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Continuous flow left ventricular assist device

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https://www.readbyqxmd.com/read/28319523/plasma-levels-of-microrna-155-are-upregulated-with-long-term-left-ventricular-assist-device-support
#1
Teresa Wang, Emily C OʼBrien, Joseph G Rogers, Daniel L Jacoby, Michael E Chen, Jeffrey M Testani, Dawn E Bowles, Carmelo A Milano, G Michael Felker, Chetan B Patel, Pramod N Bonde, Tariq Ahmad
Left ventricular assist device (LVAD) therapy unloads the failing heart but exposes the human body to unique pathophysiological demands such as continuous blood-flow and complete univentricular support, which are associated with increased risk of adverse clinical outcomes. MiRNAs are 22-23 nucleotide RNAs involved in regulation of multiple biological processes including the pathogenesis of heart failure (HF). Thus, measurement of miRNAs may have potential in both diagnostics as circulating biomarkers, and in therapeutics for targeted interventions...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28319521/warfarin-and-aspirin-versus-warfarin-alone-for-prevention-of-embolic-events-in-patients-with-a-heartmate-ii%C3%A2-left-ventricular-assist-device
#2
Joseph S Van Tuyl, Ian B Hollis, Khalid A Alburikan, Richard Tran, Brian P Murray, Jo E Rodgers, Jason N Katz, Brett C Sheridan
Acquired von Willebrand disease increases bleeding risk in patients implanted with a continuous-flow left ventricular assist device. Lower aspirin doses decrease the risk of bleeding without an increased risk of embolic events. No published studies in the U.S. have compared the incidence of bleeding and thrombotic events between antithrombotic regimens with and without aspirin. A single-center, retrospective analysis was conducted of adult patients implanted with a HM II. Patients received warfarin and aspirin 81 mg daily or warfarin alone...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28288574/association-of-global-and-disease-specific-health-status-with-outcomes-following-continuous-flow-left-ventricular-assist-device-implantation
#3
Kelsey M Flint, John A Spertus, Fengming Tang, Philip Jones, Timothy J Fendler, Larry A Allen
BACKGROUND: The prognostic value of heart failure specific and global health status before and after left ventricular assist device (LVAD) implantation in the usual care setting is not well studied. METHODS: We included 3,836 continuous-flow LVAD patients in the INTERMACS registry. Health status was measured pre-operatively and 3 months post-LVAD using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol visual analog scale (VAS). Primary outcomes were mortality/rehospitalization...
March 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28285118/dynamic-changes-in-aortic-vascular-stiffness-in-patients-bridged-to-transplant%C3%A2-with-continuous-flow-left%C3%A2-ventricular-assist-devices
#4
Amit C Patel, R Blair Dodson, William K Cornwell, Kendall S Hunter, Joseph C Cleveland, Andreas Brieke, JoAnn Lindenfeld, Amrut V Ambardekar
OBJECTIVES: The aim of this study was to measure aortic vascular stiffness from orthotopic heart transplant (OHT) patients exposed to varying types of flow as a result of the presence or absence of left ventricular assist device (LVAD) support pre-OHT. BACKGROUND: The effects of continuous-flow LVADs (CF-LVADs) on vascular properties are unknown, but may contribute to the pathophysiology of CF-LVAD complications such as stroke, hypertension, and bleeding. METHODS: Echocardiograms were reviewed from 172 OHT patients immediately before LVAD and at 3 time points post-OHT: baseline, 6 months, and 1 year...
March 4, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28283496/physical-activity-guided-by-pulse-pressure-in-patients-with-continuous-flow-left-ventricular-assist-devices-a-pilot-study
#5
Sven Haufe, Christoph Bara, Julian Eigendorf, Kristine Chobanyan-Jürgens, Sebastian V Rojas, Jan D Schmitto, Uwe Tegtbur, Jens Jordan, Jens Tank
Continuous flow left ventricular assist devices (cfLVADs) are increasingly used as bridge to cardiac transplantation or destination therapy in patients with end-stage heart failure.(1) Patients implanted with cfLVADs exhibit marked arterial pulse pressure (PP) reductions which could adversely affect cardiovascular health. Indeed, a pulsatile blood pressure provides stimuli for vascular smooth muscle cell growth and arterial baroreceptor functions.(2, 3) LVAD designs attempting to simulate PP have been developed recently with the hope to improve clinical outcomes...
March 10, 2017: Circulation
https://www.readbyqxmd.com/read/28281287/application-of-a-lumped-parameter-model-to-study-the-feasibility-of-simultaneous-implantation-of-a-continuous-flow-ventricular-assist-device-vad-and-a-pulsatile-flow-vad-in-bivad-patients
#6
Arianna Di Molfetta, Gianfranco Ferrari, Roberta Iacobelli, Sergio Filippelli, Libera Fresiello, Paolo Guccione, Alessandra Toscano, Antonio Amodeo
The aim of this work is to develop and test a lumped parameter model of the cardiovascular system to simulate the simultaneous use of pulsatile (P) and continuous flow (C) ventricular assist devices (VADs) on the same patient. Echocardiographic and hemodynamic data of five pediatric patients undergoing VAD implantation were retrospectively collected and used to simulate the patients' baseline condition with the numerical model. Once the baseline hemodynamic was reproduced for each patient, the following assistance modalities were simulated: (a) CVAD assisting the right ventricle and PVAD assisting the left ventricle (RCF + LPF), (b) CVAD assisting the left ventricle and PVAD assisting the right ventricle (LCF + RPF)...
March 2017: Artificial Organs
https://www.readbyqxmd.com/read/28218352/concomitant-pulsatile-and-continuous-flow-vad-in-biventricular-and-univentricular-physiology-a-comparison-study-with-a-numerical-model
#7
Arianna Di Molfetta, Gianfranco Ferrari, Roberta Iacobelli, Sergio Filippelli, Paolo Guccione, Libera Fresiello, Gianluigi Perri, Antonio Amodeo
INTRODUCTION: To develop and test a lumped parameter model to simulate and compare the effects of the simultaneous use of continuous flow (CF) and pulsatile flow (PF) ventricular assist devices (VADs) to assist biventricular circulation vs. single ventricle circulation in pediatrics. METHODS: Baseline data of 5 patients with biventricular circulation eligible for LVAD and of 5 patients with Fontan physiology were retrospectively collected and used to simulate patient baselines...
February 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#8
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...
February 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28198133/left-ventricular-assist-device-therapy-in-advanced-heart-failure-patient-selection-and-outcomes
#9
REVIEW
Finn Gustafsson, Joseph G Rogers
Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25-50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy...
February 15, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28191682/aortic-root-thrombus-complicated-by-left-main-coronary-artery-occlusion-visualized-by-3d-echocardiography-in-a-patient-with-continuous-flow-left-ventricular-assist-device
#10
Monique S Tanna, Alex Reyentovich, Leora B Balsam, John A Dodson, Alan F Vainrib, Ricardo J Benenstein, Barry P Rosenzweig, Muhamed Saric
Aortic root thrombus is an uncommon complication of continuous-flow left ventricular assist devices (LVAD). We present the case of a 71-year-old man with ischemic cardiomyopathy who underwent destination therapy HeartMate II LVAD placement. Eighteen months later, he presented with a cerebrovascular accident followed by myocardial infarction. Transesophageal echocardiography revealed an aortic root thrombus spanning the left and noncoronary cusps and obliterating the left main coronary artery. We discuss the incidence, risk factors, and management of aortic root thrombus in LVAD patients...
February 2017: Echocardiography
https://www.readbyqxmd.com/read/28187048/utility-of-cha2ds2-vasc-and-has-bled-scores-as-predictor-of-thromboembolism-and-bleeding-after-left-ventricular-assist-device-implantation
#11
Hatice S Kemal, Serkan Ertugay, Sanem Nalbantgil, Pelin Ozturk, Cagatay Engin, Tahir Yagdi, Mustafa Ozbaran
Ischemic and hemorrhagic events are the common causes of morbidity and mortality after continuous-flow left ventricular assist device implantation (CF-LVAD). CHA2DS2-VASc score predicts thromboembolic (TE) event risk and HAS-BLED score predicts bleeding risk in patients on anti-coagulant with atrial fibrillation. We aimed to evaluate if these scoring systems would be predictive of TE and bleeding complications following CF-LVAD implantation. From December 2010 to December 2014, 145 patients who underwent CF-LVAD implantation at a single center were included...
February 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28176387/bridge-with-a-left-ventricular-assist-device-to-a-simultaneous-heart-and-kidney-transplant-review-of-the-united-network-for-organ-sharing-database
#12
Ann C Gaffey, Carol W Chen, Jennifer Chung, Edward Wilson Grandin, Paige M Porrett, Michael A Acker, Pavan Atluri
BACKGROUND: Left ventricular assist device (LVAD) implantation as a bridge to cardiac transplantation (BTT) is an effective treatment for end-stage heart failure patients. Currently, there is an increasing number of patients with a LVAD who need a heart and kidney transplant (HKT). Little is known of the prognostic outcomes in these patients. This study was undertaken to determine whether an equivalent outcome would be present in HKTs as compared to a non-LVAD primary HKT cohort. METHODS: We reviewed the United Network for Organ Sharing database from 2004 to 2013...
February 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28169115/angiotensin-ii-antagonism-is-associated-with-reduced-risk-for-gastrointestinal-bleeding-caused-by-arteriovenous-malformations-in-patients-with-left-ventricular-assist-devices
#13
Brian A Houston, Andrea L C Schneider, Joban Vaishnav, David M Cromwell, P Elliott Miller, Kamil F Faridi, Ashish Shah, Chris Sciortino, Glenn Whitman, Ryan J Tedford, Gerin R Stevens, Daniel P Judge, Stuart D Russell, Rosanne Rouf
BACKGROUND: Angiogenesis is implicated in formation of gastrointestinal arteriovenous malformations (AVMs). Angiotensin II signaling is involved in angiogenesis through the vascular endothelial growth factor (VEGF) and angiopoietin-2 pathways. We hypothesized that angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) therapy would be associated with a reduced risk of all-cause gastrointestinal bleeding (GIB) and AVM-associated GIB in patients with left ventricular assist devices (LVADs)...
December 30, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28168962/changes-in-end-organ-function-in-patients-with-prolonged-continuous-flow-left-ventricular-assist-device-support
#14
Daisuke Yoshioka, Hiroo Takayama, Paolo C Colombo, Melana Yuzefpolskaya, Arthur R Garan, Veli K Topkara, Jiho Han, Paul Kurlansky, Yoshifumi Naka, Koji Takeda
BACKGROUND: Few studies have evaluated the long-term effects of continuous blood flow with reduced pulsatility on end-organ function. METHODS: Between May 2004 and December 2015, 469 patients underwent continuous-flow left ventricular assist device (LVAD) implantation at our center. Our study included 59 (13%) patients who were supported with an LVAD for a minimum of 3 years. We evaluated postoperative renal function and hepatic function at 1 and 6 months, and 1, 2, and 3 years after implantation in those 59 patients...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28168379/continuous-flow-left-ventricular-assist-device-support-improves-myocardial-supply-demand-in-chronic-heart-failure
#15
Kevin G Soucy, Carlo R Bartoli, Dustin Phillips, Guruprasad A Giridharan, Michael A Sobieski, William B Wead, Robert D Dowling, Zhongjun J Wu, Sumanth D Prabhu, Mark S Slaughter, Steven C Koenig
Continuous-flow left ventricular assist devices (CF LVADs) are rotary blood pumps that improve mean blood flow, but with potential limitations of non-physiological ventricular volume unloading and diminished vascular pulsatility. In this study, we tested the hypothesis that left ventricular unloading with increasing CF LVAD flow increases myocardial flow normalized to left ventricular work. Healthy (n = 8) and chronic ischemic heart failure (IHF, n = 7) calves were implanted with CF LVADs. Acute hemodynamics and regional myocardial blood flow were measured during baseline (LVAD off, clamped), partial (2-4 L/min) and full (>4 L/min) LVAD support...
February 6, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28163837/simultaneous-ramp-right-heart-catheterization-and-echocardiography-in-a-reliantheart-left-ventricular-assist-device
#16
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/28134659/assessment-of-bleeding-and-thrombosis-based-on-aspirin-responsiveness-after-continuous-flow-left-ventricular-assist-device-placement
#17
Catherine K Floroff, Krista L Rieger, Tara M Veasey, Sara E Strout, Walter F DeNino, Holly B Meadows, Martha R Stroud, John M Toole, Dawn P Heyward, Meredith A Brisco, Jennifer L Cook, John Lazarchick, Walter E Uber
Pump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding following LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial non-responders who were then titrated upward to achieve therapeutic response.Patients ≥ 18 years of age with initial placement of HeartMate II® (HMII) LVAD at our institution and at least one VerifyNow® Aspirin test performed during initial hospitalization were included...
January 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28089072/the-role-of-implantable-cardioverter-defibrillators-in-patients-bridged-to-transplantation-with-a-continuous-flow-left-ventricular-assist-device-a-propensity-score-matched-analysis
#18
Kevin J Clerkin, Veli K Topkara, Donna M Mancini, Melana Yuzefpolskaya, Ryan T Demmer, Jose M Dizon, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, A Reshad Garan
BACKGROUND: Implantable cardioverter defibrillators (ICDs) provide a significant mortality benefit for appropriately selected patients with advanced heart failure. ICDs are associated with a mortality benefit when used in patients with a pulsatile left ventricular assist device (LVAD). It is unclear whether patients with a continuous-flow LVAD (CF-LVAD) derive the same benefit. We sought to determine if the presence of an ICD provided a mortality benefit during CF-LVAD support as a bridge to transplantation...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28087105/left-ventricular-assist-device-outcomes-based-on-flow-configuration-and-pre-operative-left-ventricular-dimension-an-interagency-registry-for-mechanically-assisted-circulatory-support-analysis
#19
Palak Shah, Sarah Birk, Simon Maltais, John Stulak, Angelo Elmi, Francis D Pagani, Jennifer A Cowger
BACKGROUND: Axial configuration (AC) and centrifugal configuration (CC) left ventricular assist devices (LVAD) have different flow characteristics, and whether the interaction between device flow configuration and the pre-operative left ventricular internal diastolic diameter (LVIDD) mediates adverse events after LVAD implantation is unknown. METHODS: We queried 9,424 continuous-flow LVAD recipients who received LVADs from April 2008 to June of 2015 in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
December 16, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28073849/caregivers-of-patients-with-left-ventricular-assist-devices-possible-impacts-on-patients-mortality-and-interagency-registry-for-mechanically-assisted-circulatory-support-defined-morbidity-events
#20
Courtenay R Bruce, Charles G Minard, L A Wilhelms, Mackenzie Abraham, Javier Amione-Guerra, Linda Pham, Sherry D Grogan, Barry Trachtenberg, Martin L Smith, Brian A Bruckner, Jerry D Estep, Kristin M Kostick
BACKGROUND: How caregivers contribute to positive or negative outcomes for left ventricular assist device (LVAD) patients remains unclear. Our primary study objectives were to (1) identify caregiver support attributes through a retrospective chart review of social workers' psychosocial assessments for LVAD patients and (2) determine how these attributes associated with patients' post-LVAD placement mortality and Interagency Registry for Mechanically Assisted Circulatory Support-defined morbidity events...
January 2017: Circulation. Cardiovascular Quality and Outcomes
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