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Continuous flow left ventricular assist device

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https://www.readbyqxmd.com/read/28822743/medical-management-of-patients-with-a%C3%A2-left-ventricular-assist-device-for-the%C3%A2-non-left-ventricular-assist-device%C3%A2-specialist
#1
REVIEW
Adam D DeVore, Priyesh A Patel, Chetan B Patel
More than 2,400 continuous-flow left ventricular assist devices (LVADs) are implanted each year in the United States alone. Both the number of patients living with LVADs and the life expectancy of these patients are increasing. As a result, patients with LVADs are increasingly encountered by non-LVAD specialists who do not have training in managing advanced heart failure for general medical care, cardiovascular procedures, and other subspecialty care. An understanding of the initial evaluation and management of patients with LVADs is now an essential skill for many health care providers...
August 3, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28800891/concomitant-mitral-repair-and-continuous-flow-left-ventricular-assist-devices-is-it-warranted
#2
Shinichi Fukuhara, Koji Takeda, Codruta Chiuzan, Jiho Han, Paul A Kurlansky, Hiroo Takayama, Yoshifumi Naka
BACKGROUND: Pre-existing mitral pathology is common in patients undergoing continuous-flow left ventricular assist device implantation. We sought to investigate whether concurrent mitral repair confers any advantage. METHODS: From March 2004 to October 2014, 374 patients received a continuous-flow left ventricular assist device. Of these, a total of 115 patients with pre-existing mitral regurgitation (MR) greater than moderate were identified and included in the analysis...
April 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28799950/orthostatic-hypotension-in-patients-with-left-ventricular-assist-devices-acquired-autonomic-dysfunction
#3
Marat Fudim, Joseph G Rogers, Camille Frazier-Mills, Chetan B Patel
Contemporary left ventricular assist device (LVAD) technology uses nonphysiologic continuous flow to deliver blood into the circulation. This results in a reduction of pulsatility, which is implicated in some of the commonly associated side effects with LVAD therapy, including hypertension and gastrointestinal arterial-venous malformation with related bleeding. A less frequently observed side effect is orthostatic hypotension (OH) in patients supported with LVAD therapy. We present three cases of OH in patients with LVAD, followed by a discussion on how LVAD therapy may induce autonomic dysfunction...
August 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28781011/pre-operative-proteinuria-in-left-ventricular-assist-devices-and-clinical-outcome
#4
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Kavita Sharma, Nisha A Gilotra, Jasper J Brugts, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Olivier C Manintveld, Stuart D Russell
BACKGROUND: This study evaluated the association of pre-operative proteinuria before continuous flow left ventricular assist device (CF-LVAD) implantation in relation to mortality and the need for renal replacement therapy (RRT) during the first year of follow-up. METHODS: This retrospective, multicenter cohort study evaluated all patients (n = 241) who underwent CF-LVAD implantation in the 2 participating tertiary referral centers. Patients were included if a urine dipstick was performed within 7 days before CF-LVAD implantation...
July 15, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28777392/long-term-follow-up-of-continuous-flow-left-ventricular-assist-devices-complications-and-predisposing-risk-factors
#5
Tolulope A Adesiyun, Rhondalyn C McLean, Ryan J Tedford, Glenn J R Whitman, Chris M Sciortino, John V Conte, Ashish S Shah, Stuart D Russell
PURPOSE: To assess LVAD complications and their overall effect on mortality and determine factors associated with development of early and long-term complications. METHODS: A retrospective cohort study of patients who underwent continuous flow LVAD placement between January 1, 2000 and November 30, 2013 was performed. The incidence of complications (sepsis or bacteremia, driveline infections, gastrointestinal bleeding, pump thrombosis, cerebrovascular accidents and anemia requiring transfusion) was collected and logistic regression and Cox proportional hazards analyses were performed...
August 2, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28777390/thrombosis-in-left-ventricular-assistance-device-with-centrifugal-technology-is-early-thrombolysis-a-better-solution
#6
Paolo Centofanti, Andrea Baronetto, Matteo Attisani, Davide Ricci, Erika Simonato, Michele W La Torre, Massimo Boffini, Mauro Rinaldi
BACKGROUND: Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. METHODS: We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016...
July 27, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28777136/incidence-and-impact-of-on-cardiopulmonary-bypass-vasoplegia-during-heart-transplantation
#7
Lauren K Truby, Koji Takeda, Maryjane Farr, James Beck, Melana Yuzefpolskaya, Paolo C Colombo, Veli Tokpara, Donna Mancini, Yoshifumi Naka, Hiroo Takayama
Despite significant advances in the medical management of heart transplant (HT) recipients, perioperative complications, including vasoplegia, remain a significant contributor to morbidity and mortality. This is a retrospective review of patients who received HT at our institution between 2012 and 2015. Mean systemic vascular resistance (SVR) was calculated during the bypass run. Vasoplegia was defined as a mean SVR <800 dynes s/cm despite a high pressor requirement (>1,500 μg neosynephrine bolused)...
August 2, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28770469/erratum-to-mechanistic-insight-of-platelet-apoptosis-leading-to-non-surgical-bleeding-among-heart-failure-patients-supported-by-continuous-flow-left-ventricular-assist-devices
#8
Nandan K Mondal, Tieluo Li, Zengsheng Chen, Hegang H Chen, Erik N Sorensen, Si M Pham, Michael A Sobieski, Steven C Koenig, Mark S Slaughter, Bartley P Griffith, Zhongjun J Wu
No abstract text is available yet for this article.
September 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28757150/temporal-differences-in-outcomes-during-long-term-mechanical-circulatory-support
#9
Simon Maltais, Lucman A Anwer, Nicholas A Haglund, Jennifer Cowger, Palak Shah, Keith D Aaronson, Francis D Pagani, Shannon M Dunlay, Ramesh Singh, Christopher T Salerno, John M Stulak
BACKGROUND: Device indications have changed for placement of continuous-flow left ventricular assist devices (CF-LVADs). We performed a multicenter analysis evaluating temporal variations in outcomes after CF-LVAD implantation. METHODS & RESULTS: We retrospectively defined three time intervals to reflect changes in CF-LVAD technology (Period 1: 2004 to 2009; Period 2: 2010 to 2012; and Period 3: 2012 to 2014). A total of 1,064 patients (HeartMate II (HMII)=835, HeartWare (HVAD)=229) underwent CF-LVAD implantation between May 2004 and October 2014...
July 27, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28756118/von-willebrand-factor-disruption-and-continuous-flow-circulatory-devices
#10
Alastair G Proudfoot, Simon J Davidson, Martin Strueber
Bleeding events remain a significant and frequent complication of continuous-flow left ventricular assist devices (VADs). von Willebrand factor (VWF) is critical to hemostasis by acting as a bridging molecule at sites of vascular injury for normal platelet adhesion as well as promoting platelet aggregation under conditions of high shear. Clinical and experimental data support a role for acquired von Willebrand disease in VAD bleeding episodes caused by shear-induced qualitative defects in VWF. Pathologic shear induces VWF unfolding and proteolysis of large multimers into smaller less hemostatic multimers via ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13)...
June 12, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28752193/readmissions-after-continuous-flow-left-ventricular-assist-device-implantation
#11
Mitsutoshi Kimura, Kan Nawata, Osamu Kinoshita, Haruo Yamauchi, Yasuhiro Hoshino, Masaru Hatano, Eisuke Amiya, Koichi Kashiwa, Miyoko Endo, Yukie Kagami, Mariko Nemoto, Minoru Ono
Continuous flow left ventricular assist device (CF-LVAD) therapy has improved the survival of patients with advanced heart failure. However, the readmission rate of CF-LVAD patients is still relatively high. A total of 90 patients who received CF-LVADs between April 2011 and March 2016 at our institute and were discharged home were analyzed retrospectively. They were followed up through March 2017. Clinical data, including frequency, length and etiology of readmission, were obtained from medical records. The mean observation period after initial discharge was 713 ± 322 days...
July 27, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28738087/exercise-physiology-with-a-left-ventricular-assist-device-analysis-of-heart-pump-interaction-with-a-computational-simulator
#12
Libera Fresiello, Frank Rademakers, Piet Claus, Gianfranco Ferrari, Arianna Di Molfetta, Bart Meyns
Patients with a Ventricular Assist Device (VAD) are hemodynamically stable but show an impaired exercise capacity. Aim of this work is to identify and to describe the limiting factors of exercise physiology with a VAD. We searched for data concerning exercise in heart failure condition and after VAD implantation from the literature. Data were analyzed by using a cardiorespiratory simulator that worked as a collector of inputs coming from different papers. As a preliminary step the simulator was used to reproduce the evolution of hemodynamics from rest to peak exercise (ergometer cycling) in heart failure condition...
2017: PloS One
https://www.readbyqxmd.com/read/28734595/arrhythmias-after-left-ventricular-assist-device-implantation-incidence-and-management
#13
REVIEW
Anis J Kadado, Joseph G Akar, James P Hummel
The use of mechanical circulatory support has become an increasingly common practice in patients with heart failure, whether used as bridge to transplantation or as destination therapy. The last couple of decades has seen a drastic change in the functioning of the left ventricular assist devices (LVAD), changing from the first generation devices running on pulsatile flow to the current continuous flow devices. Atrial and ventricular arrhythmias are common among heart failure patients, and though the systematic circulation is well supported in patients on mechanical circulatory support, these arrhythmias can still be the cause of detrimental symptoms and lead to potentially fatal outcomes...
July 10, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28730986/long-term-use-of-left-ventricular-assist-devices-a-report-on-clinical-outcomes
#14
Sneha Raju, Jane MacIver, Farid Foroutan, Carolina Alba, Filio Billia, Vivek Rao
BACKGROUND: The literature examining clinical outcomes and readmissions during extended (> 1 yr) left ventricular assist device (LVAD) support is scarce, particularly in the era of continuous-flow LVADs. METHODS: We completed a retrospective cohort study on consecutive LVAD patients from June 2006 to March 2015, focusing on those who received more than 1 year of total LVAD support time. Demographic characteristics, clinical outcomes and readmissions were analyzed using standard statistical methods...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28729354/continuous-flow-lvad-support-causes-a-distinct-form-of-intestinal-angiodysplasia
#15
Jooeun Kang, Samson Hennessy-Strahs, Pawel Kwiatkowski, Christian Bermudez, Michael A Acker, Pavan Atluri, Patrick McConnell, Carlo R Bartoli
Rationale: The objective of this autopsy study was to determine whether abnormal gastrointestinal vascularity develops during continuous-flow LVAD support. Objective: Left ventricular assist device (LVAD) support causes pathologic degradation of von Willebrand factor (vWF) and bleeding from gastrointestinal angiodysplasia at an alarming rate. It has been speculated that LVAD support, itself may cause angiodysplasia. The relationship to abnormal vWF metabolism is unknown. We tested the hypothesis that abnormal gastrointestinal vascularity develops during continuous-flow LVAD support...
July 20, 2017: Circulation Research
https://www.readbyqxmd.com/read/28711755/palliative-care-clinicians-caring-for-patients-before-and-after-continuous-flow-left-ventricular-assist-device
#16
Sara E Wordingham, Colleen K McIlvennan, Timothy J Fendler, Amy L Behnken, Shannon M Dunlay, James N Kirkpatrick, Keith M Swetz
Left ventricular assist devices (LVADs) are an available treatment option for carefully-selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. While survival and quality of life improve with LVADs compared to medical therapy, complications persist including bleeding, infection, and stroke...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711647/surgical-training-improves-performance-in-minimally-invasive-left-ventricular-assist-device-implantation-without-cardiopulmonary-bypass
#17
Lu-Feng Zhang, Hai-Bo Feng, Zhi-Guo Yu, Shi Jing, Feng Wan
OBJECTIVE: We introduced a live animal model for training of minimally invasive implantation of a continuous-flow left ventricular assist device (CF-LVAD) without cardiopulmonary bypass for operator's performance improvement. DESIGN: After watching a videotape of LVAD implantation on the beating heart through the cardiac apex, the surgical team performed implantation of LVADs into 5 pigs during 3 training sessions in a time series. The procedure success rate, operating time, and technical and global performances by self-evaluation and senior evaluation were compared among the sessions...
July 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28709930/particle-image-velocimetry-study-of-the-celiac-trunk-hemodynamic-induced-by-continuous-flow-left-ventricular-assist-device
#18
Francesco Scardulla, Diego Bellavia, Leonardo D'Acquisto, Giuseppe M Raffa, Salvatore Pasta
Whereas left ventricular assist device (LVAD) is the gold-standard therapy for patients with heart failure, gastrointestinal bleeding is one of the most common complications. LVAD implantation may remarkably impact aortic hemodynamics so that experimental and computational flow analyses can be used to study the disease mechanisms. Here we present an experimentally-calibrated computational model of the celiac trunk hemodynamic of a LVAD-supported patient who experienced bleeding after device implantation. Specifically, both particle image velocimetry (PIV) and echocardiography were used to measure and compare flow distributions in each branch of a phantom model of the patient abdominal aorta...
July 12, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28709666/novel-rotational-speed-modulation-system-used-with-venoarterial-extracorporeal-membrane-oxygenation
#19
Noritsugu Naito, Takashi Nishimura, Kei Iizuka, Yutaka Fujii, Yoshiaki Takewa, Akihide Umeki, Masahiko Ando, Minoru Ono, Eisuke Tatsumi
BACKGROUND: Femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is widely used to maintain blood flow in patients with cardiogenic shock. However, retrograde blood flow increases left ventricular (LV) afterload during femoral VA-ECMO. Additional support by means of an intraaortic balloon pump (IABP) alleviates LV afterload but is associated with significant adverse events. We previously developed a system for rotational speed modulation in synchrony with the native cardiac cycle, for use with implantable continuous-flow LV assist devices...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28707188/hemodynamic-benefits-of-counterpulsation-implantable-percutaneous-and-intraaortic-rotary-blood-pumps-an-in-silico-and-in-vitro-study
#20
Yu Wang, Steven C Koenig, Michael A Sobieski, Mark S Slaughter, Guruprasad A Giridharan
Mechanical circulatory support (MCS) devices have become a standard therapy for heart failure (HF) patients. MCS device designs may differ by level of support, inflow and/or outflow cannulation sites, and mechanism(s) of cardiac unloading and blood flow delivery. Investigation and direct comparison of hemodynamic parameters that help characterize performance of MCS devices has been limited. We quantified cardiac and vascular hemodynamic responses for different types of MCS devices. Continuous flow (CF) left ventricular (LV) assist devices (LVAD) with LV or left atrial (LA) inlet, counterpulsation devices, percutaneous CF LVAD, and intra-aortic rotary blood pumps (IARBP) were quantified using established computer simulation and mock flow loop models...
July 13, 2017: Cardiovascular Engineering and Technology
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