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ventricular assist devices

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https://www.readbyqxmd.com/read/29444276/extracorporeal-resuscitation-as-a-further-modifier-of-clinical-outcome-in-patients-with-left-ventricular-assist-device-implantation-and-interagency-registry-for-mechanically-assisted-circulatory-support-level-1
#1
Edis Ljajikj, Armin Zittermann, Andreas Koster, Jochen Börgermann, Michael Schönbrodt, Kavous Hakim-Meibodi, Jan Gummert, Michiel Morshuis
In cardiogenic shock patients with Interagency Registry for Mechanical Circulatory Support (INTERMACS) level 1, the need for temporary circulatory support is a predictor and modifier of patient outcome. Because this group includes patients with and without cardiopulmonary resuscitation (CPR) and is thus very heterogeneous, we investigated whether a further subclassification is useful. We compared 30-day and 1-year mortality of patients who underwent left ventricular assist device implantation after extracorporeal CPR with the aid of an extracorporeal life support system (CPR+ group; n = 40) with cardiogenic shock patients in which the extracorporeal life support system was implanted under non-CPR conditions (CPR- group, n = 68)...
February 12, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29444250/are-elevated-serum-haemolysis-markers-a-harbinger-of-adverse-events-in-heartmate-ii-patients
#2
Rashad Zayat, Mohamed Shoaib, Mohammad Amen Khattab, Usaama Ahmad, Andreas Goetzenich, Christian Stoppe, Ann Christina Foldenauer, Ajay Moza, Heike Schnoering, Rüdiger Autschbach, Lachmandath Tewarie
OBJECTIVES: Haemolysis during left ventricular assist device support is associated with thrombosis. In this retrospective study, we analysed whether low-level haemolysis (LLH) as defined by simultaneously elevated lactate dehydrogenase (LDH) and free haemoglobin (fHb) levels had an impact on thromboembolic and bleeding events and on von Willebrand factor levels in HeartMate II patients. METHODS: After exclusion of patients with LDH >700 U/l and fHb >40 mg/dl at hospital discharge, 79 HeartMate II patients were included...
February 12, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29443352/levitronix-bilateral-ventricular-assist-device-a-bridge-to-recovery-in-a-patient-with-acute-fulminant-myocarditis-and-concomitant-cerebellar-infarction
#3
Yi-Fan Huang, Po-Shun Hsu, Chien-Sung Tsai, Yi-Ting Tsai, Chih-Yuan Lin, Hong-Yan Ke, Yi-Chang Lin, Hsiang-Yu Yang
We report on the case of a 27-year-old male who presented to our emergency room with chest tightness, dyspnoea and cold sweats. The 12-lead electrocardiogram showed diffuse ventricular tachycardia with wide QRS complexes. Troponin-I level was elevated to 100 ng/ml. The coronary angiogram showed good patency of all three coronary vessels, and acute fulminant myocarditis was suspected. The patient underwent cardiopulmonary resuscitation in the catheter room and high-dose inotropic support was initiated to stabilise his haemodynamic status...
February 7, 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29439593/bleeding-risks-in-patients-on-percutaneous-ventricular-assist-devices-receiving-two-different-dextrose-concentrations-of-heparinized-purge-solution-a-case-series
#4
Jenna N Dietrich, Hasan Kazmi
BACKGROUND: The Impella manufacturer has changed its recommendation for the diluent of the heparinized purge solution from 20% dextrose (D20) to 5% dextrose (D5). This reduced viscosity may result in increased purge solution infusion rates and unfractionated heparin (UFH) exposure. Increased UFH exposure could potentially cause increased bleeding events and may necessitate reduction in UFH concentration in the purge solution. Our objective was to evaluate anticoagulation for patients on Impella pumps receiving heparinized purge solution with D20 or D5 diluents...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29438111/comparison-of-transplant-waitlist-outcomes-for-pediatric-candidates-supported-by-ventricular-assist-devices-versus-medical-therapy
#5
Sabrina P Law, Assaf P Oron, Mariska S Kemna, Erin L Albers, D Michael McMullan, Jonathan M Chen, Yuk M Law
OBJECTIVES: Ventricular assist devices have gained popularity in the management of refractory heart failure in children listed for heart transplantation. Our primary aim was to compare the composite endpoint of all-cause pretransplant mortality and loss of transplant eligibility in children who were treated with a ventricular assist device versus a medically managed cohort. DESIGN: This was a retrospective cohort analysis. SETTINGS: Data were obtained from the Scientific Registry of Transplant Recipients...
February 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29437819/echocardiographic-evaluation-of-sandwich-plug-closure-of-mechanical-aortic-valve-at-left-ventricular-assist-device-implantation
#6
Amanda Kleiman, Daniel A Smith, Leora T Yarboro, John S McNeil
No abstract text is available yet for this article.
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29436010/changes-in-total-cardiac-output-and-oxygen-extraction-during-exercise-in-patients-supported-with-an-hvad-left-ventricular-assist-device
#7
Thomas Schmidt, Birna Bjarnason-Wehrens, Stephanie Mommertz, Meike Hannig, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO 2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO 2 ). We investigated the changes in CO and avDO 2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29433532/is-there-a-difference-in-bleeding-after-left-ventricular-assist-device-implant-centrifugal-versus-axial
#8
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29432298/ventricular-assist-device-patients-have-different-clinical-outcomes-and-altered-patterns-of-bleeding-with-intracranial-hemorrhage
#9
Mustafa M Ahmed, Maryam Rahman, Dan Neal, Juan M Aranda, Charles T Klodell
Intracranial hemorrhage (ICH) is one of the most feared complications of left ventricular assist device (LVAD) support. However, outcomes in this group have not been well described. We therefore sought to examine clinical outcomes in this patient population in comparison to those with heart failure (HF) and no LVAD, as well as those without HF or LVAD. The National Inpatient Sample database, years 2002-2012, was queried to classify patients into 3 groups: any ICH (group 1), any HF with any ICH (group 2), and any LVAD with any ICH (group 3)...
February 9, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29432132/outcomes-of-heart-failure-admissions-under-observation-versus-short-inpatient-stay
#10
Ahmad Masri, Andrew D Althouse, Jeffrey McKibben, Floyd Thoma, Michael Mathier, Ravi Ramani, Jeffrey Teuteberg, Oscar Marroquin, Joon S Lee, Suresh R Mulukutla
BACKGROUND: Patients with heart failure (HF) are admitted either under observation (OBS) or inpatient stays; however, there is little data on whether this designation reflects the clinical status of a patient, with significant logistical and financial implications. We sought to compare the outcomes of patients with HF admitted OBS versus inpatient stay (≤2 days; INPT). METHODS AND RESULTS: From January 1, 2008 to September 30, 2015, our multisite health system saw 21 339 unique patients totaling 52 493 hospital admissions with a primary diagnosis of HF...
January 31, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29431154/helical-flow-component-of-left-ventricular-assist-devices-lvads-outflow-improves-aortic-hemodynamic-states
#11
Qi Zhang, Bin Gao, Yu Chang
BACKGROUND Although LVADs are confirmed to have strong effects on aortic hemodynamics, the precise mechanisms of the helical flow component of LVAD outflow are still unclear. MATERIAL AND METHODS To clarify these effects, 3 cases - normal case, flat flow case, and realistic flow case - were designed and studied by using the CFD approach. The normal case denoted the normal aorta without LVAD support, and the flat flow case represented the aorta with the outflow cannula. Similarly, the realistic flow case included the aortic model, the model of outflow cannula, and the model of LVAD...
February 12, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29430470/transjugular-intrahepatic-portosystemic-shunt-for-refractory-variceal-bleeding-in-a-patient-with-a-left-ventricular-assist-device
#12
Anusha Shirwaikar Thomas, Jerry Estep, David W Victor
Transjugular intrahepatic portosystemic shunt (TIPS) is an attractive therapeutic option in cirrhotic patients with recurrent variceal bleeding refractory to medical and endoscopic therapy. There is little known about the use of TIPS in patients with left ventricular assist devices (LVAD). We describe a patient with a durable continuous-flow LVAD and concurrent decompensated cardiac cirrhosis who underwent successful TIPS placement for recurrent variceal bleeding. The patient has had no rebleeding or encephalopathy in >12 months since TIPS placement...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29428715/routine-clinical-anti-platelet-agents-have-limited-efficacy-in-modulating-hypershear-mediated-platelet-activation-associated-with-mechanical-circulatory-support
#13
Lorenzo Valerio, Jawaad Sheriff, Phat L Tran, William Brengle, Alberto Redaelli, Gianfranco B Fiore, Federico Pappalardo, Danny Bluestein, Marvin J Slepian
INTRODUCTION: Continuous flow ventricular assist devices (cfVADs) continue to be limited by thrombotic complications associated with disruptive flow patterns and supraphysiologic shear stresses. Patients are prescribed complex antiplatelet therapies, which do not fully prevent recurrent thromboembolic events. This is partially due to limited data on antiplatelet efficacy under cfVAD-associated shear conditions. MATERIALS AND METHODS: We investigated the efficacy of antiplatelet drugs directly acting on three pathways: (1) cyclooxygenase (aspirin), (2) phosphodiesterase (dipyridamole, pentoxifylline, cilostazol), and (3) glycoprotein IIb-IIIa (eptifibatide)...
December 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29428358/central-veno-arterial-extracorporeal-membrane-oxygenation-c-va-ecmo-after-cardiothoracic-surgery-a-single-center-experience
#14
Antonio Rubino, Diego Costanzo, Daniel Stanszus, Kamen Valchanov, David Jenkins, Federico Sertic, Jo-Anne Fowles, Alain Vuylsteke
OBJECTIVES: Central veno-arterial extracorporeal membrane oxygenation (C-VA-ECMO) provides temporary cardiorespiratory support for patients in heart failure who cannot be weaned from cardiopulmonary bypass successfully. Outcomes are influenced by the reversibility of the initial insult and complications of the technique. METHODS: The authors reviewed their single-center experience over the last 8 years to inform future practice. The study included all patients supported with C-VA-ECMO after cardiothoracic surgery between January 2008 and July 2016...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29427603/long-acting-octreotide-reduces-the-recurrence-of-gastrointestinal-bleeding-in-patients-with-a-continuous-flow-left-ventricular-assist-device
#15
Colleen Juricek, Teruhiko Imamura, Ann Nguyen, Ben Chung, Daniel Rodgers, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyohi Ota, Tae Song, Daniel Burkhoff, Gabriel Sayer, Valluvan Jeevanandam, Nir Uriel
BACKGROUND: Recurrent gastrointestinal bleeding is one of the most significant adverse events in patients with left ventricular assist devices (LVAD). METHODS: We enrolled LVAD patients who had received an intramuscular injection of 20 mg of octreotide LR every 4 weeks as secondary prevention for recurrent gastrointestinal bleeding despite conventional medical therapies and repeated transfusions. The frequency of gastrointestinal bleeding and other associated clinical outcomes before and during octreotide therapy were compared...
February 7, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29425550/efficacy-of-intramyocardial-injection-of-algisyl-lvr-for-the-treatment-of-ischemic-heart-failure-in-swine
#16
Jenny S Choy, Shuang Leng, Gabriel Acevedo-Bolton, Semion Shaul, Lijuan Fu, Xiaomei Guo, Liang Zhong, Julius M Guccione, Ghassan S Kassab
BACKGROUND: Progressive thinning and dilation of the LV due to ischemic heart failure (IHF) increases wall stress and myocardial oxygen consumption. Injectable biopolymers implanted in the myocardial wall have been used to increase wall thickness to reduce chamber volume, decrease wall stress, and improve cardiac function. We sought to evaluate the efficacy of a biopolymer (Algisyl-LVR) to prevent left ventricular (LV) remodeling in a swine model of IHF. METHODS: IHF was induced in 11 swine by occluding the marginal obtuse branches of the left circumflex artery...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29425530/ventricular-assist-devices-for-neonates-and-infants
#17
REVIEW
Katsuhide Maeda, David N Rosenthal, Olaf Reinhartz
Heart transplant waitlist survival in pediatric patients has been substantially improved since the introduction of pediatric-specific ventricular assist device. In neonates and infants, however, the waitlist mortality remains very high. The only long-term device currently approved for use in the United States is the Berlin Heart EXCOR, but this device has several important limitations because of the paracorporeal, pulsatile nature of the underlying technology. We reviewed Stanford ventricular assist experience on patients less than 1 year old since 2004...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/29425519/an-adverse-event-analysis-inadvertent-exsanguination-following-left-ventricular-assist-device-implantation-in-a-child
#18
REVIEW
Alex Robertson, Tain-Yen Hsia
Neurologic deficit subsequent to cardiac surgery remains a cause of postoperative morbidity and mortality. Although myriad risk factors for postoperative cognitive decline have been identified, their individual influence remains undefined. Although less emphasis is now placed on the heart lung machine as the major source of postoperative cognitive decline, the conduct of cardiopulmonary bypass and, in particular, the management of the bypass circuit remain key to patient safety. We present a case of inadvertent intraoperative exsanguination of a patient following open heart surgery for implantation of a left ventricular assist device...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/29420718/predictors-of-right-ventricular-failure-after-implantation-of-left-ventricular-assist-devices
#19
Orhan Gokalp, Hasan Iner, Yuksel Besir, Gamze Gokalp
No abstract text is available yet for this article.
February 6, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29419538/percutaneous-mechanical-circulation-support-combined-with-extracorporeal-membrane-oxygenation-oxyrvad-in-secondary-right-heart-failure
#20
Philipp M Lepper, Sabrina I Hörsch, Frederik Seiler, Annegret Kamp, Sören L Becker, Christian Lensch, Lars O Conzelmann, Hendrik Haake, Ralf M Muellenbach, Robert Bals, Markus Kredel, Frank Langer, Heinrike Wilkens, Franziska C Trudzinski
Right heart failure (RHF) because of pulmonary hypertension (PH) is a frequently encountered clinical problem with high mortality. The last resort, if pharmacological therapy fails, is mechanical circulatory support. There is a lack of percutaneous systems to support the right ventricle (RV). Venoarterial extracorporeal membrane oxygenation is widely used as a bailout in acute RHF in non-left ventricular assist device patients. Venoarterial extracorporeal membrane oxygenation does not unload the left ventricle and may cause failure of the left ventricle if used for a longer period of time...
February 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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