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https://www.readbyqxmd.com/read/28033201/right-ventricular-failure-post-lvad-implantation-corrected-with-biventricular-support-an-in-vitro-model
#1
Sajad Shehab, Sabine M Allida, Patricia M Davidson, Phillip J Newton, Desiree Robson, Paul C Jansz, Christopher S Hayward
Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. Management remains limited to pharmacologic therapy and temporary mechanical support. Delayed right ventricular assist device (RVAD) support after LVAD implantation is associated with poorer outcomes. With the advent of miniaturized, durable, continuous flow ventricular assist device systems, chronic RVAD and biventricular assist device (BiVAD) support has been used with some success. The purpose of this study was to assess combined BiVAD and LVAD with delayed RVAD support within a four-elemental mock circulatory loop (MCL) simulating the human cardiovascular system...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27987352/design-of-a-right-ventricular-mock-circulation-loop-as-a-test-bench-for-right-ventricular-assist-devices
#2
Indra Mueller, So-Hyun Jansen-Park, Michael Neidlin, Ulrich Steinseifer, Dirk Abel, Rüdiger Autschbach, Rolf Rossaint, Thomas Schmitz-Rode, Simon Johannes Sonntag
Right heart failure (RHF), e.g. due to pulmonary hypertension (PH), is a serious health issue with growing occurrence and high mortality rate. Limited efficacy of medication in advanced stages of the disease constitutes the need for mechanical circulatory support of the right ventricle (RV). An essential contribution to the process of developing right ventricular assist devices (RVADs) is the in vitro test bench, which simulates the hemodynamic behavior of the native circulatory system. To model healthy and diseased arterial-pulmonary hemodynamics in adults (mild and severe PH and RHF), a right heart mock circulation loop (MCL) was developed...
December 17, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27984489/intraobserver-and-interobserver-measurement-variability-of-the-rib-vertebral-angle-difference
#3
Robert G Tysklind, Karen Myung, George Gantsoudes, Shyam Kishan, Chad Turner, Stella Lee, Matthew Wanner, Meagan Sabatino, Scott Linger, Randall T Loder
BACKGROUND: The rib-vertebral angle (RVAD) differentiates between progressive and resolving infantile idiopathic scoliosis (IIS) curves. Those with a RVAD<20 degrees often resolve without treatment, whereas those >20 degrees often progress and require treatment. The mathematical magnitude of RVAD measurement variability has not been described, and was thus the purpose of this study. It is important to know the reliability of RVAD measurements so as to understand changes that can be attributed to observer error alone...
December 14, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27909839/biventricular-support-using-a-centrifugal-pump-in-a-6%C3%A2-year-old-with-fulminant-myocarditis
#4
Hiromu Kehara, Tamaki Takano, Takamitsu Terasaki, Kenji Okada
We experienced a case of ventricular assist with both a pulsatile-flow and a continuous-flow pump in a pediatric patient, and herein report the clinical course and characteristics of the pumps. A 6-year-old female was diagnosed with fulminant myocarditis and transferred to our hospital for mechanical support. After 12 days of extracorporeal membrane oxygenation, we implanted a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) using centrifugal Gyro pumps with a membrane oxygenator in a paracorporeal fashion...
December 1, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27909480/a-case-of-wide-complex-tachycardia-in-a-patient-with-a-biventricular-assist-device
#5
Abrams Mark P, Whang William, Iyer Vivek, Garan Hasan, Biviano Angelo
This case report highlights the variety of wide complex tachycardias, and the need for their prompt management, in the growing population of patients with circulatory support devices. We present a case that demonstrates how a wide complex supraventricular tachycardia in a patient with a biventricular assist device can be safely and effectively targeted for treatment using percutaneous radiofrequency catheter ablation, allowing for clinical improvement, weaning of RVAD treatment, and discharge home with LVAD alone...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27831998/hemodynamic-performance-of-a-novel-right-ventricular-assist-device-perkat%C3%A2
#6
Daniel Kretzschmar, P Christian Schulze, Markus W Ferrari
Acute right ventricular failure (RVF) is an increasingly clinical problem and a life-threatening condition. Right ventricular assist devices (RVADs) represent a reasonable treatment option for patients with refractory RVF. We here present a novel percutaneously implantable device for RV support.The PERKAT device is based on a nitinol stent cage which is covered with valve- carrying foils. A flexible outlet trunk with a pigtail tip is connected to the distal part. The device is driven by an IABP drive unit which inflates/deflates a standard IABP balloon placed within in the stent cage...
November 9, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27821152/a-20-year-multicentre-outcome-analysis-of-salvage-mechanical-circulatory-support-for-refractory-cardiogenic-shock-after-cardiac-surgery
#7
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
https://www.readbyqxmd.com/read/27801308/how-i-do-it-temporary-rvad-placed-at-the-time-of-implantation-of-a-heartmate-ii-lvad
#8
William Zachary Chancellor, Curt Tribble
Left ventricular assist devices (LVAD) are increasingly used to support patients as they await heart transplantation and as destination therapy for patients with end-stage cardiac failure. While the methods of LVAD implantation have become fairly standardized, early postoperative management of patients receiving these devices remains challenging. One issue that has plagued surgeons, cardiologists, and intensivists caring for patients after LVAD implantation is right heart dysfunction. While many scoring systems have been developed to try to anticipate RV failure, the accuracy of these predictive tools remains low...
October 31, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27570334/percutaneous-double-lumen-cannula-for-right-ventricle-assist-device-system-a-computational-fluid-dynamics-study
#9
Francesca Condemi, Dongfang Wang, Gionata Fragomeni, Fuqian Yang, Guangfeng Zhao, Cameron Jones, Cherry Ballard-Croft, Joseph B Zwischenberger
OBJECTIVES: Our goal is to develop a double lumen cannula (DLC) for a percutaneous right ventricular assist device (pRVAD) in order to eliminate two open chest surgeries for RVAD installation and removal. The objective of this study was to evaluate the performance, flow pattern, blood hemolysis, and thrombosis potential of the pRVAD DLC. METHODS: Computational fluid dynamics (CFD), using the finite volume method, was performed on the pRVAD DLC. For Reynolds numbers <4000, the laminar model was used to describe the blood flow behavior, while shear-stress transport k-ω model was used for Reynolds numbers >4000...
2016: Biocybernetics and Biomedical Engineering
https://www.readbyqxmd.com/read/27469015/right-ventricular-response-to-pulsatile-load-is-associated-with-early-right-heart-failure-and-mortality-after-left-ventricular-assist-device
#10
E Wilson Grandin, Payman Zamani, Jeremy A Mazurek, Gregory S Troutman, Edo Y Birati, Esther Vorovich, Julio A Chirinos, Ryan J Tedford, Kenneth B Margulies, Pavan Atluri, J Eduardo Rame
BACKGROUND: Right ventricular (RV) adaptation to afterload is crucial for patients undergoing continuous-flow left ventricular assist device (cf-LVAD) implantation. We hypothesized that stratifying patients by RV pulsatile load, using pulmonary arterial compliance (PAC), and RV response to load, using the ratio of central venous to pulmonary capillary wedge pressure (CVP:PCWP), would identify patients at high risk for early right heart failure (RHF) and 6-month mortality after cf-LVAD...
June 24, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27321789/can-perioperative-right-ventricular-support-prevent-postoperative-right-heart-failure-in-patients-with-biventricular-dysfunction-undergoing-left-ventricular-assist-device-implantation
#11
Heinz Deschka, Alexander J Holthaus, Jürgen R Sindermann, Henryk Welp, Dominik Schlarb, Nadejda Monsefi, Sven Martens, Mirela Scherer
OBJECTIVES: Depending on the pre-existing condition of the right ventricle (RV), left ventricular assist device (LVAD) implantation may have a detrimental effect on RV function, subsequently leading to right heart failure. This study details the authors' experience with perioperative mechanical RV support in patients with biventricular impairment but primarily scheduled for isolated LVAD implantation. DESIGN: Retrospective study. SETTING: Two center study, university hospital...
June 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27184945/short-term-ventricular-assist-device-as-a-bridge-to-decision-in-cardiogenic-shock-is-it-a-justified-strategy
#12
Mohamed Zeriouh, Prashant Mohite, Binu Rai, Anton Sabashnikov, Javid Fatullayev, Diana Garcia Saez, Bartrlomiej Zych, Ali Ghodsizad, Parwis Rahmanian, Yeong-Hoon Choi, Thorsten Wahlers, Andre R Simon, Aron F Popov, Achim Koch
PURPOSE: Low cardiac output syndrome is associated with significant mortality. In patients with refractory low cardiac output left ventricular assist devices (VAD) are used to re-establish cardiac output and to prevent death. However, long-term LVAD implantation in these is complicated by a high rate of right heart failure and mortality. Therefore, our strategy is to implant a short-term VAD (left or biventricular) as a bridge to decission. METHODS: We retrospectively analysed data from 66 patients who received a short-term LVAD support prior to implantation of a long-term LVAD or HTx between 2003 and 2014...
May 16, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27164039/pediatric-extracorporeal-life-support-using-a-third-generation-diagonal-pump
#13
Marlene Speth, Frank Münch, Ariawan Purbojo, Martin Glöckler, Okan Toka, Robert A Cesnjevar, André Rüffer
This study reports a single-centre experience of the Medos Deltastream diagonal-pump (DP3) for extracorporeal cardiac, pulmonary, or combined support in a single-center pediatric cohort. Twenty-seven consecutive patients with 28 runs of the DP3 between January 2013 and June 2014 were included for analysis. Median patient age, weight, and duration of support were 278 days (range: 0 days-14.2 years), 7.2 kg (range: 2.5-39 kg), and 8 days (range: 2-69 days). Midline sternotomy (n = 20, 71.4%) or cervical approaches (n = 8, 28...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27164037/delayed-sternal-closure-after-continuous-flow-left-ventricle-assist-device-implantation-analysis-of-risk-factors-and-impact-on-outcomes-and-costs
#14
Mohammed Quader, Damien J LaPar, Luke Wolfe, Gorav Ailawadi, Jeffrey Rich, Alan Speir, Clifford Fonner, Vigneshwar Kasirajan
Patient and institutional factors predictive of delayed sternal closure (DSC) practice and its impact on clinical and cost outcomes when compared with primary sternal closure (PSC) following continuous-flow left ventricular assist device (CF-LVAD) implantation were examined. Statewide Society of Thoracic Surgeons and hospital cost data on CF-LVADs implanted were analyzed. Between January 2007 and December 2013, 558 CF-LVADs were implanted (PSC = 464, 83.2%; DSC = 94, 16.8%). Among the six institutions implanting CF-LVADs, DSC practice ranged from 3...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27145697/concurrent-left-ventricular-assist-device-lvad-implantation-and-percutaneous-temporary-rvad-support-via-cardiacassist-protek-duo-tandemheart-to-preempt-right-heart-failure
#15
Bastian Schmack, Alexander Weymann, Aron-Frederik Popov, Nikhil Prakash Patil, Anton Sabashnikov, Jamila Kremer, Mina Farag, Andreas Brcic, Christoph Lichtenstern, Matthias Karck, Arjang Ruhparwar
Right ventricular failure (RVF) is an unfortunate complication that continues to limit outcomes following durable left ventricular assist device (LVAD) implantation. Despite several 'RVF risk scores' having been proposed, preoperative prediction of post-LVAD RVF remains a guesstimate at best. Current strategies for institution of temporary RVAD support are invasive, necessitate additional re-thoracotomy, restrict postoperative mobilization, and/or entail prolonged retention of prosthetic material in-situ. The authors propose a novel surgical strategy comprising simultaneous implantation of a permanent LVAD and percutaneous TandemHeart® plus ProtekDuo® to provide temporary RVAD support and preempt RVF in patients with impaired RV function...
May 5, 2016: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/27076733/fatal-right-ventricular-failure-and-pulmonary-hypertension-after-protamine-administration-during-cardiac-transplantation
#16
Bibek S Pannu, Devang K Sanghavi, Pramod K Guru, Dereddi Raja Reddy, Vivek N Iyer
Protamine sulfate is the only Food and Drug administration approved medication for reversal of intraoperative heparin-induced anticoagulation during cardiac and vascular surgeries. One of the rare side effects of protamine sulfate is an idiosyncratic reaction resulting in acute pulmonary hypertension (APH) and right ventricular (RV) failure occurring after protamine administration. These reactions are rare but catastrophic with high mortality. A 36-year-old female with severe congestive heart failure was undergoing cardiac transplant surgery...
March 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27052930/successful-treatment-of-near-fatal-fulminant-myocarditis-using-bi-ventricular-assist-device-support
#17
Seiko Nakajima, Osamu Seguchi, Tomoyuki Fujita, Hiroki Hata, Kizuku Yamashita, Takuma Sato, Haruki Sunami, Masanobu Yanase, Norihide Fukushima, Junjiro Kobayashi, Takeshi Nakatani
Fulminant myocarditis is a rare but fatal serious disease that may cause prolonged native cardiac dysfunction with multiorgan failure despite temporary mechanical circulatory support with percutaneous venoatrial extracorporeal membrane oxygenation (VA-ECMO) or intraaortic balloon pumping (IABP). A 26-year-old man with fulminant myocarditis developed life-threatening multiorgan failure after 8 days support by VA-ECMO and IABP. He was transferred to our institution with prolonged cardiac dysfunction on hospital day 8; massive pulmonary edema developed into severe pulmonary dysfunction...
September 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27001224/relationship-between-the-different-torsion-related-thoracic-deformity-parameters-of-adolescent-idiopathic-scoliosis
#18
Javier Pizones, Lorenzo Zúñiga, Felisa Sánchez-Mariscal, Enrique Izquierdo
INTRODUCTION: Torsion has recently become essential in curve evaluation, not only to assess the degree of clinical deformity that can influence decision making, but also to predict curve progression. Since torsion cannot be currently measured using plain X-rays, our aim was to study the relationships between the different torsion-related parameters measured on 2D radiographs that can indirectly guide the clinician about the torsion of a given curve. METHODS: This is a cross-sectional study analyzing prospectively registered data of a consecutive cohort of 113 AIS patients with progressive main thoracic deformity...
October 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/26916756/biventricular-intracorporeal-ventricular-assist-device-in-a-10-year-old-child
#19
Martin Schweiger, Barnard Krüger, Anna Cavigelli-Brunner, Hitendu Dave, Martin Schmiady, Michael Hübler
PURPOSE: The pediatric population has benefited greatly by the evolution of ventricular assist devices (VADs) leading to miniaturization. Device design like the HeartWare® VAD allows for implantation in smaller patients or even as an implantable biventricular assist device. CASE REPORT: A ten-year-old female patient (body surface area: 1.02 m2, 27 kg) waiting for 7 months for heart transplantation was admitted to the intensive care unit due to terminal heart failure...
January 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/26849954/long-term-biventricular-heartware-ventricular-assist-device-support-case-series-of-right-atrial-and-right-ventricular-implantation-outcomes
#20
Sajad Shehab, Peter S Macdonald, Anne M Keogh, Eugene Kotlyar, Andrew Jabbour, Desiree Robson, Phillip J Newton, Sriram Rao, Louis Wang, Sabine Allida, Mark Connellan, Emily Granger, Kumud Dhital, Phillip Spratt, Paul C Jansz, Christopher S Hayward
BACKGROUND: There is limited information on outcomes using the HeartWare ventricular assist device (HVAD; HeartWare, Framington, MA) as a biventricular assist device, especially with respect to site of right ventricular assist device (RVAD) implantation. METHODS: Outcomes in 13 patients with dilated cardiomyopathy and severe biventricular failure who underwent dual HVAD implantation as bridge to transplantation between August 2011 and October 2014 were reviewed...
April 2016: Journal of Heart and Lung Transplantation
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