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Counterpulsation

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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
#1
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...
May 16, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28500136/percutaneous-mechanical-circulatory-support-devices-in-cardiogenic-shock
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27770498/acute-physical-exercise-and-long-term-individual-shear-rate-therapy-increase-telomerase-activity-in-human-peripheral-blood-mononuclear-cells
#15
A Zietzer, E E Buschmann, D Janke, L Li, M Brix, H Meyborg, P Stawowy, C Jungk, I Buschmann, P Hillmeister
AIM: Physical activity is a potent way to impede vascular ageing. However, patients who suffer from peripheral artery disease (PAD) are often unable to exercise adequately. For those patients, we have developed individual shear rate therapy (ISRT), which is an adaptation of external counterpulsation and enhances endovascular fluid shear stress to increase collateral growth (arteriogenesis). To evaluate the effects of physical exercise and ISRT on the telomere biology of peripheral blood mononuclear cells (PBMCs), we conducted two clinical trials...
October 22, 2016: Acta Physiologica
https://www.readbyqxmd.com/read/27746015/contemporary-clinical-niche-for-intra-aortic-balloon-counterpulsation-in-perioperative-cardiovascular-practice-an-evidence-based-review-for-the-cardiovascular-anesthesiologist
#16
REVIEW
Emily J MacKay, Prakash A Patel, Jacob T Gutsche, Stuart J Weiss, John G Augoustides
No abstract text is available yet for this article.
July 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27580008/sunshine-heart-c-pulse-device-for-nyha-class-iii-and-ambulatory-class-iv-heart-failure
#17
Matthew C Black, Erin M Schumer, Michael Rogers, Jaimin Trivedi, Mark S Slaughter
Advanced heart failure (HF) patients not meeting criteria for ventricular assist device or heart transplant with life-limiting symptoms are limited to medical and resynchronization therapy. The Sunshine Heart C-Pulse, based on intra-aortic balloon pump physiology, provides implantable, on-demand, extra-aortic counterpulsation, which reduces afterload and improves cardiac perfusion in New York Heart Association Class III and ambulatory Class IV HF. The C-Pulse reduces New York Heart Association Class, improves 6-min walk distances, inotrope requirements and HF symptom questionnaires...
September 2016: Future Cardiology
https://www.readbyqxmd.com/read/27548685/enhanced-external-counterpulsation-therapy-past-present-and-future
#18
REVIEW
Anoshia Raza, Kate Steinberg, Joseph Tartaglia, William H Frishman, Tanush Gupta
External counterpulsation therapy was first developed over half a century ago as a resuscitative tool to support the failing heart and was based on hemodynamic principles of the intraaortic balloon pump. Over the course of last few decades, it has evolved into the modern enhanced external counterpulsation (EECP) therapy, which has proven to be a safe, effective, and low-cost noninvasive treatment for patients with debilitating angina and chronic heart failure who are poor candidates for revascularization procedures and have suboptimal results from other therapies...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27546830/echocardiographic-predictors-of-immediate-postoperative-outcomes-in-patients-with-severe-left-ventricular-systolic-dysfunction-undergoing-on-pump-coronary-artery-bypass-grafting
#19
Ajay Kumar Jha, Vishwas Malik, Parag Gharde, Sandeep Chauhan, Usha Kiran, Milind P Hote
OBJECTIVES: The postoperative course following on-pump coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) systolic dysfunction is often unpredictable. Therefore, the aim of this study was to identify predictors of poor postoperative outcome in this subset of patients. DESIGN: Prospective observational study SETTING: Single university hospital PARTICIPANTS: Forty patients with severe LV systolic dysfunction undergoing isolated on-pump CABG INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Comprehensive transesophageal echocardiographic examination was performed to obtain the indices of systolic and diastolic LV function after induction of anesthesia...
April 29, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27542611/impact-of-non-infarct-related-artery-disease-on-infarct-size-and-outcomes-from-the-crisp-ami-trial
#20
Rohan Shah, Robert M Clare, Karen Chiswell, W Schuyler Jones, A Sreenivas Kumar, Holger Thiele, Richard W Smalling, Praveen Chandra, Marc Cohen, Divaka Perera, Derek P Chew, John K French, Jonathan Blaxill, E Magnus Ohman, Manesh R Patel
BACKGROUND: Non-infarct-related artery (non-IRA) disease is prevalent in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to assess the impact of non-IRA disease on infarct size and clinical outcomes in patients with acute STEMI. METHODS: The Counterpulsation to Reduce Infarct Size Pre-PCI Acute Myocardial Infarction (CRISP-AMI) trial randomized patients to intra-aortic balloon counterpulsation (IABC) vs no IABC prior to percutaneous coronary intervention in patients with acute STEMI...
December 2016: American Journal of Medicine
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