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https://www.readbyqxmd.com/read/28514261/doppler-ultrasound-evaluation-of-circulatory-support-devices
#1
Zachary Nuffer, Andrey Rupasov, Shweta Bhatt
In the setting of mechanical circulatory support devices, including ventricular assist devices, extracorporeal membrane oxygenation, intraaortic balloon pumps, and the total artificial heart, the spectral Doppler waveform is significantly altered, reflecting systemic hemodynamic changes. As the prevalence of these devices increases, a better understanding of both the devices themselves and their associated Doppler ultrasound findings is necessary for accurate image interpretation. This article reviews the clinical indications, pathophysiology, and sonographic findings of these devices, with emphasis on the variation in arterial Doppler waveforms that can be seen with normal function, as well as the major complications...
May 16, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28471885/extracorporeal-membrane-oxygenation-for-acute-decompensated-heart-failure
#2
Laurence Dangers, Nicholas Bréchot, Matthieu Schmidt, Guillaume Lebreton, Guillaume Hékimian, Ania Nieszkowska, Sébastien Besset, Jean-Louis Trouillet, Jean Chastre, Pascal Leprince, Alain Combes, Charles-Edouard Luyt
OBJECTIVE: Long-term outcomes of patients treated with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure (i.e., cardiogenic shock complicating chronic cardiomyopathy) have not yet been reported. This study was undertaken to describe their outcomes and determine mortality-associated factors. DESIGN: Retrospective analysis of data prospectively collected. SETTING: Twenty-six-bed tertiary hospital ICU. PATIENTS: One hundred five patients implanted with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure...
May 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28408020/risk-stratification-for-patients-in%C3%A2-cardiogenic-shock-after-acute%C3%A2-myocardial%C3%A2-infarction
#3
RANDOMIZED CONTROLLED TRIAL
Janine Pöss, Jelena Köster, Georg Fuernau, Ingo Eitel, Suzanne de Waha, Taoufik Ouarrak, Johan Lassus, Veli-Pekka Harjola, Uwe Zeymer, Holger Thiele, Steffen Desch
BACKGROUND: Mortality in cardiogenic shock (CS) remains high. Early risk stratification is crucial to make adequate treatment decisions. OBJECTIVES: This study sought to develop an easy-to-use, readily available risk prediction score for short-term mortality in patients with CS, derived from the IABP-SHOCK II (Intraaortic Balloon Pump in Cardiogenic Shock) trial. METHODS: The score was developed using a stepwise multivariable regression analysis...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28258731/hypotension-and-left-bundle-branch-block
#4
Mazen M Kawji, David Luke Glancy
A 69-year-old man with chronic kidney disease and no chest pain had the new onset of hypotension. An electrocardiogram revealed left bundle branch block and inferior ST-segment elevation concordant with the QRS complexes in leads II and aVF, a pattern diagnostic of acute inferior myocardial infarction. Coronary arteriography showed triple vessel disease with complete occlusion of the right. He was treated with an intraaortic balloon pump and percutaneous coronary intervention, followed by coronary artery bypass operation at a nearby hospital...
April 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28098650/was-the-intraaortic-balloon-pumping-under-venoarterial-extracorporeal-membrane-oxygenation-really-effective-in-reducing-the-mortality-of-cardiogenic-patients
#5
Toshinobu Yamagishi, Tomoko Sakatani, Yukihiro Kitamura, Masahiro Kashiura
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28096836/coronary-artery-spasm-following-on-pump-coronary-artery-bypass-grafting-with-20-months-follow-up
#6
Adam R Kowalówka, Marcin Malinowski, Magdalena Onyszczuk, Marek Deja
We report on a 69-year-old woman who demonstrated native coronary artery and grafted vessel spasm following on-pump coronary artery bypass grafting (CABG). Despite intraaortic balloon pump (IABP) insertion, electrocardiogram (ECG) abnormalities did not disappear. Emergency coronary angiography (CAG) was performed. The patient was successfully treated with systemic and intracoronary injection of vasodilator agents. ECG changes disappeared, with normalized and stable hemodynamic function. Intraaortic balloon pump was maintained for 48 h...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28074788/comparison-of-two-doses-of-heparin-on-outcome-in-off-pump-coronary-artery-bypass-surgery-patients-a-prospective-randomized-control-study
#7
RANDOMIZED CONTROLLED TRIAL
Murali Chakravarthy, Dattatreya Prabhakumar, Patil Thimmannagowda, Jayaprakash Krishnamoorthy, Antony George, Vivek Jawali
INTRODUCTION: While off pump coronary artery bypass surgery is practiced with an intention to reduce the morbidity associated with cardiopulmonary bypass, the resultant 'hypercoagulability' needs to be addressed. Complications such as cavitary thrombus possibly due to the hyper coagulability after off pump coronary artery bypass surgery have been described. Many clinicians use higher doses of heparin - up to 5 mg/kg in order to thwart this fear. Overall, there appears to be no consensus on the dose of heparin in off pump coronary artery bypass surgeries...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28007064/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-public-reporting-initiative
#8
REVIEW
Jeffrey P Jacobs
Three basic principles provide the rationale for the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (CHSD) public reporting initiative: (1) Variation in congenital and pediatric cardiac surgical outcomes exist. (2) Patients and their families have the right to know the outcomes of the treatments that they will receive. (3). It is our professional responsibility to share this information with them in a format they can understand. The STS CHSD public reporting initiative facilitates the voluntary transparent public reporting of congenital and pediatric cardiac surgical outcomes using the STS CHSD Mortality Risk Model...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27913738/extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-replacement
#9
Elena Dolmatova, Kasra Moazzami, Thomas P Cocke, Elie Elmann, Pranay Vaidya, Arthur F Ng, Kumar Satya, Rajeev L Narayan
Background Patients undergoing transcatheter aortic valve replacement can experience severe perioperative complications leading to hemodynamic instability and death. Venoarterial extracorporeal membrane oxygenation can be used to provide cardiorespiratory support during this time. Methods From 2012 to 2015, of 247 patients who underwent transcatheter aortic valve replacement, 6 (2.42%) required extracorporeal membrane oxygenation support. Their mean age was 82 ± 7.4 years, mean Society of Thoracic Surgeons score was 9...
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27884411/celsior-versus-microplegia-analysis-of-myocardial-protection-in-elective-aortic-valve-replacement
#10
Jose López-Menéndez, Javier Miguelena, Carlos Morales, Carmen L Díaz, Francisco Callejo, Juan Carlos Llosa, Jacobo Silva
BACKGROUND: Previous studies have analyzed the efficacy of crystalloid cardioplegic solutions, but the use of Celsior (Genzyme Corp, Boston, MA) as a crystalloid cardioplegic solution has not been evaluated. METHODS: In this observational retrospective study, Celsior crystalloid solution was compared with an all-blood continuous myocardial protection (microplegia). The study included all patients who underwent elective aortic valve replacement operations in whom the myocardial protection was Celsior or microplegia...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27865117/catalytic-iron-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-a-biomarker-substudy-of-the-iabp-shock-ii-trial
#11
Georg Fuernau, Florian Traeder, Suhas S Lele, Mohan M Rajapurkar, Banibrata Mukhopadhyay, Suzanne de Waha, Steffen Desch, Ingo Eitel, Gerhard Schuler, Volker Adams, Holger Thiele
BACKGROUND: Catalytic iron (CI) is unbound ferric iron with the potential to generate reactive oxygen species with further deleterious vascular effects. In acute coronary syndromes, high levels of CI are linked to all-cause mortality. The prognostic impact of CI and iron metabolism in cardiogenic shock (CS) is currently undetermined. Aims of this study were to investigate the prognostic impact of CI and to identify predictors of high CI levels in patients with CS complicating acute myocardial infarction...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27801303/levosimendan-use-increases-cardiac-performance-after-coronary-artery-bypass-grafting-in-end-stage-renal-disease-patients
#12
Hakan Atalay, Zeki Temizturk, Hasan Baki Altinsoy, Davut Azboy, Salih Colak, Atakan Atalay, Omer Faruk Dogan
BACKGROUND: The effect of levosimendan on myocardial performance has not been studied in dialysis-dependent end-stage renal disease patients who have undergone coronary artery bypass grafting (CABG) surgery. Our aim was to investigate the effect of levosimendan on postoperative hemodynamic effects in end-stage renal disease patients undergoing CABG operation. METHODS: We performed 58 elective isolated CABG operations in end-stage renal disease patients. The study group received levosimendan at a slow bolus dose of 3 µg/kg, followed by a 24-hour infusion of 0...
October 27, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27660572/percutaneous-ventricular-assist-devices-a-novel-approach-in-the-management-of-patients-with-acute-cardiogenic-shock
#13
REVIEW
Kevin Ergle, Parham Parto, Selim R Krim
BACKGROUND: Despite recent advances in the management of heart failure, cardiogenic shock remains a challenging and devastating condition with significant morbidity and mortality. METHODS: We review currently available percutaneous mechanical circulatory support (MCS) devices and address each device's characteristics, mechanism of action, specific clinical indications, and contraindications. RESULTS: Four types of percutaneous MCS devices are currently available: the intraaortic balloon pump (IABP), Impella devices, the TandemHeart, and extracorporal membrane oxygenation (ECMO)...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27660567/using-the-minimally-invasive-impella-5-0-via-the-right-subclavian-artery-cutdown-for-acute-on-chronic-decompensated-heart-failure-as-a-bridge-to-decision
#14
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27521557/-smoker-s-paradox-in-patients-with-cardiogenic-shock-complicating-myocardial-infarction-a-substudy-of-the-iabp-shock-ii-trial-and-registry
#15
Mohammed Saad, Georg Fuernau, Steffen Desch, Ingo Eitel, Christian Jung, Janine Pöss, Steffen Schneider, Gerhard Schuler, Karl Werdan, Uwe Zeymer, Holger Thiele
BACKGROUND: Several studies in patients with acute myocardial infarction (AMI) without cardiogenic shock (CS) indicate a better survival in smokers, the so called "smoker's paradox". For CS, this relationship has not been investigated so far in the primary percutaneous coronary intervention (PCI) era. METHODS: In a predefined substudy of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial and its accompanying registry including patients with CS complicating AMI we investigated differences in outcome of smokers compared to non-smokers...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27487772/iabp-history-evolution-pathophysiology-indications-what-we-need-to-know
#16
REVIEW
H Parissis, V Graham, S Lampridis, M Lau, G Hooks, P C Mhandu
Treatment with the intraaortic balloon pump (IABP) is the most common form of mechanical support for the failing heart. Augmentation of diastolic pressure during balloon inflation contributes to the coronary circulation and the presystolic deflation of the balloon reduces the resistance to systolic output. Consequently, the myocardial work is reduced. The overall effect of the IABP therapy is an increase in the myocardial oxygen supply/demand ratio and thus in endocardial viability.This is an overall synopsis of what we need to know regarding IABP...
August 4, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27436116/postcardiotomy-ecmo-support-after-high-risk-operations-in-adult-congenital-heart-disease
#17
Benjamin Acheampong, Jonathan N Johnson, John M Stulak, Joseph A Dearani, Sudhir S Kushwaha, Richard C Daly, Dawit T Haile, Gregory J Schears
BACKGROUND: Cardiac operations in high-risk adult congenital heart disease (ACHD) patients may require mechanical circulatory support (MCS), such as extracorporeal membrane oxygenation (ECMO) or intraaortic balloon pump (IABP), to allow the cardiopulmonary system to recover. METHODS: We reviewed records for all ACHD patients who required MCS following cardiotomy at our institution from 1/2001 to 12/2013. RESULTS: During the study period, 2264 (mean age 39...
December 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27397468/undiagnosed-aortic-dissection-in-patient-with-intra-aortic-balloon-pump
#18
Monish S Raut, Arun Maheshwari, Manish Sharma
60 years old lady presented with chest pain and was admitted in local hospital. Electrocardiogram was suggestive of anterior myocardial ischemia. Patient underwent coronary angiography which revealed severe triple vessles coronary artery disease. As patient was hemodynamically unstable and in cardiogenic shock, intraaortic balloon pump was inserted .IABP augmented diastolic blood pressure was less than unassisted systolic blood pressure despite setting maximum augmentation on IABP machine.
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27378612/culprit-lesion-location-and-outcome-in-patients-with-cardiogenic-shock-complicating-myocardial-infarction-a-substudy-of-the-iabp-shock-ii-trial
#19
RANDOMIZED CONTROLLED TRIAL
Georg Fuernau, Karl Fengler, Steffen Desch, Ingo Eitel, Franz-Josef Neumann, Hans-Georg Olbrich, Antoinette de Waha, Suzanne de Waha, Gert Richardt, Marcus Hennersdorf, Klaus Empen, Rainer Hambrecht, Christian Jung, Michael Böhm, Janine Pöss, Ruth H Strasser, Steffen Schneider, Taoufik Ouarrak, Gerhard Schuler, Karl Werdan, Uwe Zeymer, Holger Thiele
BACKGROUND: In myocardial infarction without cardiogenic shock (CS), the affected coronary vessel has significant influence on the final infarct size and patient prognosis. CS data on this relation are scarce. The objective of this study was to determine the prognostic relevance of the culprit lesion location in patients with CS complicating acute myocardial infarction. METHODS: In the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial patients with CS were randomized to therapy with intraaortic balloon pump or control...
December 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27354871/histological-examination-of-the-right-atrial-appendage-after-failed-catheter-ablation-for-focal-atrial-tachycardia-complicated-by-cardiogenic-shock-in-a-post-partum-patient
#20
Akira Mizukami, Makoto Suzuki, Rena Nakamura, Shunsuke Kuroda, Maki Ono, Yuya Matsue, Ryota Iwatsuka, Taishi Yonetsu, Akihiko Matsumura, Yuji Hashimoto
A 26-year-old woman in her first pregnancy presented with persistent atrial tachycardia (AT). AT was resistant to medications, cardioversions, and the first attempt of catheter ablation. Two months after delivery she developed severe systolic dysfunction and circulatory collapse. Emergent catheter ablation was performed with the support of percutaneous cardiopulmonary bypass and intraaortic balloon pump. The AT originated in the apex of the right atrial appendage (RAA). Repeated attempts at ablation were unsuccessful, prompting surgical RAA resection, which terminated the tachycardia and improved the cardiac function...
June 2016: Journal of Arrhythmia
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