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Continuous flow left ventricular assist device

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https://www.readbyqxmd.com/read/29223289/frequency-and-consequences-of-right-sided-heart-failure-after-continuous-flow-left-ventricular-assist-device-implantation
#1
Chitaru Kurihara, Andre C Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Gabriel Loor, Andrew B Civitello, Jeffrey A Morgan
Postoperative right-sided heart failure (RHF) is a common complication after continuous-flow left ventricular assist device implantation. Studies have examined RHF in the perioperative period, but few have assessed late-onset RHF. We analyzed the incidence of early and late RHF in patients with HeartMate II and HeartWare left ventricular assist devices and associated morbidity, mortality, and independent predictors of RHF. We retrospectively analyzed records of 526 patients with chronic heart failure who underwent continuous-flow left ventricular assist device implantation; 147 (27...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29215366/implantable-cardioverter-defibrillators-and-survival-in-continuous-flow-left-ventricular-assist-device-patients
#2
Valentina Kutyifa, Genaro Fernandez, Saadia Sherazi, Mehmet Aktas, David Huang, Scott McNitt, Anna Papernov, Meng Wang, H Todd Massey, Leway Chen, Jeffrey D Alexis
The association of an implantable cardioverter defibrillator (ICD) with survival in patients with left ventricular assist devices (LVADs) is not well understood. We evaluated all-cause mortality by the presence of an ICD at the time of LVAD implantation, or by ICD implantation after LVAD placement in 191 patients, using Kaplan-Meier survival analyses and Cox models with multivariate adjustment. During the median follow-up of 23 months, 33 of 129 patients (26%) with an ICD and 17 of 62 patients (27%) without an ICD died...
December 5, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29210772/bleeding-complication-rates-are-higher-in-females-after-continuous-flow-left-ventricular-assist-device-implantation
#3
Zubin Yavar, Jennifer A Cowger, Sina L Moainie, Christopher T Salerno, Ashwin K Ravichandran
The aims of this analysis were to characterize the burden and timing of bleeding events in females versus males on left ventricular assist device (LVAD) support. A single-center retrospective review of 375 patients receiving continuous-flow LVADs was performed. Bleeding events included gastrointestinal, naso-oropharyngeal, gynecologic (GYN), intracranial hemorrhage (ICH), and mediastinal bleeding. Cox hazard ratios (HRs) [95% CI] and incident event rates for females versus males were calculated. Eighty-four females (22%) and 291 males (78%) received an LVAD...
November 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29206805/axial-to-centrifugal-continuous-flow-lvad-pump-exchange-using-minimally-invasive-technique
#4
Amit A Pawale, Ariel Farkash, Dimosthenis Pandis, Anelechi C Anyanwu
Driveline or device infection may complicate left ventricular assist device implants, and only curative option may be pump exchange. Replacement with similar device may be liable to reinfection, because pump configuration is such that the new device and driveline may partly lie within the pocket of the previous pump. One approach to overcome this is using a different pump design such that the new pump would lie in a different location from the old pump. We describe treatment of severe HeartMate II (Abbott, [St Jude Thoratec Corp], Pleasanton, CA USA) left ventricular assist device infection by minimally invasive exchange to an intrapericardial HVAD (HeartWare International, Inc, Framingham, MA USA) left ventricular assist device...
December 4, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29200070/perioperative-management-of-the-patient-with-a-left-ventricular-assist-device-for-noncardiac-surgery
#5
Mabel Chung
The pandemic of heart failure and the limited options for treatment of end-stage disease have resulted in an increase in the utilization of left ventricular assist devices (LVADs). Improvements in device technology and patient survival have led to an expanding population of patients requiring noncardiac surgery while on LVAD therapy, thus leading to a growing need for familiarity with the physiology of these patients. This review describes the functional mechanics of the most prevalent continuous-flow LVAD, the HeartMate II, and focuses on perioperative anesthetic concerns...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29198691/successful-liver-transplantation-from-a-donor-with-a-continuous-flow-left-ventricular-assist-device-for-9-months
#6
K Munawar, N Rajagopalan, A Grigorian, D Dennis, M Guglin
Organ donor criteria continue to be extended in an attempt to meet growing demands. Patients with continuous-flow left ventricular assist devices are one group of potential donors being considered. One concern with this group is the effect of continuous flow for a prolonged duration, as opposed to normal pulsatile flow, on end-organ function. We report the 1st case of a liver transplantation from a donor who had a continuous-flow left ventricular assist device for 9 months. The recipient was a 69-year-old woman with a history of cryptogenic cirrhosis and hepatocellular carcinoma...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29198630/long-term-survival-in-patients-receiving-a-continuous-flow-left-ventricular-assist-device
#7
Igor Gosev, Michael S Kiernan, Peter Eckman, Behzad Soleimani, Ahmet Kilic, Nir Uriel, Johnatan D Rich, Jason N Katz, Jennifer Cowger, Brian Lima, Siobhan McGurk, Meredith A Brisco-Bacik, Sanjin Lee, Susan M Joseph, Chetan B Patel
BACKGROUND: Long-term survivors after implantation of left ventricular assist devices (LVADs) are increasing in prevalence. We describe the characteristics and outcomes in patients surviving longer than 4 years on LVAD support. METHODS: We performed a multicenter, retrospective analysis of patients surviving at least 4 years on continuous-flow LVAD (CF-LVAD) support with a HeartMate II at centers participating in the Evolving Mechanical support Research Group. RESULTS: Between 2005 and 2010, 156 long-term survivors were identified with a mean survival of 7...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29191299/implantable-cardioverter-defibrillators-in%C3%A2-patients-with-a-continuous-flow-left%C3%A2-ventricular-assist-device-an-analysis-of%C3%A2-the-intermacs-registry
#8
Kevin J Clerkin, Veli K Topkara, Ryan T Demmer, Jose M Dizon, Melana Yuzefpolskaya, Justin A Fried, Xingchen Mai, Donna M Mancini, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, A Reshad Garan
OBJECTIVES: This study sought to determine if the presence of implantable cardioverter-defibrillators (ICD) provided a mortality benefit during continuous-flow left ventricular assist device (LVAD) support. BACKGROUND: An ICD decreases mortality in selected patients with advanced heart failure and have been associated with reduced mortality in patients with pulsatile LVAD. However, it is unclear whether that benefit extends to patients with a contemporary continuous-flow LVAD...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29179901/ct-imaging-of-complications-associated-with-continuous-flow-left-ventricular-assist-devices-lvads
#9
Girish S Shroff, Daniel Ocazionez, Bindu Akkanti, Daniel Vargas, Alheli Garza, Pushpender Gupta, Jayeshkumar A Patel, Manish K Patel, Igor D Gregoric
Heart failure is becoming increasingly prevalent, and more patients are being treated with left ventricular assist devices (LVADs), either as a bridge to transplant or as destination therapy. The use of continuous-flow LVADs is on the rise. LVAD therapy is associated with several classes of complications, including bleeding, thrombosis, and infection. CT imaging can be used effectively to diagnose LVAD complications, including mediastinal hematomas and pericardial, abdominal wall, and retroperitoneal hemorrhage, inflow and outflow graft and aortic thrombi, and driveline and pump pocket infections...
December 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/29177686/preclinical-animal-study-of-the-nipro-ventricular-assist-device-for-use-in-pediatric-patients
#10
Noritsugu Naito, Yoshiaki Takewa, Satoru Kishimoto, Kei Iizuka, Toshihide Mizuno, Tomonori Tsukiya, Minoru Ono, Eisuke Tatsumi
Although the outcomes of patients with end-stage heart failure treated with implantable left ventricular assist devices have improved, extracorporeal left ventricular assist devices continue to play an important role, especially in pediatric patients. The present study aimed to examine the long-term biocompatibility of a small-sized extracorporeal pneumatic left ventricular assist device (NIPRO-LVAD) used in a 30- to 90-day animal experiment. The NIPRO-LVAD was designed for pediatric patients or small-sized adults...
November 24, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29174532/acute-kidney-injury-and-1-year-mortality-after-left-ventricular-assist-device-implantation
#11
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Kavita Sharma, Nisha A Gilotra, Alina A Constantinescu, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Stuart D Russell, Olivier C Manintveld
BACKGROUND: Data on the consequences of acute kidney injury (AKI) after continuous-flow left ventricle assist device (LVAD) implantation are scarce and inconsistent. In this study, we evaluated the incidence, predictors and the impact of AKI on mortality and renal function in the first year after LVAD implantation. METHODS: A retrospective, multicenter cohort study was conducted, including all patients (age ≥18 years) undergoing LVAD implantation (91% with a HeartMate II device and 9% with a HeartWare device)...
November 6, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29172742/the-risk-of-right-ventricular-failure-with-current-continuous-flow-left-ventricular-assist-devices
#12
Antonio Loforte, Francesco Grigioni, Giuseppe Marinelli
Right ventricular failure (RVF) still results as the major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Despite overall improved outcomes and lower rates of RVF with the use of the newer, continuous-flow (CF) LVADs over pulsatile-flow devices, and development of clinical prediction scores to facilitate preoperative identification of patients at risk for RVF after implantation, RVF occurs in 13% to 40% of continuous-flow device. Areas covered: In this article, a review has been carried out on the current evidence for preoperative assessment of RV function and RVF risk for appropriate patient selection mainly focusing on current imaging and invasive assessment tools...
November 25, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29164425/outflow-graft-anastomosis-site-design-could-be-correlated-to-aortic-valve-regurgitation-under-left-ventricular-assist-device-support
#13
Kei Iizuka, Tomohiro Nishinaka, Yuki Ichihara, Takuma Miyamoto, Kenji Yamazaki
Aortic valve regurgitation (AR) is a critical complication during circulatory support with a left ventricular assist device (LVAD). The time-course of AR and related factors, including outflow graft anastomosis site design, were investigated. Twenty-three patients who had continuous-flow LVAD implantation and were supported for more than 6 months were investigated. AR grade (none, 0; trivial, 0.5; mild, 1; mild-moderate, 1.5; moderate, 2; moderate-severe, 2.5; severe, 3) and aortic valve opening were evaluated with echocardiography...
November 21, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29158058/regional-cerebral-oxygen-saturation-level-predicts-30-day-mortality-rate-after-left-ventricular-assist-device-surgery
#14
Soutik Ghosal, Jaimin Trivedi, James Chen, Michael P Rogers, Allen Cheng, Mark S Slaughter, Maiying Kong, Jiapeng Huang
OBJECTIVE: Left ventricular assist device (LVAD) surgery is complex, high risk, and expensive. The authors' hypothesis is baseline regional cerebral oxygen saturation (rSO2) might be a predictor of postoperative clinical outcomes. DESIGN: Retrospective review of 210 consecutive continuous flow LVAD patients between 2008 and 2014. The primary measure is 30-day mortality rate and secondary measures include modified major adverse cardiocerebral events (MACE), length of stay (LOS), and intensive care unit (ICU) stay...
August 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29157741/biventricular-support-with-intracorporeal-continuous-flow-centrifugal-ventricular-assist-devices
#15
Francisco A Arabía, Carmelo A Milano, Claudius Mahr, Edwin C McGee, Nahush A Mokadam, J Eduardo Rame, Jaime D Moriguchi, Danny Ramzy, David C Naftel, Susan L Myers, James K Kirklin
BACKGROUND: The incidence of right ventricular dysfunction requiring right ventricular assist device after left ventricular assist device placement has been reported between 10% to 30%. The mortality rate is higher compared with patients who require left ventricular assist device only; the most effective and safest biventricular assist device remains unknown. We aimed to determine the survival outcomes and frequency of adverse events in patients with two durable, intracorporeal, continuous flow centrifugal pumps for support...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29156176/management-of-patients-with-left-ventricular-assist-devices-requiring-teeth-extraction-is-halting-anticoagulation-appropriate
#16
Visakha Suresh, Muath Bishawi, Michael W Manning, Chetan Patel, Joseph Rogers, Carmelo Milano, Jacob Schroder, Mani Daneshmand, David Powers
PURPOSE: An increasing number of patients with end-stage heart failure are supported with left ventricular assist device (LVAD) implantation and must be maintained on a consistent anticoagulation regimen. Pre-emptive extraction of carious teeth in these patients is necessary to prevent seeding of the implanted device and endocarditis. Thus, the objective of this study was to evaluate bleeding complications after minor oral surgery, specifically teeth extractions, in this unique patient population requiring long-term anticoagulation...
October 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29150326/concomitant-mitral-valve-procedures-in-patients-undergoing-implantation-of-continuous-flow-left-ventricular-assist-devices-an-intermacs-database-analysis
#17
Jason O Robertson, David C Naftel, Susan L Myers, Ryan J Tedford, Susan M Joseph, James K Kirklin, Scott C Silvestry
BACKGROUND: Management of existing mitral valve (MV) disease in patients undergoing left ventricular assist device (LVAD) implantation remains controversial. METHODS: Among continuous-flow LVAD patients with moderate to severe mitral regurgitation entered into the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database between April 2008 and March 2014 (n = 4,930), outcomes were compared between patients who underwent MV repair (MVr, n = 252), MV replacement (MVR, n = 11) and no MV procedure (no MVP, n = 4,667)...
October 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29148023/fluid-structure-interaction-model-analysis-of-cerebrospinal-fluid-circulation-in-patients-with-continuous-flow-left-ventricular-assist-devices
#18
Jessica G Y Luc, Clifford A Pierre, Kevin Phan, Yashar S Vahedein, Alexander S Liberson, William K Cornwell, Steven J Phillips, Vakhtang Tchantchaleishvili
PURPOSE: The current 1-dimensional fluid structure interaction model (FSI) for understanding cerebrospinal fluid (CSF) circulation requires pulsatility as a precondition and has not been applied to patients with continuous-flow left ventricular assist devices (CF-LVAD) where pulsatility is chronically reduced. Our study aims to characterize the behavior of CSF pressure and flow in patients with CF-LVADs using a computational FSI model. METHODS: Utilizing the computational FSI model, CSF production in choroid plexuses of the 4 ventricles was specified as a boundary condition for the model...
November 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29141860/multicenter-evaluation-of-octreotide-as-secondary-prophylaxis-in-patients-with-left-ventricular-assist-devices-and-gastrointestinal-bleeding
#19
MULTICENTER STUDY
Keyur B Shah, Sampath Gunda, Sitaramesh Emani, Manreet K Kanwar, Nir Uriel, Paolo C Colombo, Patricia A Uber, Melissa L Sears, Joyce Chuang, David J Farrar, Donald F Brophy, George B Smallfield
BACKGROUND: Gastrointestinal (GI) bleeding is one of the most common complications after continuous-flow left ventricular assist device implantation. More than one third of patients with incident bleed go on to develop recurrent GI bleeding. Octreotide, a somatostatin analog, is proposed to reduce the risk of recurrent GI bleeding in this population. METHODS AND RESULTS: This multicenter, retrospective analysis evaluated 51 continuous-flow left ventricular assist device patients who received secondary prophylaxis with octreotide after their index GI bleed from 2009 to 2015...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29141690/resternotomy-does-not-adversely-affect-outcome-after-left-ventricular-assist-device-implantation
#20
Maria Papathanasiou, Loukas Tsourelis, Nikolaus Pizanis, Achim Koch, Markus Kamler, Tienush Rassaf, Peter Luedike
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients...
November 15, 2017: European Journal of Medical Research
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