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ventricular assist devices

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https://www.readbyqxmd.com/read/28106960/a-novel-technique-to-exclude-the-left-ventricle-with-an-assist-device
#1
Stefan Klotz, Roza MeyerSaraei, Alex Frydrychowicz, Michael Scharfschwerdt, Andreas Koertge, Leon Putman, Hans Sievers
Left ventricular assist device implantation disrupts the natural intracavitary blood flow path through the heart, introducing flow patterns potentially associated with thrombosis, especially around the inflow cannula. We describe a novel technique for completely excluding the left ventricle with an assist device by using a cone shaped ring-reinforced prosthesis.
December 9, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28106959/implanting-permanent-left-ventricular-assist-devices-in-patients-on-veno-arterial-extracorporeal-membrane-oxygenation-support
#2
Diyar Saeed, Alexander Assmann, Muhammad Abdeen, Alexander Albert, Bujar Maxhera, Najla Sadat, Stephan Sixt, Artur Lichtenberg
Selected patients who fail to be weaned off temporary veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support may be considered for long-term left ventricular assist devices (LVADs).  We describe here an LVAD implantation technique in patients with prior VA-ECMO support without the use of a cardiopulmonary bypass machine, which minimizes the intraoperative trauma and blood loss while still meeting all the goals of the standard procedure.
December 9, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28104118/cerebrovascular-accident-rate-is-different-between-centrifugal-and-axial-flow-pumps-but-survival-and-driveline-infection-rates-are-similar
#3
M Kimura, K Nawata, O Kinoshita, H Yamauchi, Y Itoda, T Imamura, M Hatano, K Kinugawa, M Ono
OBJECTIVES: We analyzed the outcome of patients with implantable left ventricular assist devices (LVADs) at the University of Tokyo Hospital to compare those with centrifugal pumps (CE group: Duraheart and Evaheart) and those with axial-flow pumps (AX group: Heartmate II and Jarvik 2000). METHODS: A total of 68 patients who underwent implantation of LVADs (Duraheart: n = 15; Evaheart: n = 23; Heartmate II: n = 22; Jarvik 2000: n = 8) as a bridge to transplantation at our institution from May 2011 to April 2015 were retrospectively reviewed...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28102475/prospective-evaluation-of-a-bivalirudin-to-warfarin-transition-nomogram
#4
Benjamin Hohlfelder, Katelyn W Sylvester, Jessica Rimsans, David DeiCicchi, Jean M Connors
Bivalirudin may cause a falsely prolonged international normalized ratio (INR) that complicates the discontinuation of bivalirudin when used as a bridge to warfarin. To prospectively validate our novel bivalirudin to warfarin transition nomogram, adult patients who received bivalirudin as a bridge to warfarin between July 2015 and June 2016 were prospectively evaluated, utilizing our predictive nomogram. The major outcome of our analysis was the correlation between the predicted change in INR upon bivalirudin discontinuation based on the nomogram, and the actual change in INR upon bivalirudin discontinuation...
January 19, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28100834/soft-robotic-sleeve-supports-heart-function
#5
Ellen T Roche, Markus A Horvath, Isaac Wamala, Ali Alazmani, Sang-Eun Song, William Whyte, Zurab Machaidze, Christopher J Payne, James C Weaver, Gregory Fishbein, Joseph Kuebler, Nikolay V Vasilyev, David J Mooney, Frank A Pigula, Conor J Walsh
There is much interest in form-fitting, low-modulus, implantable devices or soft robots that can mimic or assist in complex biological functions such as the contraction of heart muscle. We present a soft robotic sleeve that is implanted around the heart and actively compresses and twists to act as a cardiac ventricular assist device. The sleeve does not contact blood, obviating the need for anticoagulation therapy or blood thinners, and reduces complications with current ventricular assist devices, such as clotting and infection...
January 18, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28097728/dabigatran-etexilate-in-a-vitamin-k-antagonist-non-responder-patient-during-heartware-hvad-support
#6
Andrea Baronetto, Paolo Centofanti, Matteo Attisani, Massimo Boffini, Davide Ricci, Erika Simonato, Mauro Rinaldi
We report a case of a patient supported with a HeartWare left ventricular assist device for idiopathic cardiomyopathy who was resistance to vitamin-K antagonists three months after implantation. The patient initially started low-molecular-weight heparin therapy and then, after the onset of an ischemic stroke, switched to dabigatran etexilate (DE). The patient had progressive recovery of cardiac function for which the device was explanted. No thrombotic or bleeding events occurred during DE therapy.
January 17, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28095452/influence-of-mechanical-circulatory-support-on-endothelin-receptor-expression-in-human-left-ventricular-myocardium-from-patients-with-dilated-cardiomyopathy-dcm
#7
Florian Gärtner, Getu Abraham, Astrid Kassner, Daniela Baurichter, Hendrik Milting
BACKGROUND: In terminal failing hearts ventricular assist devices (VAD) are implanted as a bridge to transplantation. Endothelin receptor (ETR) antagonists are used for treatment of secondary pulmonary hypertension in VAD patients. However, the cardiac ETR regulation in human heart failure and during VAD support is incompletely understood. METHODS: In paired left ventricular samples of 12 dilated cardiomyopathy patients we investigated the density of endothelin A (ETA) and B (ETB) receptors before VAD implantation and after device removal...
2017: PloS One
https://www.readbyqxmd.com/read/28094176/atrial-septal-defect-in-a-patient-with-a-mechanical-mitral-valve-prosthesis-undergoing-implantation-of-a-left-ventricular-assist-device-to-repair-or-not-to-repair
#8
Michael Essandoh, Bryan Whitson, Luke Dong, Ashley Yager, Ashley Gabrielsen, Ahmet Kilic
No abstract text is available yet for this article.
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28093805/heartware-ventricular-assist-device-implantation-in-patients-with-fontan-physiology
#9
Bartlomiej R Imielski, Robert A Niebler, Steven J Kindel, Ronald K Woods
We aim to describe the clinical course of a series of patients with hypoplastic left heart syndrome and refractory systolic heart failure supported with a HeartWare ventricular assist device (HVAD) following Fontan palliation. This is a retrospective review of three consecutive patients supported with a HVAD following Fontan palliation through February 2016. Data include patient characteristics, operative variables, postimplantation hemodynamic/device parameters, event outcomes, and duration of HVAD support...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28093804/successful-bridge-to-transplant-of-functionally-univentricular-patients-with-a-modified-continuous-flow-ventricular-assist-device
#10
Michael C Mongé, Bradley T Kulat, Osama Eltayeb, Neale R Zingle, Steven T Moss, Jeffrey G Gossett, Elfriede Pahl, John M Costello, Carl L Backer
A continuous flow extracorporeal ventricular assist device (VAD) was modified to support functionally univentricular infants and children awaiting heart transplantation. A centrifugal VAD, designed to flow from 1.5 to 8 L/min, was used as a bridge-to-transplant in four patients with functionally univentricular circulation. A variable restrictive recirculation shunt permitted lower flow ranges in small patients. In hypoxic patients, an oxygenator was incorporated into the circuit. From 2012 to 2015, the modified VAD was placed in four patients with Glenn physiology...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28093312/palliative-medicine-and-preparedness-planning-for-patients-receiving-left-ventricular-assist-device-as-destination-therapy-challenges-to-measuring-impact-and-change-in-institutional-culture
#11
Brandon P Verdoorn, Angela J Luckhardt, Sara E Wordingham, Shannon M Dunlay, Keith M Swetz
CONTEXT: While left ventricular assist devices as destination therapy (DT-LVAD) can improve survival, quality of life, and functional capacity in well-selected patients with advanced heart failure, there remain unique challenges to providing quality end-of-life care in this population. Palliative care involvement is universally recommended, but how to best operationalize this care and measure success is unknown. OBJECTIVES: To characterize the process of preparedness planning (PP) for patients receiving DT-LVAD at our institution and better understand opportunities for quality improvement or procedural transferability...
January 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28092289/the-impact-of-obesity-on-heart-failure
#12
Alexander B Zhai, Haissam Haddad
PURPOSE OF REVIEW: Obesity, a growing global health problem, contributes to the development of heart failure. However, increased BMI seems protective for those with established disease, a phenomenon known as the 'obesity paradox'. In this review, we outline the mechanism through which obesity can contribute to the development of heart failure, explore the concept of obesity paradox, and highlight the challenges that obesity presents for advanced heart failure therapy. RECENT FINDINGS: Although the mechanism underlying the obesity paradox is complex, meta-analysis shows that intentional weight loss through bariatric surgery can indeed improve cardiac structure and function...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28089072/the-role-of-implantable-cardioverter-defibrillators-in-patients-bridged-to-transplantation-with-a-continuous-flow-left-ventricular-assist-device-a-propensity-score-matched-analysis
#13
Kevin J Clerkin, Veli K Topkara, Donna M Mancini, Melana Yuzefpolskaya, Ryan T Demmer, Jose M Dizon, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, A Reshad Garan
BACKGROUND: Implantable cardioverter defibrillators (ICDs) provide a significant mortality benefit for appropriately selected patients with advanced heart failure. ICDs are associated with a mortality benefit when used in patients with a pulsatile left ventricular assist device (LVAD). It is unclear whether patients with a continuous-flow LVAD (CF-LVAD) derive the same benefit. We sought to determine if the presence of an ICD provided a mortality benefit during CF-LVAD support as a bridge to transplantation...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#14
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/28087105/left-ventricular-assist-device-outcomes-based-on-flow-configuration-and-pre-operative-left-ventricular-dimension-an-interagency-registry-for-mechanically-assisted-circulatory-support-analysis
#15
Palak Shah, Sarah Birk, Simon Maltais, John Stulak, Angelo Elmi, Francis D Pagani, Jennifer A Cowger
BACKGROUND: Axial configuration (AC) and centrifugal configuration (CC) left ventricular assist devices (LVAD) have different flow characteristics, and whether the interaction between device flow configuration and the pre-operative left ventricular internal diastolic diameter (LVIDD) mediates adverse events after LVAD implantation is unknown. METHODS: We queried 9,424 continuous-flow LVAD recipients who received LVADs from April 2008 to June of 2015 in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
December 16, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#16
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28076895/implantation-of-left-ventricular-assist-device-in-a-patient-with-left-ventricular-non-compaction
#17
Keki R Balsara, Andrew Bierhals, Justin Vader, Michael K Pasque, Aki Itoh
Left ventricular noncompaction (LVNC) may result in systolic left ventricular (LV) failure resulting in the need for heart transplantation. LV assist devices (LVAD) have been used to bridge these patients to transplantation; however, the extensive trabeculations found in these patients predispose them to thromboembolic events and pump thrombosis. We describe a patient with LVNC in whom an aggressive surgical approach was used to debride the LV cavity of trabeculations to successfully implant an LVAD.
January 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28073849/caregivers-of-patients-with-left-ventricular-assist-devices-possible-impacts-on-patients-mortality-and-interagency-registry-for-mechanically-assisted-circulatory-support-defined-morbidity-events
#18
Courtenay R Bruce, Charles G Minard, L A Wilhelms, Mackenzie Abraham, Javier Amione-Guerra, Linda Pham, Sherry D Grogan, Barry Trachtenberg, Martin L Smith, Brian A Bruckner, Jerry D Estep, Kristin M Kostick
BACKGROUND: How caregivers contribute to positive or negative outcomes for left ventricular assist device (LVAD) patients remains unclear. Our primary study objectives were to (1) identify caregiver support attributes through a retrospective chart review of social workers' psychosocial assessments for LVAD patients and (2) determine how these attributes associated with patients' post-LVAD placement mortality and Interagency Registry for Mechanically Assisted Circulatory Support-defined morbidity events...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28073805/sheet-like-remodeling-of-the-transverse-tubular-system-in-human-heart-failure-impairs-excitation-contraction-coupling-and-functional-recovery-by-mechanical-unloading
#19
Thomas Seidel, Sutip Navankasattusas, Azmi A Ahmad, Nikolaos A Diakos, Weining D Xu, Martin Tristani-Firouzi, Michael Bonios, Iosif Taleb, Dean Y Li, Craig H Selzman, Stavros G Drakos, Frank B Sachse
BACKGROUND: -Cardiac recovery in response to mechanical unloading by left ventricular assist devices (LVADs) has been demonstrated in subgroups of chronic heart failure (HF) patients. Hallmarks of HF are depletion and disorganization of the transverse tubular system (t-system) in cardiomyocytes. Here, we investigated remodeling of the t-system in human end-stage HF and its role in cardiac recovery. METHODS: -Left ventricular biopsies were obtained from 5 donors (CTRL) and 26 chronic HF patients undergoing implantation of LVADs...
January 10, 2017: Circulation
https://www.readbyqxmd.com/read/28073804/hemodynamic-support-with-a-micro-axial-percutaneous-left-ventricular-assist-device-impella%C3%A2-protects-against-acute-kidney-injury-in-patients-undergoing-high-risk-percutaneous-coronary-intervention
#20
Michael P Flaherty, Sadip Pant, Samir V Patel, Tyler Kilgore, Sujith Dassanayaka, John Loughran, Wasiq Rawasia, Buddhadeb Dawn, Allen Cheng, Carlo R Bartoli
RATIONALE: Acute kidney injury (AKI) is common during high-risk percutaneous coronary intervention (PCI) particularly in those with severely reduced left ventricular (LV) ejection fraction (EF). The impact of partial hemodynamic support with a micro-axial percutaneous LV assist device (pLVAD) on renal function following high-risk PCI remains unknown. OBJECTIVE: We tested the hypothesis that partial hemodynamic support with the Impella 2.5 micro-axial pLVAD during high-risk PCI protected against AKI...
January 10, 2017: Circulation Research
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