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Counterpulsation

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https://www.readbyqxmd.com/read/29132918/the-first-in-human-experience-with-a-minimally-invasive-ambulatory-counterpulsation-heart-assist-system-for-advanced-congestive-heart-failure
#1
Valluvan Jeevanandam, Tae Song, David Onsager, Takeyoshi Ota, Colleen Juricek LaBuhn, Thomas Lammy, Gabriel Sayer, Gene Kim, Sonna Patel-Raman, Nir Uriel
BACKGROUND: The intravascular ventricular assist system (iVAS) is a new, minimally invasive, ambulatory counterpulsation heart assist system delivered via the subclavian artery and powered by a portable driver. It is designed for recovery, bridge to transplantation (BTT) or for prolonging medical therapy. We report the first-in-human (FIH) experience with iVAS. METHODS: This is a prospective, non-randomized single arm, U.S. Food and Drug Administration (FDA)-approved early feasibility trial in patients listed for cardiac transplantation...
November 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29127472/prognostic-impact-of-atrial-fibrillation-in-cardiogenic-shock-complicating-acute-myocardial-infarction-a-substudy-of-the-iabp-shock-ii-trial
#2
Suzanne de Waha, Katharina Schoene, Georg Fuernau, Steffen Desch, Ingo Eitel, Janine Pöss, Roza Meyer-Saraei, Charlotte Eitel, Roland Tilz, Gerhard Schuler, Karl Werdan, Steffen Schneider, Taoufik Ouarrak, Uwe Zeymer, Holger Thiele
BACKGROUND: Aim of the current study was to analyse the impact of atrial fibrillation (AF) on prognosis in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI), which has never been investigated yet. METHODS: The current analysis is a substudy of the IABP-SHOCK II trial. Patients were grouped according to the presence or absence of AF. The primary endpoint was all-cause mortality at 30-day follow-up. Secondary endpoints included all-cause mortality, recurrent myocardial infarction, repeat revascularisation, and stroke at 12 months...
November 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28975854/clinical-application-of-intra-aortic-balloon-counterpulsation-in-high-risk-patients-undergoing-cardiac-surgery
#3
Dengbang Hou, Feng Yang, Xiaotong Hou
The intra-aortic balloon pump (IABP) has been the most commonly used mechanical circulatory support device for nearly five decades. In theory, the IABP can increase the blood and oxygen supply of the coronary artery by increasing the diastolic pressure in the aortic root when the balloon is inflated and reduce left ventricular afterload by rapidly deflating the balloon during the systolic phase. Therefore, some researchers put forward the idea of preoperative prophylactic use of an IABP, which has been frequently performed in high-risk patients undergoing elective percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG)...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28973669/transcranial-doppler-waveforms-during-intra-aortic-balloon-pump-counterpulsation-for-vasospasm-detection-after-subarachnoid-hemorrhage
#4
Nicholas A Morris, Nathan Manning, Randolph S Marshall, E Sander Connolly, Jan Claassen, Sachin Agarwal, David J Roh, J Michael Schmidt, Soojin Park
BACKGROUND: Transcranial Doppler ultrasound is a standard screening tool for vasospasm after subarachnoid hemorrhage. Prevention of vasospasm-induced delayed cerebral ischemia after subarachnoid hemorrhage depends on optimization of cerebral perfusion pressure, which can be challenged by neurogenic stress cardiomyopathy. Intra-aortic balloon pumps have been utilized to augment cerebral perfusion, but they change the transcranial Doppler waveform, altering its interpretability for vasospasm screening...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28962495/is-there-a-role-for-upper-extremity-intra-aortic-balloon-counterpulsation-as-a-bridge-to-recovery-or-a-bridge-to-transplant-in-the-treatment-of-end-stage-heart-failure
#5
Nnamdi Nwaejike, Andre Y Son, Carmelo A Milano, Mani A Daneshmand
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Is there a role for upper-extremity intra-aortic balloon pump counterpulsation (UE-IABP) in the treatment of end-stage heart failure? Altogether 230 papers were found using the reported search, of which 6 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28857849/advanced-percutaneous-mechanical-circulatory-support-devices-for-cardiogenic-shock
#6
REVIEW
P Elliott Miller, Michael A Solomon, Dorothea McAreavey
OBJECTIVES: To review temporary percutaneous mechanical circulatory support devices for the treatment of cardiogenic shock, including current evidence, contraindications, complications, and future directions. DATA SOURCES: A MEDLINE search was conducted with MeSH terms: cardiogenic shock, percutaneous mechanical circulatory support, extracorporeal membrane oxygenation, Impella, and TandemHeart. STUDY SELECTION: Selected publications included randomized controlled trial data and observational studies describing experience with percutaneous mechanical circulatory support in cardiogenic shock...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28819361/unilateral-headache-status-after-intra-aortic-balloon-pump-placement
#7
Garret M Weber, Alan L Gass, Shalvi B Parikh
INTRODUCTION: Intra-aortic balloon pump (IABP) counterpulsation is a catheter-based treatment for coronary artery disease and decompensated heart failure to increase coronary blood flow and improve cardiac output. IABP is generally well tolerated, and complications are usually related to peripheral vasculature or red blood cell and platelet consumption. The usual insertion site via femoral artery renders the patient bedbound. Recently, axillary artery has been used in patients with atherosclerotic peripheral vascular disease and documented small arteries or in those awaiting transplant to ensure ambulation and prevent deconditioning...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28804232/acute-beneficial-effects-of-muscular-counterpulsation-in-patients-with-coronary-heart-diseases
#8
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
#9
COMPARATIVE STUDY
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
#10
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
#11
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...
November 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
#12
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
#13
Corstiaan A den Uil, Dinis Dos Reis Miranda, Nicolas M Van Mieghem, Lucia S Jewbali
No abstract text is available yet for this article.
July 24, 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
August 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
#20
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
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