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LVAD thrombus

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https://www.readbyqxmd.com/read/28191682/aortic-root-thrombus-complicated-by-left-main-coronary-artery-occlusion-visualized-by-3d-echocardiography-in-a-patient-with-continuous-flow-left-ventricular-assist-device
#1
Monique S Tanna, Alex Reyentovich, Leora B Balsam, John A Dodson, Alan F Vainrib, Ricardo J Benenstein, Barry P Rosenzweig, Muhamed Saric
Aortic root thrombus is an uncommon complication of continuous-flow left ventricular assist devices (LVAD). We present the case of a 71-year-old man with ischemic cardiomyopathy who underwent destination therapy HeartMate II LVAD placement. Eighteen months later, he presented with a cerebrovascular accident followed by myocardial infarction. Transesophageal echocardiography revealed an aortic root thrombus spanning the left and noncoronary cusps and obliterating the left main coronary artery. We discuss the incidence, risk factors, and management of aortic root thrombus in LVAD patients...
February 13, 2017: Echocardiography
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#2
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
January 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#3
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28009715/impact-of-lvad-implantation-site-on-ventricular-blood-stagnation
#4
Anthony R Prisco, Alberto Aliseda, Jennifer A Beckman, Nahush A Mokadam, Claudius Mahr, Guilherme J M Garcia
Treatment of end-stage heart failure includes cardiac transplantation or ventricular assist device (VAD) therapy. While increasingly prevalent, current VAD therapy has inherent complications, including thrombosis. Studies have demonstrated that VAD implantation alters intra-cardiac blood flow, creating areas of stagnation that predispose to thrombus formation. Two potential surgical configurations exist for VAD implantation: through the apical or diaphragmatic surfaces of the heart. We hypothesized that diaphragmatic implantation causes more stagnation than apical implantation...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28009710/subxiphoid-exchange-of-heartmate-ii-left-ventricular-assist-device
#5
Vakhtang Tchantchaleishvili, Jessica G Y Luc, Joshua Haswell, William Hallian, H Todd Massey
With increasing use of left ventricular assist devices (LVAD) for long-term circulatory support comes a growing need for device exchange. The conventional surgical approach for device exchanges has been a reoperative median resternotomy. Less invasive HeartMate II LVAD exchange via a non-muscle-dividing subxiphoid incision as an alternative to a left subcostal incision may reduce pain burden and facilitate recovery. From November 2006 through June 2015, 292 patients underwent HeartMate II LVAD placement, of which 30 (10...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27984314/medical-management-of-pump-related-thrombosis-in-patients-with-continuous-flow-left-ventricular-assist-devices-a-systematic-review-and-meta-analysis
#6
Geetanjali Dang, Narendranath Epperla, Vijayadershan Mupiddi, Natasha Sahr, Amy Pan, Pippa Simpson, Lisa Baumann Kreuziger
Pump thrombosis is a dreaded complication of left ventricular assist device (LVADs). We completed a systematic review to evaluate the efficacy and complications associated with medical management of LVAD thrombosis. Databases were searched using the terms "vad*" or "ventricular assist device" or "heart assist device" and "thrombus" or "thrombosis" or "thromboembolism". Of 2383 manuscripts, 49 articles met the inclusion criteria. The risk of partial or no resolution of LVAD thrombosis did not significantly differ between thrombolytic and non-thrombolytic regimens (OR 0...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27909839/biventricular-support-using-a-centrifugal-pump-in-a-6%C3%A2-year-old-with-fulminant-myocarditis
#7
Hiromu Kehara, Tamaki Takano, Takamitsu Terasaki, Kenji Okada
We experienced a case of ventricular assist with both a pulsatile-flow and a continuous-flow pump in a pediatric patient, and herein report the clinical course and characteristics of the pumps. A 6-year-old female was diagnosed with fulminant myocarditis and transferred to our hospital for mechanical support. After 12 days of extracorporeal membrane oxygenation, we implanted a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) using centrifugal Gyro pumps with a membrane oxygenator in a paracorporeal fashion...
December 1, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27849849/207-eptifibatide-in-suspected-pump-thrombus-or-thrombosis-in-lvad-patients
#8
Cody Parsons
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27834450/echocardiographic-detection-of-left-ventricular-thrombus-in-patients-undergoing-heartmate-ii-left-ventricular-assist-device-implantation
#9
Heidi B Schubmehl, Vakhtang Tchantchaleishvili, Eugene Storoznsky, Jeffrey D Alexis, Leway Chen, Howard T Massey
PURPOSE: Transthoracic (TTE) and transesophageal echocardiograms (TEE) are considered accurate in detecting the presence of left ventricular (LV) thrombus. A persistent LV thrombus poses risks of pump thrombosis and stroke in LVAD recipients. The relationship between preoperative echocardiography and intraoperative findings at LVAD implantation has not previously been studied. METHODS: A retrospective review examined all patients undergoing LVAD placement or exchange from October 2011 to March 2014...
November 11, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27793517/a-multi-institutional-outcome-analysis-of-patients-undergoing-left-ventricular-assist-device-implantation-stratified-by-sex-and-race
#10
Justin van Meeteren, Simon Maltais, Shannon M Dunlay, Nicholas A Haglund, Mary Beth Davis, Jennifer Cowger, Palak Shah, Keith D Aaronson, Francis D Pagani, John M Stulak
BACKGROUND: Earlier studies have demonstrated disparities in patients undergoing left ventricular assist device (LVAD) implantation when stratified according to sex and race. Because very few data exist from large investigations, we reviewed data from the registry of the Mechanical Circulatory Support Research Network. METHODS: Between May 2004 and September 2014, 734 patients underwent primary LVAD implantation at our institutions. Median age at implant was 57 (range 18 to 82) years and there were 577 males (80%)...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27692952/left-ventricular-assist-device-as-destination-therapy-in-cardiac-end-stage-dystrophinopathies-midterm-results
#11
Gianluigi Perri, Sergio Filippelli, Rachele Adorisio, Roberta Iacobelli, Francesca Iodice, Giuseppina Testa, Maria Giovanna Paglietti, Domenico D'Amario, Massimo Massetti, Antonio Amodeo
OBJECTIVE: We report our experience with the use of a left ventricular assist device (LVAD) as destination therapy (DT) for the management of patients with cardiac end-stage dystrophinopathies. METHODS: From February 2011 to February 2016, 7 patients with dystrophinopathies and dilated cardiomyopathy (DCM) were treated with LVADs at our institution. Median age at surgery was 16.5 years (range, 14.2-23.4 years). All patients were preoperatively evaluated by a multidisciplinary team approach...
August 28, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27660906/heat-generation-in-axial-and-centrifugal-flow-left-ventricular-assist-devices
#12
Gardner Yost, Christine Rachel Joseph, Thomas Royston, Antone Tatooles, Geetha Bhat
Despite increasing use of left ventricular assist devices (LVADs) as a surgical treatment for advanced heart failure in an era of improved outcomes with LVAD support, the mechanical interactions between these pumps and the cardiovascular system are not completely understood. We utilized an in vitro mock circulatory loop to analyze the heat production incurred by operation of an axial flow and centrifugal flow LVAD.A HeartMate II and a HeartWare HVAD were connected to an abbreviated flow loop and were implanted in a viscoelastic gel...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27556143/extracorporeal-left-ventricular-circulatory-support-as-a-bridge-to-implantable-lvad-for-a-patient-with-pan-left-ventricular-thrombosis
#13
Mitsugu Ogawa, Keki R Balsara, Muhammad Faraz Masood, Akinobu Itoh
We present the case of a 57-year-old woman who developed pan-left ventricular thrombus while being supported with central extracorporeal membrane oxygenation support for cardiogenic shock. The left heart thrombus was evacuated emergently through the aortic valve, left atriotomy and left ventriculotomy. The cannulation was then revised with the addition of a 36-French angled cannula in the apex of the left ventricle to decompress the ventricle, minimize stasis and allow for any residual micro thrombus to be trapped in the oxygenator membrane, not causing embolization...
August 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27282897/diagnosis-and-treatment-algorithm-for%C3%A2-blood-flow-obstructions-in-patients-with%C3%A2-left-ventricular-assist-device
#14
Anna Mara Scandroglio, Friedrich Kaufmann, Marina Pieri, Alexandra Kretzschmar, Marcus Müller, Panagiotis Pergantis, Stephan Dreysse, Volkmar Falk, Thomas Krabatsch, Evgenij V Potapov
BACKGROUND: Thrombosis is an uncommon, but severe complication of left ventricular assist devices (LVADs). OBJECTIVES: This study analyzed experience with obstruction of blood flow through the LVAD with the purpose of developing optimal diagnosis and treatment of LVAD-related thrombosis. METHODS: Between October 2009 and July 2015, a total of 652 LVAD were implanted in 557 patients. Blood flow abnormalities in patients with LVAD (n = 524) were identified and classified as "high-power" and "low-flow" events...
June 14, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/26919069/investigating-the-impact-of-non-newtonian-blood-models-within-a-heart-pump
#15
Mohammed G Al-Azawy, A Turan, A Revell
A detailed Computational Fluid Dynamics (CFD) study of transient, turbulent blood flow through a positive displacement left ventricular assist device (LVAD) is performed. Two common models for Non-Newtonian blood flow are compared to the Newtonian model to investigate their impact on predicted levels of shear rate and wall shear stress. Given that both parameters are directly relevant to the evaluation of risk from thrombus and haemolysis, there is a need to assess the sensitivity to modelling non-Newtonian flow effects within a pulsatile turbulent flow, in order to identify levels of uncertainly in CFD...
February 26, 2016: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/26899195/asymptomatic-sustained-polymorphic-ventricular-tachycardia-in-a-patient-with-a-left-ventricular-assist-device-case-report-and-what-the-emergency-physician-should-know
#16
James Fitzgibbon, Nicholas E Kman, Diane Gorgas
BACKGROUND: Left ventricular assist devices (LVADs) are a viable treatment option for patients with end-stage heart failure. LVADs can improve survival, quality of life, and functional status. The indications for LVAD placement to support left ventricular function are temporary support, a bridge to transplantation, or destination therapy. CASE REPORT: A 61-year-old man with past medical history significant for advanced congestive heart failure from ischemic cardiomyopathy, status post LVAD (HeartMate II; Thoratec Corporation, Pleasanton, CA) placement 2009 as destination therapy, presented to the Emergency Department (ED) with implantable cardiac defibrillators firing four times that morning...
March 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26681123/treatment-of-device-thrombus-in-the-heartware-hvad-success-and-outcomes-depend-significantly-on-the-initial-treatment-strategy
#17
MULTICENTER STUDY
John M Stulak, Shannon M Dunlay, Shashank Sharma, Nicholas A Haglund, Mary Beth Davis, Jennifer Cowger, Palak Shah, Faraz Masood, Keith D Aaronson, Francis D Pagani, Simon Maltais
BACKGROUND: Pump thrombosis is a major adverse event in patients supported with a left ventricular assist device (LVAD). Treatment approaches include device exchange, lytic therapy, or augmentation of anticoagulation or antiplatelet therapy. The optimal strategy in the HeartWare HVAD Ventricular Assist System (HeartWare, Framingham, MA) is uncertain, and because few large studies have examined differing treatment outcomes, we have reviewed findings from the Mechanical Circulatory Support Research Network registry...
December 2015: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/26545967/adverse-events-in-contemporary-continuous-flow-left-ventricular-assist-devices-a-multi-institutional-comparison-shows-significant-differences
#18
MULTICENTER STUDY
John M Stulak, Mary E Davis, Nicholas Haglund, Shannon Dunlay, Jennifer Cowger, Palak Shah, Francis D Pagani, Keith D Aaronson, Simon Maltais
OBJECTIVES: We review differences in the incidence and timing of adverse events in patients implanted with continuous-flow left ventricular assist devices (LVADs), using the Mechanical Circulatory Support Research Network registry. METHODS: From May 2004 to September 2014, a total of 734 patients (591 men; median age: 59 years) underwent primary continuous-flow LVAD implantation at our institutions. Patients implanted with the HeartMate II (HMII) (560 [76%] patients), compared with the HeartWare ventricular assist device (HVAD; 174 [24%]) were more often receiving destination therapy (47% vs 20%; P < ...
January 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26539463/initial-in-vivo-evaluation-of-a-novel-left-ventricular-assist-device
#19
Guanghui Wu, Changyan Lin, Haiyang Li, Xiaotong Hou, Chen Chen, Xiujian Liu, Chuangye Xu, Jing Wang, Peng Yang, Wenbo Qu
The aim of the study was to use the ovine model to evaluate the hemocompatibility and end-organ effects of a newly developed magnetic suspension centrifugal left ventricular assist device (LVAD) by CH Biomedical Inc., Jiangsu, China. The LVADs were implanted in 6 healthy sheep, where inflow was inserted into the left ventricular apex and outflow was anastomosed to the descending aorta. All sheep received anticoagulation and antiaggregation therapy during the study. Hematologic and biochemical tests were performed to evaluate anemia, hepatorenal function, and the extent of hemolysis...
2015: BioMed Research International
https://www.readbyqxmd.com/read/26452760/intraoperative-bronchoscopic-visualization-of-left-ventricular-assist-device-thrombus
#20
Gardner Yost, Geetha Bhat, Sejal Modi, Pat Pappas, Antone Tatooles
Despite advancements in left ventricular assist device (LVAD) design and clinical management, device thrombosis remains a pertinent complication. Limited imaging makes precise visualization of clot location and shape very challenging. We report the usage of videobronchoscopic exploration of explanted LVADs for direct visualization of clot in two patients. This technique is a rapid and inexpensive means of improving our understanding of LVAD clot formation and may be useful in surgical exploration of inflow and outflow tracts during LVAD exchange...
July 2016: Perfusion
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