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LVAD outflow graft

Shuichi Yoshitake, Yoshifumi Itoda, Kan Nawata, Tomoyuki Iwase, Yasuhiro Hoshino, Mitsutoshi Kimura, Osamu Kinoshita, Haruo Yamauchi, Minoru Ono
Nipro-Toyobo-paracorporeal pulsatile flow VAD (Nipro VAD; Nipro, Osaka, Japan) has been used most commonly as a paracorporeal VAD (p-VAD) in Japan. There are few reports describing clinical course of post LVAD explantation and its complication. We herein present two cases of apical abscess after the explantation of the device. SSI is a main risk factor of formation of the apical abscess at the time of LVAD explantation. It is mandatory to perform sufficient debridement and closure of the layers including abdominal muscle and anterior abdominal fascia at exit sites in the explantation surgery...
August 9, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Michael Neidlin, Chiara Corsini, Simon J Sonntag, Sebastian Schulte-Eistrup, Thomas Schmitz-Rode, Ulrich Steinseifer, Giancarlo Pennati, Tim A S Kaufmann
Subclavian arteries are a possible alternate location for left ventricular assist device (LVAD) outflow grafts due to easier surgical access and application in high risk patients. As vascular blood flow mechanics strongly influence the clinical outcome, insights into the hemodynamics during LVAD support can be used to evaluate different grafting locations. In this study, the feasibility of left and right subclavian artery (SA) grafting was investigated for the HeartWare HVAD with a numerical multiscale model...
June 6, 2016: Journal of Biomechanics
Anna Mara Scandroglio, Friedrich Kaufmann, Marina Pieri, Alexandra Kretzschmar, Marcus Müller, Panagiotis Pergantis, Stephan Dreysse, Volkmar Falk, Thomas Krabatsch, Evgenij V Potapov
BACKGROUND: Thrombosis is an uncommon, but severe complication of left ventricular assist devices (LVADs). OBJECTIVES: This study analyzed experience with obstruction of blood flow through the LVAD with the purpose of developing optimal diagnosis and treatment of LVAD-related thrombosis. METHODS: Between October 2009 and July 2015, a total of 652 LVAD were implanted in 557 patients. Blood flow abnormalities in patients with LVAD (n = 524) were identified and classified as "high-power" and "low-flow" events...
June 14, 2016: Journal of the American College of Cardiology
Michele Piazza, Francesco Squizzato, Franco Grego, Tommaso Bottio, Gino Gerosa, Michele Antonello
PURPOSE: To demonstrate the safety and feasibility of carotid artery stenting (CAS) in a patient with a continuous-flow left ventricular assist device (LVAD). CASE REPORT: A 54-year-old woman with a LVAD was referred for a 90% stenosis of the right internal carotid artery (ICA). The patient was offered CAS, and oral anticoagulant was not discontinued in the periprocedural period. Because of absent arterial pulses, percutaneous transfemoral access was obtained under ultrasound guidance...
August 2016: Journal of Endovascular Therapy
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
Christof Karmonik, Mahwash Kassi, Arvind Bhimaraj, Jerry Estep, Matthias Loebe, Su Chang
No abstract text is available yet for this article.
December 16, 2015: Journal of Cardiothoracic Surgery
Gardner L Yost, Thomas J Royston, Geetha Bhat, Antone J Tatooles
The use of left ventricular assist devices (LVADs), implantable pumps used to supplement cardiac output, has become an increasingly common and effective treatment for advanced heart failure. Although modern continuous-flow LVADs improve quality of life and survival more than medical management of heart failure, device malfunction remains a common concern. Improved noninvasive methods for assessment of LVAD function are needed to detect device complications. An electronic stethoscope was used to record sounds from the HeartMate II axial flow pump in vitro and in vivo...
January 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Andrew C W Baldwin, Elena Sandoval, George V Letsou, Hari R Mallidi, William E Cohn, O H Frazier
OBJECTIVE: Ventricular reconditioning and device weaning in select patients with continuous-flow left ventricular assist devices (CF LVADs) has been shown to be feasible. However, little is known regarding the outcomes associated with different surgical methods of device removal. We examined the effect of surgical explantation approach on early and late outcomes. METHODS: We retrospectively reviewed data from all patients who underwent successful ventricular weaning and CF LVAD explantation at our center...
January 2016: Journal of Thoracic and Cardiovascular Surgery
Justin Sacks, Gonzalo V Gonzalez-Stawinski, Shelley Hall, Brian Lima, Juan MacHannaford, William Dockery, Marco Cura, Themistokles Chamogeorgakis
OBJECTIVES: Proper inflow cannula orientation during implantation of the HeartMate II (HMII) left ventricular assist device (LVAD) is important for optimal pump function. This article describes our experience with cardiac computed tomography (CCT) to evaluate inflow cannula patency and predict future adverse outcomes (AE) after HMII LVAD implantation. METHODS: Ninety-three patients underwent HMII LVAD implantation for end-stage cardiomyopathy from January 2010 until March 2014...
November 2015: Interactive Cardiovascular and Thoracic Surgery
K Nadeem, B C Ng, E Lim, S D Gregory, R F Salamonsen, M C Stevens, M Mubin, N H Lovell
As a left ventricular assist device is designed to pump against the systemic vascular resistance (SVR), pulmonary congestion may occur when using such device for right ventricular support. The present study evaluates the efficacy of using a fixed right outflow banding in patients receiving biventricular assist device support under various circulatory conditions, including variations in the SVR, pulmonary vascular resistance (PVR), total blood volume (BV), as well as ventricular contractility. Effect of speed variation on the hemodynamics was also evaluated at varying degrees of PVR...
April 2016: Annals of Biomedical Engineering
Andrew Callington, Quan Long, Prashant Mohite, Andre Simon, Tarun Kumar Mittal
OBJECTIVES: To quantify the range of blood flow parameters in ascending aorta that can result from various angulations of outflow graft anastomosis of a left ventricular assist device (LVAD) to the aortic wall, as a means to understand the mechanism of aortic valve insufficiency. METHODS: A realistic aorta model with LVAD anastomosis was generated from computed tomographic images of a patient. Based on this model, the LVAD anastomosis geometry parameters, such as anastomosis locations, inclination angle, and azimuthal angle (cross-sectional plane) of the graft, were varied, to create 21 models...
September 2015: Journal of Thoracic and Cardiovascular Surgery
Julia Hillebrand, Juergen Sindermann, Christoph Schmidt, Rolf Mesters, Sven Martens, Mirela Scherer
Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening side effect of heparin therapy. It is a demanding therapeutic challenge in patients undergoing left ventricular assist device (LVAD) implantation. We present our experience with LVAD implantation under extracorporeal life support (ECLS) in patients suffering from HIT. Seven patients (mean age 54.0 ± 16.7 years, 1 female, 6 male patients) suffering from acute heart failure were stabilized with ECLS. Under heparin therapy, they all showed a sudden decrease of mean platelet count (maximum 212...
December 2015: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Duc Thinh Pham, Navin K Kapur, Meghan Dermody, Neil Halin
No abstract text is available yet for this article.
July 2015: Journal of Thoracic and Cardiovascular Surgery
Changyan Lin, Guanghui Wu, Xiujian Liu, Chuangye Xu, Xiaotong Hou, Haiyang Li, Chen Chen, Peng Yang, Jing Wang, Yuyang Liu
PURPOSE: The CH-VAD is an implantable, fully magnetically suspended ventricular assist device developed by the China Heart Biomedical Corporation (Suzhou, China) for full cardiac support. This study was performed to evaluate the reliability, hemocompatibility and end-organ effects of CH-VAD in a 35-day animal model trial. METHODS: The pump was implanted in 6 sheep. The pump inflow was inserted into the left ventricle and the outflow graft was anastomosed to the descending aorta...
March 2015: International Journal of Artificial Organs
Jasmin S Hanke, Sebastian V Rojas, Andreas Martens, Jan D Schmitto
No abstract text is available yet for this article.
April 2015: Journal of Thoracic and Cardiovascular Surgery
Guruprasad A Giridharan, Steven C Koenig, Kevin G Soucy, Young Choi, Tohid Pirbodaghi, Carlo R Bartoli, Gretel Monreal, Michael A Sobieski, Erin Schumer, Allen Cheng, Mark S Slaughter
In the event of left ventricular assist device (LVAD) failure, we hypothesized that rotary blood pumps will experience significant retrograde flow and induce adverse physiologic responses. Catastrophic LVAD failure was investigated in computer simulation with pulsatile, axial, and centrifugal LVAD, mock flow loop with pulsatile (PVAD) and centrifugal (ROTAFLOW), and healthy and chronic ischemic heart failure bovine models with pulsatile (PVAD), axial (HeartMate II), and centrifugal (HVAD) pumps. Simulated conditions were LVAD "off" with outflow graft clamped (baseline), LVAD "off" with outflow graft unclamped (LVAD failure), and LVAD "on" (5 L/min)...
May 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Aron-Frederik Popov, Prashant Nanasaheb Mohite, Anton Sabashnikov, Alexander Weymann, Nikhil Prakash Patil, Diana García Sáez, Andre Ruediger Simon
Left ventricular assist device (LVAD) is now a routine therapy for advanced heart failure. Authors demonstrate a novel technique of LVAD implantation through a single left thoracotomy with anastomosis of outflow graft to the arch of aorta. The technique avoids sternotomy or additional right thoracotomy, keeps ascending aorta clear and puts outflow graft away from the sternum.
June 2015: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Maria Vittoria Caruso, Vera Gramigna, Michele Rossi, Giuseppe Filiberto Serraino, Attilio Renzulli, Gionata Fragomeni
Left ventricular assist devices (LVADs) are mechanical supports used in case of heart failure. Little is known as the height of the anastomosis in aorta might influence the hemodynamic. The aim of the study was to evaluate the fluid dynamic behavior due to the outflow graft placement of a continuous flow LVAD in ascending aorta and to identify the insertion site with the best hemodynamic profile. Computational fluid dynamic studies were carried out to analyze 4 different anastomosis locations in a patient-specific aorta 3D model coupled with a lumped parameters model: 1 cm (case 1), 2 cm (case 2), 3 cm (case 3) and 4 cm (case 4) above the ST junction...
February 2015: International Journal for Numerical Methods in Biomedical Engineering
Robert M Adamson, Abeel A Mangi, Robert L Kormos, David J Farrar, Walter P Dembitsky
Proper left ventricular assist device (LVAD) insertion will help maximize LVAD flow and may reduce adverse events such as right heart failure and pump thrombosis. Although no standardized insertion technique has been universally accepted, the goals are: unobstructed inflow cannula, unobstructed outflow graft with avoidance of right ventricular compression, and prevention of pump migration. To achieve these objectives for the HeartMate II LVAD, we delineate four principles: proper pump pocket creation, optimized positioning of inflow cannula and outflow graft, proper pump position in the body, and fixation...
March 2015: Journal of Cardiac Surgery
Magdy M El-Sayed Ahmed, Muhammad Aftab, Steve K Singh, Hari R Mallidi, Oscar H Frazier
We describe three alternative approaches for the left ventricular assist device (LVAD) outflow graft during implantation of the LVAD. The supraceliac abdominal aorta, innominate artery and left axillary artery were employed as alternative sites for the LVAD outflow graft in the setting of a heavily calcified ascending aorta or a hostile chest wall and mediastinum. The first approach involved the use of the supraceliac abdominal aorta. Given that the patient had a history of multiple previous breast surgeries and chest wall radiation for breast cancer treatment, a left subcostal incision was employed as a sternotomy-sparing approach...
September 2014: Annals of Cardiothoracic Surgery
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