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LVAD outflow graft

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https://www.readbyqxmd.com/read/28741841/pulmonary-valve-opening-with-two-rotary-left-ventricular-assist-devices-for-biventricular-support
#1
Eric L Wu, Frank Nestler, Matthias Kleinheyer, Michael C Stevens, Jo P Pauls, John F Fraser, Shaun D Gregory
Right ventricular failure is a common complication associated with rotary left ventricular assist device (LVAD) support. Currently, there is no clinically approved long-term rotary right ventricular assist device (RVAD). Instead, clinicians have implanted a second rotary LVAD as RVAD in biventricular support. To prevent pulmonary hypertension, the RVAD must be operated by either reducing pump speed or banding the outflow graft. These modes differ in hydraulic performance, which may affect the pulmonary valve opening (PVO) and subsequently cause fusion, valvular insufficiency, and thrombus formation...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28265218/minimally-invasive-lvad-deactivation-in-a-65-year-old-man-with-recurrent-pump-thrombosis-and-left-ventricular-recovery
#2
Akshay Pendyal, Christopher V Chien, James O Mudd, Jill M Gelow
Pump thrombosis is a dire sequela after left ventricular assist device (LVAD) implantation. Treatment comprises antiplatelet agents, anticoagulants, thrombolytic agents, and pump exchange. Although pump exchange is the definitive therapy, it is also the most invasive, often exposing patients to the risks of repeat sternotomy and cardiopulmonary bypass. In some cases, patients experience left ventricular recovery after LVAD implantation. The optimal strategy surrounding the management of LVADs in patients who have experienced ventricular recovery is unknown; techniques range from total system explantation to partial pump resection...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#3
Rohan J Kalathiya, Jonathan Grinstein, Nir Uriel, Atman P Shah
Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28195884/interventional-treatment-of-lvad-outflow-graft-stenosis-by-introduction-of-bare-metal-stents
#4
Dominik Wiedemann, Thomas Schlöglhofer, Thomas Haberl, Julia Riebandt, Kamen Dimitrov, Heinrich Schima, Johannes Kastner, Wolfgang Matzek, Günther Laufer, Daniel Zimpfer
LVAD outflow graft stenosis is a rare but life-threatening complication of MCS-therapy. Current treatment modalities (pump exchange or systemic thrombolytic therapy) are associated with significant mortality and morbidity.Implantation of bare metal stents within the stenosed outflow graft is an alternative. Herein we describe a series of 3-cases with successful stent placement. This seems to be safe and successful however correct and early diagnosis of outflow stenosis can be challenging. Information provided by the HeartWare HVAD logfiles are extremely helpful for diagnosis...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28163837/simultaneous-ramp-right-heart-catheterization-and-echocardiography-in-a-reliantheart-left-ventricular-assist-device
#5
Dipanjan Banerjee, Debleena Dutt, Sebastien Duclos, Karim Sallam, Matthew Wheeler, Richard Ha
Many clinicians caring for patients with continuous flow left ventricular assist devices (CF-LVAD) use ramp right heart catheterization (RHC) studies to optimize pump speed and also to troubleshoot CF-LVAD malfunction. An investigational device, the ReliantHeart Heart Assist 5 (Houston, TX), provides the added benefit of an ultrasonic flow probe on the outflow graft that directly measures flow through the CF-LVAD. We performed a simultaneous ramp RHC and echocardiogram on a patient who received the above CF-LVAD to optimize pump parameters and investigate elevated flow through the CF-LVAD as measured by the flow probe...
January 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#6
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
February 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28070902/a-modified-lvad-technique-to-augment-caval-and-pulmonary-arterial-blood-flow-in-the-failing-fontan-circulation
#7
Michael F Swartz, Louis DiVincenti, Karen Smith, Robin Westcott, Kevin Belmont, William Harris, Francisco Gensini, George M Alfieris
BACKGROUND: There are minimal circulatory support options for patients with a failing Fontan. The Heartmate II (HMII) left ventricular assist device (Thoratec, Bedford, MA) in its packaged state cannot augment caval/pulmonary arterial blood flow. AIM: We hypothesized that a modified HMII pump could augment caval and pulmonary arterial blood flow. METHODS: A bifurcated ringed Gore-Tex graft (W. L. Gore & Associates, Flagstaff, AZ) was sewn to the HMII inflow, and the outflow graft transected and tapered from 16 mm to 8 mm in diameter...
February 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28033200/lvad-outflow-graft-angle-and-thrombosis-risk
#8
Alberto Aliseda, Venkat Keshav Chivukula, Patrick Mcgah, Anthony R Prisco, Jennifer A Beckman, Guilherme J M Garcia, Nahush A Mokadam, Claudius Mahr
This study quantifies thrombogenic potential (TP) of a wide range of left ventricular assist device (LVAD) outflow graft anastomosis angles through state-of-the-art techniques: 3D imaged-based patient-specific models created via virtual surgery and unsteady computational fluid dynamics with Lagrangian particle tracking. This study aims at clarifying the influence of a single parameter (outflow graft angle) on the thrombogenesis associated with flow patterns in the aortic root after LVAD implantation. This is an important and poorly-understood aspect of LVAD therapy, because several studies have shown strong inter and intrapatient thrombogenic variability and current LVAD implantation strategies do not incorporate outflow graft angle optimization...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28033184/effect-of-outflow-graft-size-on-flow-in-the-aortic-arch-and-cerebral-blood-flow-in-continuous-flow-pumps-possible-relevance-to-strokes
#9
Sindhoor Bhat, Jayakala Mathew, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is stroke, with a higher incidence in HeartWare Ventricular Assist Device (HVAD) as compared with HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Because outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates. A computational fluid-structure interaction model was created from the computed tomography (CT) scan of a patient...
March 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27794072/off-pump-left-ventricular-assist-device-exchange-via-re-do-left-mini-thoracotomy-with-original-outflow-graft-preservation
#10
Jessika Iwanski, Phat L Tran, Catherine Jerman, Richard Smith, Toshinobu Kazui, Zain Khalpey
Complications associated with long-term left ventricular assist device (LVAD) use may require pump exchange due to device thrombosis or thromboembolism. Minimally invasive off-pump procedures represent an advantageous alternative to standard full sternotomy exchanges and those performed with the use of cardiopulmonary bypass. By mitigating surgical invasion and trauma to the central chest, the potential for post-operative bleeding, transfusions and complications can be reduced. This case report describes the successful off-pump exchange of a HeartWare LVAD via left re-do-thoracotomy with the re-use of the original outflow graft...
April 2017: Perfusion
https://www.readbyqxmd.com/read/27772595/concomitant-thoracic-aortobifemoral-bypass-with-left-ventricular-assist-device-implantation
#11
Muath Bishawi, Asad A Shah, Richard L McCann, Carmelo A Milano
Improved quality of life for patients after left ventricular assist device (LVAD) implantation can be greatly limited by peripheral vascular disease even if heart failure symptoms are resolved by LVAD support. We present a case of concomitant thoracic aortobifemoral bypass and LVAD implantation in a patient with ischemic cardiomyopathy, severe peripheral vascular disease, and multiple previous failed revascularization attempts. In this patient, we used the LVAD outflow to provide the inflow to the femoral artery bypass graft...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27507585/successful-management-of-apical-abscess-after-nipro-left-ventricular-assisted-device-explantation-by-removal-of-apical-cuff-and-omentopexy
#12
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...
December 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27298155/hemodynamic-analysis-of-outflow-grafting-positions-of-a-ventricular-assist-device-using-closed-loop-multiscale-cfd-simulations-preliminary-results
#13
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
https://www.readbyqxmd.com/read/27282897/diagnosis-and-treatment-algorithm-for%C3%A2-blood-flow-obstructions-in-patients-with%C3%A2-left-ventricular-assist-device
#14
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
https://www.readbyqxmd.com/read/27009976/carotid-artery-stenting-in-a-patient-with-a-continuous-flow-left-ventricular-assist-device
#15
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
https://www.readbyqxmd.com/read/26916756/biventricular-intracorporeal-ventricular-assist-device-in-a-10-year-old-child
#16
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/26739576/elevated-pressures-on-aortic-valve-leaflets-correlate-with-orientation-of-lvad-outflow-graft
#17
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
https://www.readbyqxmd.com/read/26536535/acoustic-characterization-of-axial-flow-left-ventricular-assist-device-operation-in-vitro-and-in-vivo
#18
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
https://www.readbyqxmd.com/read/26344685/surgical-approach-to-continuous-flow-left-ventricular-assist-device-explantation-a-comparison-of-outcomes
#19
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
https://www.readbyqxmd.com/read/26223857/utility-of-cardiac-computed-tomography-for-inflow-cannula-patency-assessment-and-prediction-of-clinical-outcome-in-patients-with-the-heartmate-ii-left-ventricular-assist-device
#20
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
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