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Counterpulsation

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https://www.readbyqxmd.com/read/28804232/acute-beneficial-effects-of-muscular-counterpulsation-in-patients-with-coronary-heart-diseases
#1
Larry V Lapanashvili, Michael D Alshibaya, Julia Veselova, Leo A Bockeria
This prospective pilot study was designed to investigate the acute hemodynamic effects and clinical applicability of muscular counterpulsation (MCP), a one-shot procedure for biomechanical circulatory support. The study included 17 consecutive patients with coronary artery disease (CAD) and impaired ejection fraction (EF ≤45%) who underwent elective coronary artery bypass grafting (CABG). Patients were divided into control ( n  = 7) and treatment ( n  = 10) groups. MCP was applied through adhesive skin electrodes to the thighs and calves with a battery-powered, portable, ECG-triggered device for 15 minutes prior to general anesthesia...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28759604/a-web-based-tool-to-predict-acute-kidney-injury-in-patients-with-st-elevation-myocardial-infarction-development-internal-validation-and-comparison
#2
Benjamin R Zambetti, Fridtjof Thomas, Inyong Hwang, Allen C Brown, Mason Chumpia, Robert T Ellis, Darshan Naik, Rami N Khouzam, Uzoma N Ibebuogu, Guy L Reed
BACKGROUND: In ST-elevation myocardial infarction (STEMI), acute kidney injury (AKI) may increase subsequent morbidity and mortality. Still, it remains difficult to predict AKI risk in these patients. We sought to 1) determine the frequency and clinical outcomes of AKI and, 2) develop, validate and compare a web-based tool for predicting AKI. METHODS & FINDINGS: In a racially diverse series of 1144 consecutive STEMI patients, Stage 1 or greater AKI occurred in 12...
2017: PloS One
https://www.readbyqxmd.com/read/28723830/early-versus-delayed-coronary-artery-bypass-graft-surgery-for-patients-with-non-st-elevation-myocardial-infarction
#3
Le Dung Ha, Gbolahan Ogunbayo, Ayman Elbadawi, Odunayo Olorunfemi, Adrian Messerli
BACKGROUND: Although coronary artery bypass graft surgery (CABG) has been proven to have mortality and morbidity benefits in patients with non-ST elevation myocardial infarction and multivessel disease, the appropriate timing of this procedure remains unclear. Therefore, we proposed a propensity score-matched analysis comparing the clinical outcomes between patients who underwent CABG within the first 48 h of admission (early CABG) and patients who underwent CABG after 48 h of admission (delayed CABG)...
July 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28709666/novel-rotational-speed-modulation-system-used-with-venoarterial-extracorporeal-membrane-oxygenation
#4
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
#5
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
https://www.readbyqxmd.com/read/28668309/a-niche-indication-for-intra-aortic-balloon%C3%A2-pump-counterpulsation-aortic-valve-opening-in-a-surgically-vented-left-ventricle-on-venoarterial-ecmo
#6
Corstiaan A den Uil, Dinis Dos Reis Miranda, Nicolas M Van Mieghem, Lucia S Jewbali
No abstract text is available yet for this article.
June 21, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28639172/influence-of-cannulation-site-on-carotid-perfusion-during-extracorporeal-membrane-oxygenation-in-a-compliant-human-aortic-model
#7
Andreas Geier, Andreas Kunert, Günter Albrecht, Andreas Liebold, Markus Hoenicka
Blood oxygenized by veno-arterial extracorporeal membrane oxygenation (ECMO) can be returned to the aorta (central cannulation) or to peripheral arteries (axillar, femoral). Hemodynamic effects of these cannulation types were analyzed in a mock loop with an aortic model representative of normal anatomy and compliance under physiological pressures and flow rates. Pressures, flow rates, and contribution of ECMO flow to total flow as a measure of oxygen supply were monitored in the carotids. Steady or pulsatile ECMO flow, residual or no cardiac output, and intraaortic balloon pump counterpulsation were tested as independent factors...
June 21, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28605731/why-all-the-pushback-against-counterpulsation
#8
Phillip J Habib, Susan M Joseph
No abstract text is available yet for this article.
2017: Cardiology
https://www.readbyqxmd.com/read/28598922/retrograde-type-b-aortic-dissection-caused-by-intraaortic-balloon-counterpulsation
#9
Lachlan F Miles, Andrew J Roscoe
No abstract text is available yet for this article.
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28574108/comparative-in-vivo-analysis-of-the-role-of-the-adventitia-and-the-endothelium-on-arterial-mechanical-function-relevance-for-aortic-counterpulsation
#10
Daniel Bia, Yanina Zócalo, Sandra Wray, Edmundo I Cabrera-Fischer
PURPOSE: The comparative effect of the intimal and adventitial layers on arterial biomechanics control, in basal and altered conditions, remains to be elucidated. This study aimed (1) to characterize the arterial conduit (CF) and buffering (distensibility) function of the iliac arteries in in vivo animals, in which the intimal and adventitial layers were removed; (2) to determine the effects of intra-aortic ballon pumping (IABP) on simultaneously de-adventitialized (DA) and de-endothelialized (DE) iliac arteries before and after induced heart failure...
May 24, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28574104/ecmo-and-cytokine-removal-for-bridging-to-surgery-in-a-patient-with-ischemic-ventricular-septal-defect-a-case-report
#11
Stefanie Marek, Gunnar Gamper, Georg Reining, Peter Bergmann, Harald Mayr, Andreas Kliegel
Even in the modern era of percutaneous coronary intervention, postinfarction ventricular septal defect (VSD) remains a serious and often lethal complication. Whether or not immediate surgical repair or delaying surgery a few days aided by intra-aortic counterpulsation provides the optimal strategy remains a matter of debate. An interdisciplinary approach of intensivists and cardiac surgeons in this setting is mandatory. We report the use of veno-arterial extracorporeal membrane oxygenation and extracorporeal blood purification therapy (CytoSorb®) as bridging to surgical closure in a patient with an ischemic VSD leading to protracted cardiogenic shock after posterior myocardial infarction...
May 23, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28554716/acute-hemodynamic-effects-of-intra-aortic-balloon-counterpulsation-pumps-in-advanced-heart-failure
#12
Shiva K Annamalai, Lyanne Buiten, Michele L Esposito, Vikram Paruchuri, Andrew Mullin, Catalina Breton, Robert Pedicini, Ryan O'Kelly, Kevin Morine, Benjamin Wessler, Ayan R Patel, Michael S Kiernan, Richard H Karas, Navin K Kapur
BACKGROUND: The utility of intra-aortic balloon counterpulsation pumps (IABPs) in low cardiac output states is unknown and no studies have explored the impact of IABP therapy on ventricular workload in patients with advanced heart failure (HF). For these reasons, we explored the acute hemodynamic effects of IABP therapy in patients with advanced HF. METHODS: We prospectively studied 10 consecutive patients with stage D HF referred for IABP placement before left ventricular assist device (LVAD) surgery and compared with 5 control patients with preserved left ventricular (LV) ejection fraction (EF) who did not receive IABP therapy...
May 26, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28512680/a-novel-idea-to-improve-cardiac-output-of-mechanical-circulatory-support-devices-by-optimizing-kinetic-energy-transfer-available-in-forward-moving-aortic-blood-flow
#13
Muhammad B Qureshi, Jacob Glower, Daniel L Ewert, Steven C Koenig
Mechanical circulatory support devices (MCSDs) have gained widespread clinical acceptance as an effective heart failure (HF) therapy. The concept of harnessing the kinetic energy (KE) available in the forward aortic flow (AOF) is proposed as a novel control strategy to further increase the cardiac output (CO) provided by MCSDs. A complete mathematical development of the proposed theory and its application to an example MCSDs (two-segment extra-aortic cuff) are presented. To achieve improved device performance and physiologic benefit, the example MCSD timing is regulated to maximize the forward AOF KE and minimize retrograde flow...
June 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28500136/percutaneous-mechanical-circulatory-support-devices-in-cardiogenic-shock
#14
REVIEW
Aditya Mandawat, Sunil V Rao
Despite a high rate of early revascularization and use of intra-aortic balloon pump counterpulsation therapy, the prognosis of patients with cardiogenic shock has remained poor. In the hopes of improving outcomes, clinicians are increasingly turning to percutaneous left and right mechanical circulatory support devices. Until recently, the evidence base for these devices had consisted only of observational data, meta-analyses, and small feasibility trials. In this article, we describe the contemporary outcomes of patients with cardiogenic shock, the hemodynamics of cardiogenic shock, and hemodynamic effects of percutaneous mechanical circulatory support devices...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28489254/use-of-intra-aortic-counterpulsation-in-cardiogenic-shock-post-liver-transplantation
#15
Arun P Palanisamy, Satish N Nadig, Gabriel R Chedister, Jacob E Dowden, David G Koch, William D Stoll, John W McGillicuddy, Kenneth D Chavin
Left ventricular dysfunction resulting in cardiogenic shock occurs infrequently following organ reperfusion in liver transplantation. The etiology of the cardiogenic shock is often multifactorial and difficult to manage due to the complex nature of the procedure and the patient's baseline physiology. Traditionally, this hemodynamic instability is managed medically using inotropic agents and vasopressor support. If medical treatment is insufficient, the use of an intra-aortic balloon pump for counterpulsation may be employed to improve the hemodynamics and stabilize the patient...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28396189/external-counterpulsation-increases-beat-to-beat-heart-rate-variability-in-patients-with-ischemic-stroke
#16
Li Xiong, Ge Tian, Li Wang, Wenhua Lin, Xiangyan Chen, Thomas Wai Hong Leung, Yannie Oi Yan Soo, Lawrence Ka Sing Wong
BACKGROUND AND PURPOSE: External counterpulsation (ECP) is a noninvasive method used to augment cerebral perfusion in ischemic stroke. However, the response of beat-to-beat heart rate variability (HRV) in patients with ischemic stroke during ECP remains unknown. METHODS: Forty-eight patients with unilateral ischemic stroke at the subacute stage and 14 healthy controls were recruited. Beat-to-beat heart rate before, during, and after ECP was monitored. The frequency components of HRV were calculated using power spectral analysis...
April 7, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28363618/extracorporeal-cpr-and-intra-aortic-balloon-pumping-in-tachycardia-induced-cardiomyopathy-complicating-cardiac-arrest
#17
Jun Wan Lee, Hong Joon Ahn, Youn Ho Yoo, Jin Woong Lee, Seung Whan Kim, Si Wan Choi
Although tachycardia-induced cardiomyopathy (TIC) due to atrial fibrillation occurs frequently, it is under-recognized in clinical settings. TIC has a wide range of clinical manifestations, from asymptomatic tachycardia to cardiomyopathy leading to end stage heart failure. We present a case of a 48year-old-woman who presented as cardiogenic shock, and rapidly progressed to cardiac arrest from recently diagnosed but undertreated atrial fibrillation, resulting TIC in the emergency department (ED). She was rescued by extracorporeal cardiopulmonary resuscitation (E-CPR) for refractory cardiac arrest in the ED, and received concomitant intra-aortic balloon counterpulsation (IABP) support for severe left ventricular failure...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28286090/surgical-revascularisation-in-the-early-phase-of-st-segment-elevation-myocardial-infarction-haemodynamic-status-is-more-important-than-the-timing-of-the-operation
#18
Vilem Rohn, Tomas Grus, Jan Belohlavek, Jan Horak
BACKGROUND: Surgical revascularisation in patients with acute myocardial infarction with ST-Segment Elevation (STEMI) is usually considered as a second choice when direct angioplasty/stent fails. However, improvements in surgical technique and postoperative care may justify coronary artery bypass grafting (CABG) in STEMI. METHODS: This was a retrospective analysis of prospectively gathered data of 135 patients with acute STEMI, treated with CABG in our department from February 2008 to December 2012...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28145044/a-single-center-tertiary-care-experience-utilizing-the-large-volume-mega-50cc-intra-aortic-balloon-counterpulsation-in-contemporary-clinical-practice
#19
Gautam K Visveswaran, Marc Cohen, Ahmed Seliem, Michael DiVita, Jonathan K R McNamara, Amar Dave, Najam Wasty, David A Baran
OBJECTIVE: Clinical outcomes and adverse events utilizing the large volume 50cc intra-aortic balloon (IAB) in contemporary clinical practice. BACKGROUND: The newer large volume 50cc IAB, recently introduced into clinical practice offers improved diastolic augmentation and better left ventricular (LV) unloading compared to the older 40cc IAB. METHODS: In 150 consecutive patients who received intra-aortic balloon counterpulsation (IABC) with a 50cc balloon from 2011 to 2015, we retrospectively analyzed demographic, clinical, laboratory, and hemodynamic variables, adverse events and survival to discharge from index hospitalization...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27984317/efficacy-of-subcutaneous-electrocardiogram-leads-for-synchronous-timing-during-chronic-counterpulsation-therapy
#20
Stephen R Carnahan, Steven C Koenig, Michael A Sobieski, Erin M Schumer, Gretel Monreal, Yu Wang, Young Choi, Brek J Meuris, Landon H Tompkins, Zhongjun J Wu, Mark S Slaughter, Guruprasad A Giridharan
Counterpulsation devices (CPDs) require an accurate, reliable electrocardiogram (ECG) waveform for triggering inflation and deflation. Surface electrodes are for short-term use, and transvenous/epicardial leads require invasive implant procedure. A subcutaneous ECG lead configuration was developed as an alternative approach for long-term use with timing mechanical circulatory support (MCS) devices. In this study, efficacy testing was completed by simultaneously recording ECG waveforms from clinical-grade epicardial (control) and subcutaneous (test) leads in chronic ischemic heart failure calves implanted with CPD for up to 30 days...
March 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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