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Antonio Loforte, Andrea Montalto, Francesco Musumeci, Cristiano Amarelli, Carlo Mariani, Vincenzo Polizzi, Paola Lilla Della Monica, Francesco Grigioni, Roberto Di Bartolomeo, Giuseppe Marinelli
Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88)...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Roland Hetzer, Mariano Francisco Del Maria Javier, Eva Maria Delmo Walter
Background: While heart transplantation has gained recognition as the gold standard therapy for advanced heart failure, the scarcity of donor organs has become an important concern. The evolution of surgical alternatives such as ventricular assist devices (VADs), allow for recovery of the myocardium and ensure patient survival until heart transplantation becomes possible. This report elaborates the role of VADs as a bridge to heart transplantation in infants and children (≤18 years old) with end-stage heart failure...
January 2018: Annals of Cardiothoracic Surgery
Anna K Schmidt, Diyar Saeed, Arash Mehdiani, Bozena Sowinski, Ralf Westenfeld, Payam Akhyari, Artur Lichtenberg, Udo Boeken
INTRODUCTION: In times of organ shortage, death while on the heart waiting-list still represents a major problem. As a consequence, bridging to transplant as well as the decision when to escalate therapy play a very important role. METHODS AND RESULTS: We report on two young patients with dilated cardiomyopathy and acute decompensation who were successfully bridged to heart transplantation with both left and temporary right ventricular assist devices in just 2 months...
October 27, 2017: International Journal of Artificial Organs
Felix Schoenrath, Dennis Hoch, Francesco Maisano, Christoph T Starck, Burkhardt Seifert, Urs Wenger, Frank Ruschitzka, Markus J Wilhelm
BACKGROUND: Mechanical circulatory support is increasingly used in acute cardiogenic shock. OBJECTIVE: To assess treatment strategies for cardiogenic shock. METHODS: Data of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed.​ RESULTS: Overall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6...
September 2016: Heart & Lung: the Journal of Critical Care
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
Michael Dandel, Thomas Krabatsch, Volkmar Falk
Left ventricular assist devices (LVADs) are safer and provide better survival and better quality of life than biventricular assist devices (BVADs) but end-stage heart failure often involves both ventricles, even if its initial cause was left-sided heart disease. Right ventricular failure (RVF) is also a severe complication in about 25% of patients receiving an LVAD, with high perioperative morbidity (renal, hepatic or multi-organ failure) and mortality. Patients who receive an RV assist device (RVAD) only days after LVAD insertion fare much worse than those who receive an RVAD simultaneously with LVAD implantation...
November 1, 2015: International Journal of Cardiology
Martin Schweiger, Volkmar Falk, Mirko Biry, Michael Hübler, Markus J Wilhelm
INTRODUCTION: Miniaturization and surgical progress in the field of ventricular assist device (VAD) therapy will lead to an increasing use in grown-up patients with congenital heart disease (GUCH). VAD implantation in such patients, especially biventricular VAD (BVAD) placement, can be very challenging, potentially associated with high morbidity and mortality. METHODS AND RESULTS: We report on a 47-year-old male patient in terminal biventricular failure with pulmonary hypertension 40 years after a Mustard procedure...
April 2015: International Journal of Artificial Organs
Roland Hetzer, Oliver Miera, Joachim Photiadis, Edwald Hennig, Christoph Knosalla, Eva Maria Delmo Walter
The use of mechanical circulatory support devices to keep patients alive until transplantation has become essential in the face of an increasing organ shortage. We report successful heart transplantations after 841 days of left ventricular assist device (LVAD) support in a child with hypoplastic left heart syndrome, and after 547 days of biventricular assist device (BVAD) support in another child with cardiomyopathy. To our knowledge, this report is the first on the longest-term (841 days) LVAD and the longest-term (547 days) BVAD support in children who were mobile and awake during the support, as a most effective bridge to heart transplantation...
November 2014: Annals of Thoracic Surgery
Thomas Strecker, Johannes Rösch, Michael Weyand, Abbas Agaimy
BACKGROUND AND AIM: Ventricular assist devices (VAD) have become an established therapy for patients with end-stage heart failure. The two main reasons for this development are the shortage of appropriate donor organs and the increasing number of patients waiting for heart transplantation (HTX). Furthermore, the enormous advances in the technical equipment and the rising clinical experience have improved the implantation technique, the durability and the long-term patient outcomes. METHODS: We reviewed all cases of left ventricular assist device (LVAD) implantation at our Erlangen Heart Center during January 2000-July 2013...
2014: International Journal of Clinical and Experimental Pathology
Daisuke Yoshioka, Koichi Toda, Yasushi Yoshikawa, Yoshiki Sawa
We report the successful longest biventricular support using dual Jarvik 2000 biventricular assist device (BVAD; Jarvik Heart, Inc., New York, NY, USA) as a bridge to transplant. A 27-year old woman with arrhythmogenic right ventricular cardiomyopathy underwent implantation of two Jarvik 2000s as a left ventricular assist device and right ventricular assist device. Although several BVAD-related complications including haemolysis, hepatic dysfunction, heart failure and pulmonary valve insufficiency developed at a very late stage, she was successfully bridged to heart transplantation after 1245 days of biventricular support, which is the longest in the literature...
December 2014: Interactive Cardiovascular and Thoracic Surgery
Richard J Blanch, Zubair Ahmed, Adam R Thompson, Nsikan Akpan, David R J Snead, Martin Berry, Carol M Troy, Robert A H Scott, Ann Logan
PURPOSE: Ocular trauma is common in civilian and military populations. Commotio retinae involves acute disruption of photoreceptor outer segments after blunt ocular trauma, with subsequent photoreceptor apoptosis causing permanent visual impairment. The mechanisms of photoreceptor death in commotio retinae have not previously been described, although caspase-dependent death is important in other nontraumatic retinal degenerations. We assessed the role of caspase-9 as a mediator of photoreceptor death in a rat model of ballistic ocular trauma causing commotio retinae...
October 2014: Investigative Ophthalmology & Visual Science
Antonio Loforte, Francesco Musumeci, Andrea Montalto, Emanuele Pilato, Paola Lilla Della Monica, Francesco Grigioni, Roberto Di Bartolomeo, Giuseppe Marinelli
BACKGROUND: Mechanical circulatory support (MCS) is the standard therapy for the management of acute or chronic end-stage heart failure. We report on our two-center experience with MCS therapy. METHODS: Between January 2000 and December 2012, 116 adult patients (mean age 56.8 ± 9.9 years, range: 31 to 76 years) were primarily supported on temporary or long-term ventricular assist devices (VADs) or total artificial hearts (TAHs) at our institutions. Temporary extracorporeal radial VAD support was established in 50 patients (43...
September 2014: Journal of Cardiac Surgery
A Loforte, A Montalto, P Lilla della Monica, A Lappa, C Contento, A Menichetti, F Musumeci
BACKGROUND: Currently, ventricular assist device (VAD) or total artificial heart (TAH) mechanical support provides an effective treatment of unstable patients with advanced heart failure. We report our single-center experience with mechanical circulatory support therapy. METHODS: From March 2002 to December 2012, 107 adult patients (mean age, 56.8 ± 9.9 y; range, 31-76 y) were primarly supported on temporary or long-term VAD or TAH support as treatment for refractory heart failure at our institution...
June 2014: Transplantation Proceedings
D Reser, G M Fröhlich, B Seifert, M L Lachat, S Jacobs, F Enseleit, F Ruschitzka, V Falk, M J Wilhelm
INTRODUCTION: There are conflicting reports on the posttransplantation morbidity and mortality of patients listed urgently and/or supported by a ventricular assist device (VAD). The aim of this study was to analyze the outcomes with regard to pretransplantation condition (elective, urgent, VAD). METHODS: All adult recipients between January 1, 2005, and October 31, 2012, were included. Demographics; preoperative, operative, and postoperative data; outpatient follow-up; and donor characteristics were collected and analyzed...
June 2014: Transplantation Proceedings
Antonio Loforte, Alexander Stepanenko, Evgenij V Potapov, Francesco Musumeci, Nikolay Dranishnikov, Martin Schweiger, Andrea Montalto, Miralem Pasic, Yuguo Weng, Michael Dandel, Henryk Siniawski, Marian Kukucka, Thomas Krabatsch, Roland Hetzer
Early planned institution of temporary right ventricular assist device (RVAD) support with the CentriMag (Levitronix LLC, Waltham, MA, USA) in left ventricular assist device (LVAD) recipients was compared with permanent biventricular assist device (BVAD) or total artificial heart (TAH) support. Between 2007 and 2011, 77 patients (age range: 25-70 years) with preoperative evidence of biventricular dysfunction (University of Pennsylvania score >50; University of Michigan score >5) were included. Forty-six patients (38 men; median age 54...
June 2013: Artificial Organs
Martin Schweiger, Julia Schrempf, Michael Sereinigg, Günther Prenner, Karlheinz H Tscheliessnigg, Andre Wasler, Jacub Krumnikel, Andreas Gamillschegg, Igor Knez
In chronic cardiomyopathy, mechanical circulatory support (MCS) plays an increasingly important role for children as the shortage of suitable donor hearts increases waiting time on the transplant list. We report our experience with the paracorporal Berlin Heart EXCOR System (Berlin Heart AG, Berlin, Germany) used as a biventricuclar assist device (BVAD). Nine patients with a BVAD EXCOR system were treated between 2006 and 2012; out of these patients, four were less than 18 years old (6, 14, 14, and 17 years old)...
August 2013: Artificial Organs
G Brancaccio, S Filippelli, G Michielon, R Iacobelli, S Alfieri, F Gandolfo, G Pongiglione, S Albanese, G Perri, F Parisi, A Carotti, A Amodeo
PURPOSE: Despite the remarkable advances with the use of ventricular assist devices (VAD) in adults, pneumatic pulsatile support in children is still limited. We report on our experience in the pediatric population. METHODS: Retrospective review of 27 consecutive children offered mechanical support with Berlin Heart as a bridge to heart transplant, and Jarvik 2000 as a destination therapy from February 2002 to October 2011. RESULTS: The median patient age was 4...
September 2012: Transplantation Proceedings
Evgenij Potapov, Martin Schweiger, Juliane Vierecke, Micheal Dandel, Alexander Stepanenko, Marian Kukucka, Beate Jurmann, Roland Hetzer, Thomas Krabatsch
During biventricular assist device (BVAD) support, right ventricular (RV) assistance may restore sufficient RV function after several weeks to months. Since November 2009, 10 patients (9 men and 1 woman; mean age, 49.7 ± 14.4 y) suffering from idiopathic dilatative cardiomyopathy received BVAD employing two implantable continuous-flow pumps of the HeartWare type. In three male patients, aged 53, 57, and 60 years, after a right ventricular assist device (RVAD) support time of 15.6, 11.2, and 3.6 months, respectively, the RVAD was stopped, and the percutaneous lead was surgically shortened in two cases...
January 2012: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Valérie Stolt, Stéphane Cook, Lorenz Räber, Sunil Wani, Ali Garachamani, Rolf Vogel, Christian Seiler, Stephan Windecker, Bernhard Meier
BACKGROUND: Iatrogenic free wall cardiac perforation is a rare but serious complication encountered during percutaneous cardiac procedures, which usually leads to tamponade and death. Septal occluder devices have been developed for sealing intracardiac shunts but may be also used in this emergency setting. METHODS AND RESULTS: We report a small series of five consecutive cases of iatrogenic heart perforations that were treated with implantation of Amplatzer Septal Occluders (ASO)...
February 1, 2012: Catheterization and Cardiovascular Interventions
Urs Benck, Simone Hoeger, Paul T Brinkkoetter, Uwe Gottmann, Duygu Doenmez, Detlef Boesebeck, Werner Lauchart, Jan Gummert, Matthias Karck, Hans B Lehmkuhl, Hartmuth B Bittner, Andreas Zuckermann, Florian Wagner, Uwe Schulz, Achim Koch, Amir K Bigdeli, Christoph Bara, Stephan Hirt, Michael Berchtold-Herz, Stefan Brose, Ulf Herold, Johannes Boehm, Henryk Welp, Thomas Strecker, Andreas Doesch, Rainer Birck, Bernhard K Krämer, Benito A Yard, Peter Schnuelle
OBJECTIVES: We determined the outcome of cardiac allografts from multiorgan donors enrolled in a randomized trial of donor pre-treatment with dopamine. BACKGROUND: Treatment of the brain-dead donor with low-dose dopamine improves immediate graft function after kidney transplantation. METHODS: A cohort study of 93 heart transplants from 21 European centers was undertaken between March 2004 and August 2007. We assessed post-transplant left ventricular function (LVF), requirement of a left ventricular assist device (LVAD) or biventricular assist device (BVAD), need for hemofiltration, acute rejection, and survival of recipients of a dopamine-treated versus untreated graft...
October 18, 2011: Journal of the American College of Cardiology
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