medicine
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