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Continuous flow left ventricular assist device

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https://www.readbyqxmd.com/read/29433532/is-there-a-difference-in-bleeding-after-left-ventricular-assist-device-implant-centrifugal-versus-axial
#1
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29430470/transjugular-intrahepatic-portosystemic-shunt-for-refractory-variceal-bleeding-in-a-patient-with-a-left-ventricular-assist-device
#2
Anusha Shirwaikar Thomas, Jerry Estep, David W Victor
Transjugular intrahepatic portosystemic shunt (TIPS) is an attractive therapeutic option in cirrhotic patients with recurrent variceal bleeding refractory to medical and endoscopic therapy. There is little known about the use of TIPS in patients with left ventricular assist devices (LVAD). We describe a patient with a durable continuous-flow LVAD and concurrent decompensated cardiac cirrhosis who underwent successful TIPS placement for recurrent variceal bleeding. The patient has had no rebleeding or encephalopathy in >12 months since TIPS placement...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29427603/long-acting-octreotide-reduces-the-recurrence-of-gastrointestinal-bleeding-in-patients-with-a-continuous-flow-left-ventricular-assist-device
#3
Colleen Juricek, Teruhiko Imamura, Ann Nguyen, Ben Chung, Daniel Rodgers, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyohi Ota, Tae Song, Daniel Burkhoff, Gabriel Sayer, Valluvan Jeevanandam, Nir Uriel
BACKGROUND: Recurrent gastrointestinal bleeding is one of the most significant adverse events in patients with left ventricular assist devices (LVAD). METHODS: We enrolled LVAD patients who had received an intramuscular injection of 20 mg of octreotide LR every 4 weeks as secondary prevention for recurrent gastrointestinal bleeding despite conventional medical therapies and repeated transfusions. The frequency of gastrointestinal bleeding and other associated clinical outcomes before and during octreotide therapy were compared...
February 7, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29419537/modification-of-a-ventricular-assistance-device-for-a-hemiplegic-left-ventricular-assist-device-patient
#4
Rahatullah Muslem, Yunus C Yalçin, Kadir Caliskan, Cees van der Heiden, Hans van Rhijn, Ad J J C Bogers, Olivier C Manintveld
Neurologic events occur in up to 18% of patients with continuous-flow left ventricular assist devices (LVAD) and is associated with significant morbidity and mortality. The current form of the LVAD equipment is not suited to serve patients who are impaired by a stroke. By creating an assistance device for the LVAD equipment, we have been able to greatly improve the quality of life and self-dependence of a hemiplegic LVAD patient.
February 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29417325/preoperative-right-sided-cardiac-congestion-is-associated-with-gastrointestinal-bleeding-in-patients-with-continuous-flow-left-ventricular-assist-devices
#5
Yutaka Tomizawa, Akiko Tanaka, Hiroto Kitahara, Atsushi Sakuraba, Nir Uriel, Valluvan Jeevanandam, Takeyoshi Ota
BACKGROUND: Large scale data on preoperative risk stratification for gastrointestinal bleeding (GIB) following continuous-flow left ventricular assist device (CF-LVAD) implantation are scarce. AIMS: To identify independent predictors for GIB following CF-LVAD implantation. METHODS: We conducted a retrospective cohort study of consecutive 243 patients who underwent CF-LVAD implantation (HeartMateII) from January 2009 to March 2015 at the University of Chicago Medical Center...
February 8, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29406356/gastrointestinal-bleeding-in-left-ventricular-assist-device-octreotide-and-other-treatment-modalities
#6
Tara L Molina, Jill Krisl, Kevin Donahue, Sara Varnado
Left ventricular assist devices (LVADs) offer a therapeutic strategy for patients with end-stage heart failure. Increased device utilization has also increased the incidence of device-related complications including gastrointestinal bleeding (GIB). Multiple mechanisms have been proposed in the pathophysiology of continuous-flow LVAD-associated GIB including physiologic changes associated with high shear and nonpulsatile flow such as gastrointestinal arteriovenous malformations and acquired von Willebrand syndrome...
February 5, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29402604/limited-usefulness-of-endoscopic-evaluation-in-patients-with-continuous-flow-left-ventricular-assist-devices-and-gastrointestinal-bleeding
#7
Jordan E Axelrad, Alberto Pinsino, Pauline N Trinh, Anusorn Thanataveerat, Christian Brooks, Ryan T Demmer, Lisa Effner, Grant Parkis, Barbara Cagliostro, Jiho Han, A Reshad Garan, Veli Topkara, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Ivonne Ramirez, Reuben Garcia-Carrasquillo, Paolo C Colombo, Tamas Gonda, Melana Yuzefpolskaya
BACKGROUND: Gastrointestinal bleeding (GIB) is a frequent cause of re-admission in patients with continuous-flow left ventricular assist devices (CF-LVADs) and is associated with multiple endoscopic procedures and high resource utilization. Our aim was to determine the diagnostic and therapeutic yield of endoscopy and to develop a more cost-effective approach for the management of GIB in CF-LVAD recipients. METHODS: We retrospectively reviewed 428 patients implanted with a CF-LVAD between 2009 and 2016 at the Columbia University Medical Center and identified those hospitalized for GIB...
December 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29400088/effects-of-continuous-and-pulsatile-flows-generated-by-ventricular-assist-devices-on-renal-function-and-pathology
#8
Takuma Miyamoto, Jamshid H Karimov, Kiyotaka Fukamachi
Continuous-flow (CF) left ventricular assist devices (LVADs) are widely used to treat end-stage heart failure. Despite substantial improvement in clinical results, numerous complications remain associated with this technology. Worsening renal function is one, associated with morbidity and mortality in patients supported by CF LVADs. The effects of CF LVAD support on renal function have been investigated since the mid-1990s by many research groups. Area covered: We review the current status of LVAD therapy, experimental results regarding the effects of types of flow generated by LVADs on renal function and pathology, changes in renal function after LVAD implant, the influence of renal function on outcomes, and risk factors for renal dysfunction post implant...
February 5, 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29397927/impact-of-obesity-on-readmission-in-patients-with-left-ventricular-assist-devices
#9
Jiho Han, Christine M Mauro, Paul A Kurlansky, Shinichi Fukuhara, Melana Yuzefpolskaya, Veli K Topkara, A Reshad Garan, Paolo C Colombo, Hiroo Takayama, Yoshifumi Naka, Koji Takeda
BACKGROUND: Hospital readmissions have an adverse effect on the quality of life in patients with end-stage heart failure. We examined the temporal pattern, predictors, and outcomes of readmission in continuous flow left ventricular assist device-supported patients. METHODS: We retrospectively reviewed inpatient data of 350 consecutive patients who received a continuous-flow left ventricular assist device at our center between May 2004 and December 2014. A total time-restricted model was used to estimate hazard ratios for readmission, and the Nelson nonparametric method was used to estimate mean cumulative function for each cause of readmission...
February 1, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29392845/recurrence-of-eosinophilic-granulomatosis-with-polyangitis-after-orthotopic-heart-transplant
#10
Ujjwal Rastogi, Ziad Sergie, Sean Pinney, Noah Moss
Eosinophilic granulomatosis with polyangitis (EGPA), previously referred to as Churg-Strauss syndrome, is a necrotizing small vessel vasculitis associated with eosinophilic infiltrates and extravascular granulomas. We report a case of a Caucasian woman successfully bridged to heart transplantation with a continuous flow left ventricular assist device (LVAD) who survived recurrence of EGPA in the allograft. This article is protected by copyright. All rights reserved.
February 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29372417/effect-of-obesity-on-outcomes-in-patients-undergoing-implantation-of-continuous-flow-left-ventricular-assist-devices
#11
Nastasya Volkovicher, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Andrew B Civitello, Jeffrey A Morgan
The purpose of this study was to analyze the effect of obesity on outcomes after continuous-flow left ventricular assist device (CF-LVAD) implantation. A single-center retrospective analysis was performed on 526 chronic heart failure patients who were implanted with the HeartMate II CF-LVAD (n = 403) or HeartWare HVAD (n = 123) between November 2003 and March 2016. Patients were stratified into 4 groups based on BMI: underweight (< 18.5 kg/m2, n = 18, 3.4%), normal-weight (18.5-25 kg/m2, n = 173, 32...
January 25, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29361299/extracorporeal-membrane-oxygenation-as-a-direct-bridge-to-heart-transplantation-in-adults
#12
Shinichi Fukuhara, Koji Takeda, Paul A Kurlansky, Yoshifumi Naka, Hiroo Takayama
OBJECTIVES: Venoarterial extracorporeal membrane oxygenation (ECMO) use as a bridge to transplant is extremely infrequent in adults. We investigated patient outcomes of the use of ECMO as bridge to transplant. METHODS: United Network of Organ Sharing provided de-identified patient-level data. Between 2003 and 2016, 25,168 adult recipients were identified. Of these, 107 (0.4%) were bridged with ECMO and 6148 (24.4%) were bridged with a continuous-flow left ventricular assist device...
December 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29346259/do-patients-supported-with-continuous-flow-left-ventricular-assist-device-cf-lvads-have-a-sufficient-risk-of-death-to-justify-a-priority-allocation-a-propensity-score-matched-analysis-of-patients-listed-in-unos-status-2
#13
Stefano Mastrobuoni, Angelo Maria Dell'Aquila, Olivier Van Caenegem, Alain Poncelet, Luc-Marie Jacquet, Josè Garcia
BACKGROUND: Outcomes of Continuous Flow Left Ventricular Assist Devices (CF-LVADs) as bridge to transplant have significantly improved. The question has arisen whether patients on CF-LVADs have an increased risk of death on the waiting list as to justify a priority allocation (status 1). The aim of this study was to compare the survival following implantation of CF-LVADs to the survival on the waiting list for patients initially listed in United Network for Organ Sharing (UNOS) status 2...
January 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29336405/looking-inside-the-third-generation-left-ventricular-assist-device-using-color-doppler-transesophageal-echocardiography
#14
Ankit Jain, Frederick C Cobey
HeartWare is a third-generation continuous flow left ventricular assist device (LVAD) and generates centrifugal pattern of blood flow. In the perioperative setting, interrogating the HeartWare devices is very difficult due to the interference of the Doppler by the impeller frequency and generation of the waterfall artifact. We present a case where using color Doppler a view "inside" the impeller can be seen which corresponds to the centrifugal flow of blood. With time, these images can be looked into in pathological states such as pump thrombosis, to come to a more meaningful conclusion regarding the flow of blood within the centrifugal chamber...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29319565/left-ventricular-assist-device-as-destination-therapy-for-end-stage-heart-failure-the-right-time-for-the-right-patients
#15
Naoto Fukunaga, Vivek Rao
PURPOSE OF REVIEW: Cardiac transplantation is the gold standard treatment for patients with end-stage heart failure. Unfortunately, the demand for donor organs far outstrips the number of available hearts. Therefore, not all patients who can benefit from this therapy are even listed for transplant. Once destination therapy was approved for the long-term support of nontransplant eligible patients, it was felt that the number of durable ventricular assist device (VAD) implants would increase...
March 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29306620/anesthetic-management-of-patients-with-continuous-flow-left-ventricular-assist-devices-undergoing-noncardiac-surgery-an-update-for-anesthesiologists
#16
REVIEW
Adam A Dalia, Brett Cronin, Marc E Stone, Katja Turner, Jennifer Hargrave, Marcos F Vidal Melo, Michael Essandoh
No abstract text is available yet for this article.
November 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29305851/quantitative-assessment-of-inflow-malposition-in-two-continuous-flow-left-ventricular-assist-devices
#17
Erik N Sorensen, Zachary N Kon, Erika D Feller, Si M Pham, Bartley P Griffith
BACKGROUND: We previously investigated preoperative variables associated with qualitative inflow cannula (IFC) malposition in the Heartmate II continuous-flow left ventricular assist device. In this report, we assess IFC malposition quantitatively in recipients of both the Heartmate II and the Heartware and examine its association with device thrombosis. METHODS: Malposition was quantified based on angular deviation from a hypothetical ideal IFC position in two orthogonal computed tomography (CT) imaging planes...
January 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29290308/continuous-flow-left-ventricular-assist-device-implantation-in-patients-with-a-small-left-ventricle
#18
Masashi Kawabori, Chitaru Kurihara, Tadahisa Sugiura, William E Cohn, Andrew B Civitello, O Howard Frazier, Jeffrey A Morgan
BACKGROUND: Having a preoperative small left ventricle (LV) has been associated with higher complication and mortality rates after left ventricular assist device (LVAD) implantation; however, the outcomes after continuous-flow LVAD implantation have not been well studied. This is the first large-scale analysis of long-term survival after continuous-flow LVAD implantation in patients with a preoperative small LV. METHODS: Our cohort comprised 511 patients who underwent primary implantation of a HeartMate II (n = 393 [Thoratec, Pleasanton, CA]) or HeartWare HVAD (n = 118 [HeartWare International, Framingham, MA]) at our institution between November 2003 and March 2016...
December 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29282819/platelet-activation-is-a-preoperative-risk-factor-for-the-development-of-thromboembolic-complications-in-patients-with-continuous-flow-left-ventricular-assist-device
#19
Filippo Consolo, Giulia Sferrazza, Giulia Motolone, Rachele Contri, Lorenzo Valerio, Rosalba Lembo, Loris Pozzi, Patrizia Della Valle, Michele De Bonis, Alberto Zangrillo, Gianfranco B Fiore, Alberto Redaelli, Marvin J Slepian, Federico Pappalardo
AIMS: To correlate the dynamics of platelet activation with the development of thromboembolic events in patients with continuous-flow left ventricular assist device (cf-LVAD). METHODS AND RESULTS: The platelet activity state (PAS) assay was utilized to evaluate platelet activation in 68 cf-LVAD patients implanted with the HeartMate II (n = 15, 22%), HeartMate 3 (n = 15, 22%), or HeartWare HVAD (n = 38, 56%). PAS was measured preoperatively, early post-implant, and at long-term follow-up (1, 3, 6, 12, 18, and 24 months post-implant)...
December 28, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29273909/emergency-department-visits-among-patients-with-left-ventricular-assist-devices
#20
Christopher R Tainter, Oscar Ö Braun, Felipe Teran, Albert P Nguyen, Kimberly Robbins, Edward O O'Brien, Zeb M McMillan, Ulrich Schmidt, Angela Meier, Mat Goebel, Victor Pretorius, Michela Brambatti, Eric D Adler, Raghu Seethala
Continuous-flow left ventricular assist devices (LVADs) are increasingly implanted to support patients with end-stage heart failure. These patients are at high risk for complications, many of which necessitate emergency care. While rehospitalization rates have been described, there is little data regarding emergency department (ED) visits. We hypothesize that ED visits are frequent and often require admission after LVAD implantation. We performed a retrospective review of patients in our health-care system followed by the advanced heart failure service for LVAD management after implantation between January 2011 and July 2015...
December 22, 2017: Internal and Emergency Medicine
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