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Laura Lombardi-Karl, Jonathan Hastie
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Maziar Khorsandi, Scott Dougherty, Andrew Sinclair, Keith Buchan, Fiona MacLennan, Omar Bouamra, Philip Curry, Vipin Zamvar, Geoffrey Berg, Nawwar Al-Attar
BACKGROUND: Refractory post-cardiotomy cardiogenic shock (PCCS) is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS), namely extra-corporeal membrane oxygenation (ECMO) or ventricular assist devices (VAD). In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO) and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period...
November 8, 2016: Journal of Cardiothoracic Surgery
Dominik Wiedemann, Thomas Schlöglhofer, Julia Riebandt, Markus Neuner, Edda Tschernko, Heinrich Schima, Daniel Zimpfer
Peripartum cardiomyopathy requiring mechanical ciruculatory support is rare however it is a lifethreatening disease with recovery rates poorer than expected. Herein we describe a case of successfull recovery of a patient with peripartum cardiomyopathy. Implantation of a biventricular ventricular assist device was performed, additonally the patient's hyperprolactinemia was treated with Cabergoline resulting in a fast complete restoration of ventricular function.
September 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Allen Cheng, Jaimin R Trivedi, Victor H Van Berkel, H Todd Massey, Mark S Slaughter
BACKGROUND: The use of left ventricular assist devices (LVAD) has increased significantly in the last decade. However, right heart dysfunction remains a problem despite the improved outcomes with continuous-flow LVADs. Surgical options for bridge to transplantation (BTT) in patients with biventricular failure are total artificial heart (TAH) or biventricular support (BiVAD). This study examines the differences in pre- and post-transplantation outcomes and survival in patients with TAH or BiVAD support as BTT...
October 2016: Journal of Cardiac Surgery
Marina Pieri, Marcus Müller, Anna Mara Scandroglio, Panagiotis Pergantis, Alexandra Kretzschmar, Friedrich Kaufmann, Volkmar Falk, Thomas Krabatsch, Georg Arlt, Marian Kukucka, Evgenij Potapov
Mediastinitis is more frequent in patients with implantable ventricular assist devices (VAD) than in other cardiac surgery patients and carries significant mortality. We report our experience with a stepwise approach including aggressive debridement, jet lavage, vacuum assisted closure (VAC) dressing and finally coverage with well-vascularized and immune active omental flaps in VAD patients with infective mediastinitis.We retrospectively collected and analyzed data of patients with continuous flow VAD who underwent plasty with the omental flap due to mediastinitis at Deutsches Herzzentrum Berlin beween 1 January 2008 and 30 October 2015 ...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
J D Simmonds, M Mustafa, D P Fajardo Jaramillo, H R Bellsham-Revell, J Marek, M Burch, V T Tsang, N Muthialu
With the imbalance between donation rates and potential recipients growing, transplant programs are increasingly using non-ideal organs from so-called marginal donors. This is the first reported case of the intentional use of a donor heart with ALCAPA. The recipient was aged one yr with restrictive cardiomyopathy who had been supported with BiVAD for over six months. Function of the donor left ventricle was shown to be well preserved, with no obvious signs of ischemia, except for a fibrotic layer on the anterolateral papillary muscle of the mitral valve...
September 2016: Pediatric Transplantation
Raymond V Mirasol, Jason J Tholany, Hasini Reddy, Billie S Fyfe-Kirschner, Christina L Cheng, Issam F Moubarak, John L Nosher
The association between continuous-flow left ventricular assist devices (CF-LVADs) and gastrointestinal (GI) bleeding from angiodysplasia is well recognized. However, the association between continuous-flow biventricular assist devices (CF-BIVADs) and bleeding angiodysplasia is less understood. We report a case of GI bleeding from a patient with a CF-BIVAD. The location of GI bleeding was identified by nuclear red blood cell bleeding scan. The vascular malformation leading to the bleed was identified and localized on angiography and then by pathology...
April 28, 2016: World Journal of Radiology
Ed Peng, Richard Kirk, Neil Wrightson, Phuoc Duong, Lee Ferguson, Massimo Griselli, Tanveer Butt, John J O'Sullivan, Guy A MacGowan, David Crossland, Stephan Schueler, Asif Hasan
BACKGROUND: Mechanical circulatory support in the pediatric population is currently limited to pulsatile ventricular assist devices (VAD). In recent years, the use of durable, newer generation, continuous flow devices have increased substantially among adults with end-stage heart failure. We examined the extended role of this device in the pediatric population (aged less than 18 years). METHODS: Between 2010 and 2015, 12 patients (median age 7.1 years; range, 3...
August 2016: Annals of Thoracic Surgery
Joshua C Grimm, Christopher M Sciortino, J Trent Magruder, Samuel P Dungan, Vicente Valero, Kavita Sharma, Ryan J Tedford, Stuart D Russell, Glenn J R Whitman, Scott C Silvestry, Ashish S Shah
BACKGROUND: Biventricular support before orthotopic heart transplantation (OHT) has been shown to adversely affect short- and long-term outcomes, but the comparative effect of support type is largely unknown. This study determined the comparative effect of univentricular and biventricular support on survival in bridged patients after OHT. METHODS: The United Network of Organ Sharing database was queried for adult patients bridged to OHT with a univentricular (left ventricular assist device [LVAD]), biventricular (biventricular assist device [BiVAD]), or total artificial heart ([TAH]) device between 2004 and 2012...
July 2016: Annals of Thoracic Surgery
Mary Lyn Stein, Justin Yeh, Olaf Reinhartz, David N Rosenthal, Beth D Kaufman, Chris S Almond, Seth A Hollander, Katsuhide Maeda
Despite increasing use of mechanical circulatory support in children, experience with biventricular device implantation remains limited. We describe our experience using the HeartWare HVAD to provide biventricular support to three patients and compare these patients with five patients supported with HeartWare left ventricular assist device (LVAD). At the end of the study period, all three biventricular assist device (BiVAD) patients had been transplanted and were alive. LVAD patients were out of bed and ambulating a median of 10...
September 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Arianna Di Molfetta, Gianfranco Ferrari, Roberta Iacobelli, Sergio Filippelli, Libera Fresiello, Maria G Gagliardi, Alessandro Toscano, Maria G Trivella, Antonio Amodeo
BACKGROUND: Right ventricular failure (RVF) is one of the major complications during LVAD. Apart from drug therapy, the most reliable option is the implantation of RVAD. However, BIVAD have a poor prognosis and increased complications. Experiments have been conducted on alternative approaches, such as the creation of an atrial septal defect (ASD), a cavo-aortic shunt (CAS) including the LVAD and a cavo-pulmonary connection (CPC). This work aims at realizing a lumped parameter model (LPM) to compare the acute hemodynamic effects of ASD, CPC, CAS, RVAD in LVAD pediatric patients with RVF...
December 2015: International Journal of Artificial Organs
Kai A Ihnken, Danny Ramzy, Fardad Esmailian, Alfredo Trento, Francisco A Arabía
Thoughtful preparation of the surgical field at the time of initial mechanical circulatory support (MCS) implantation has the potential for decreasing operative time and surgical risk of subsequent heart transplantation. It sets the stage for expeditious, safe sternal reentry, and identification of structures necessary for initiation of cardiopulmonary bypass (CPB).
March 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Allison P Levin, Natalia Jaramillo, A Reshad Garan, Koji Takeda, Hiroo Takayama, Melana Yuzefpolskaya, Donna M Mancini, Yoshifumi Naka, Paolo C Colombo, Veli K Topkara
OBJECTIVES: Severe right ventricular failure often is considered a contraindication for left ventricular assist device (LVAD) therapy and necessitates use of biventricular assist devices (BiVADs). Available options for BiVADs are limited, and comparative outcomes are largely unknown. METHODS: Heart transplant candidates who were registered on the United Network for Organ Sharing waitlist and underwent long-term contemporary LVAD (n = 3195) or BiVAD (n = 408) implantation, from January 2010 through June 2014, were retrospectively analyzed...
February 2016: Journal of Thoracic and Cardiovascular Surgery
Daisuke Nitta, Koichiro Kinugawa, Teruhiko Imamura, Miyoko Endo, Toshiro Inaba, Hisataka Maki, Eisuke Amiya, Masaru Hatano, Osamu Kinoshita, Kan Nawata, Shunei Kyo, Minoru Ono
BACKGROUND: Although destination therapy (DT) is now expected to be a promising strategy for those who are not suitable for heart transplantation in Japan, there has not been any investigation into ineligibility for bridging to implantable left ventricular assist device (I-LVAD) as DT among patients with extracorporeal LVAD. METHODS AND RESULTS: We retrospectively studied 85 patients who had received an extracorporeal LVAD. To assess ineligibility for a bridge to I-LVAD for DT, we defined DT ineligibility (DTI) as BiVAD requirement, death within 6 months, and persistent end-organ dysfunction (medium or high J-VAD risk score) at 6 months after extracorporeal LVAD implantation...
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Eddie Brown, Luis Urrutia, Jeremy Patterson, Russell Carter, Karen Korzick
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Marina Pieri, Rachele Contri, Dario Winterton, Matteo Montorfano, Antonio Colombo, Alberto Zangrillo, Michele De Bonis, Federico Pappalardo
BACKGROUND: The treatment of cardiogenic shock with percutaneous mechanical circulatory support (MCS) is attractive: however, at present it is not clear which is the best strategy, as no survival benefit has been demonstrated for any device as single therapy. Aim of this study is to describe the role of percutaneous Impella in a comprehensive MCS program. METHODS: Observational study on 22 patients supported with the Impella device in our hospital from May 2013 to June 2014...
2015: BMC Cardiovascular Disorders
Teruhiko Imamura, Koichiro Kinugawa, Osamu Kinoshita, Kan Nawata, Minoru Ono
Although the right ventricular stroke work index (RVSWI) is a good index for RV function, a low RVSWI is not necessarily an indicator for the need for a right ventricular assist device at the time of left VAD implantation. We here aimed to determine a more precise indicator for the need for a biventricular assist device (BiVAD). In total, 116 patients (mean age, 38 ± 14 years), who underwent hemodynamic assessments preoperatively including 12 BiVAD patients, and had been followed at our institute from 2003 to 2015, were included...
March 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Jo P Pauls, Michael C Stevens, Emma Schummy, Geoff Tansley, John F Fraser, Daniel Timms, Shaun D Gregory
The low preload and high afterload sensitivities of rotary ventricular assist devices (VADs) may cause ventricular suction events or venous congestion. This is particularly problematic with rotary biventricular support (BiVAD), where the Starling response is diminished in both ventricles. Therefore, VADs may benefit from physiological control systems to prevent adverse events. This study compares active, passive and combined physiological controllers for rotary BiVAD support with constant speed mode. Systemic (SVR) and pulmonary (PVR) vascular resistance changes and exercise were simulated in a mock circulation loop to evaluate the capacity of each controller to prevent suction and congestion and increase exercise capacity...
May 2016: Annals of Biomedical Engineering
Justin Godown, Debra A Dodd, Thomas P Doyle, Andrew H Smith, Dana Janssen, Bret A Mettler
Bleeding and thrombosis are well-known potential complications of VAD support. We present a pediatric patient who developed massive bilateral pulmonary emboli while on BiVAD support that was successfully treated with intravenous tPA and bridged to heart transplant.
November 2015: Pediatric Transplantation
Jacob R Miller, Deirdre J Epstein, Matthew C Henn, Tracey Guthrie, Richard B Schuessler, Kathleen E Simpson, Charles E Canter, Pirooz Eghtesady, Umar S Boston
Biventricular assist device (BiVAD) support is considered a risk factor for worse outcomes compared with left ventricular assist device (LVAD) alone for children with end-stage heart failure. It remains unclear whether this is because of the morbidity associated with a second device or the underlying disease severity. We aimed to show that early BiVAD support can result in good survival by analyzing our prospectively collected database for all pediatric patients who underwent BiVAD implantation. From 2005 to 2009, BiVADs were used exclusively...
November 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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