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Counterpulsation

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https://www.readbyqxmd.com/read/28639172/influence-of-cannulation-site-on-carotid-perfusion-during-extracorporeal-membrane-oxygenation-in-a-compliant-human-aortic-model
#1
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
#2
Phillip J Habib, Susan M Joseph
No abstract text is available yet for this article.
June 13, 2017: Cardiology
https://www.readbyqxmd.com/read/28598922/retrograde-type-b-aortic-dissection-caused-by-intraaortic-balloon-counterpulsation
#3
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
#4
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
#5
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
#6
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 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 prior to LVAD surgery and compared to five 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
#7
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
#8
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
#9
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
#10
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
#11
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...
March 22, 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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27960614/long-term-individual-shear-rate-therapy-counterpulsation-enhances-plasma-nitrite-release-in-patients-with-pad
#15
RANDOMIZED CONTROLLED TRIAL
Michèle Brix, Eva-Elina Buschmann, Andreas Zietzer, Jonnel Anthony Jaurigue, Lulu Li, Constantin Jungk, Ivo Buschmann, Doreen Janke, Philipp Hillmeister
BACKGROUND: Individual shear rate therapy (ISRT) has been designed as a novel non-invasive treatment option for peripheral artery disease (PAD) patients and has been shown to improve endothelial function and walking distance. The aim of this study was to elucidate the impact of ISRT on the level of nitric oxide in patient blood plasma and the expression of related molecular markers in peripheral blood mononuclear cells (PBMCs). Molecular diagnostic tests were performed for two ISRT trials...
January 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27935891/-rate-of-in-hospital-cardiovascular-complications-in-patients-with-postoperative-renal-dysfunction-after-surgical-myocardial-revascularization
#16
L V Kremneva, O V Abaturova, S V Shalaev
The study was aimed at revealing the factors associated with renal dysfunction having developed after coronary artery bypass grafting (CABG) and assessing the in-hospital cardiovascular complications rate amongst patients with postoperative renal dysfunction. The study included a total of 99 patients presenting with stable angina pectoris and having indications for CABG. The mean age of the patients amounted to 57±7 years, with the average duration of coronary artery disease (CAD) of 6±5.7 years. A multi-vessel lesion of coronary arteries was revealed in 69...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27894326/preserved-autoregulation-of-coronary-flow-after-off-pump-coronary-artery-bypass-grafting-retrospective-assessment-of-intraoperative-transit-time-flowmetry-with-and-without-intra-aortic-balloon-counterpulsation
#17
Hiroyuki Nakajima, Atsushi Iguchi, Mimiko Tabata, Masaru Kambe, Masahiro Ikeda, Kazuhiko Uwabe, Toshihisa Asakura, Hiroshi Niinami
BACKGROUND: Intra-aortic balloon pumping (IABP) markedly increases graft flow after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. We sought to delineate the effects of IABP on graft flow after off-pump CABG (OPCAB). METHODS: The clinical records of 32 patients (25 male, 7 female; mean age: 70 ± 9 years) who underwent OPCAB with IABP between January 2011 and May 2015 were retrospectively reviewed. Thirteen patients (41%) had a history of myocardial infarction, and 13 patients (41%) had a history of percutaneous coronary intervention...
November 28, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27867655/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-in-postcardiotomy-cardiogenic-shock-how-much-pump-flow-is-enough
#18
COMMENT
Federico Pappalardo, Andrea Montisci
Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery associated with a poor prognosis: veno-arterial extracorporeal membrane oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and lung function, though it is associated with unsatisfactory results. Few studies have identified reliable predictors of poor prognosis early in the course of extracorporeal support. A recent study showed the strong prognostic power of urine output in the first 24 hours of VA ECMO in predicting early and late mortality of PCCS...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27843778/acute-severe-thrombocytopenia-occurring-after-administration-of-eptifibatide-postpones-emergent-coronary-artery-surgery
#19
Brent T Boettcher, Timothy J Olund, Paul S Pagel
INTRODUCTION: Eptifibatide is a platelet glycoprotein IIb/IIIa (GP IIb/IIIa) receptor antagonist that inhibits fibrinogen binding to the activated GP IIb/IIIa site and prevents platelet-platelet interaction and clot formation. GP IIb/IIIa inhibitors improve outcome in patients undergoing percutaneous coronary intervention for acute coronary syndrome. Thrombocytopenia is a complication of GP IIb/IIIa inhibitors, but severe thrombocytopenia is unusual. Most reported cases of severe thrombocytopenia after eptifibatide occurred in patients with acute coronary syndrome...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27782354/effects-of-enhanced-external-counterpulsation-on-skeletal-muscle-gene-expression-in-patients-with-severe-heart-failure
#20
Michael Melin, Andreas Montelius, Lars Rydén, Adrian Gonon, Inger Hagerman, Eric Rullman
Enhanced external counterpulsation (EECP) is a non-invasive treatment in which leg cuff compressions increase diastolic aortic pressure and coronary perfusion. EECP is offered to patients with refractory angina pectoris and increases physical capacity. Benefits in heart failure patients have been noted, but EECP is still considered to be experimental and its effects must be confirmed. The mechanism of action is still unclear. The aim of this study was to evaluate the effect of EECP on skeletal muscle gene expression and physical performance in patients with severe heart failure...
October 26, 2016: Clinical Physiology and Functional Imaging
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