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ventricular assist devices

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https://www.readbyqxmd.com/read/29057766/clinical-results-adverse-events-and-change-in-end-organ-function-in-elderly-patients-with-heartmateii-left-ventricular-assist-device%C3%A3-japanese-multicenter-study
#1
Daisuke Yoshioka, Koichi Toda, Minoru Ono, Takeshi Nakatani, Akira Shiose, Yoshiro Matsui, Kenji Yamazaki, Yoshikatsu Saiki, Akihiko Usui, Hiroshi Niinami, Goro Matsumiya, Hirokuni Arai, Yoshiki Sawa
BACKGROUND: Advanced age has an adverse impact on clinical results in left ventricular assist device (LVAD) patients. We compared the clinical results of patients aged >60 years with younger patients using a national Japanese database.Methods and Results:Between April 2013 and December 2016, 300 patients underwent HeartMateII implantation. Of these, 37 patients were ≥60 years at LVAD implantation, and the clinical results of these patients were compared with the other younger 263 patients...
October 21, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29053103/ultrasound-functional-imaging-in-an-i-ex-vivo-i-beating-porcine-heart-platform
#2
Niels J Petterson, Louis S Fixsen, Marcel C M Rutten, Nico H J Pijls, Frans N van de Vosse, Richard G P Lopata
In recent years, novel ultrasound functional imaging (UFI) techniques have been introduced to assess cardiac function by measuring, e.g., cardiac output (CO) and/or myocardial strain. Verification and reproducibility assessment in a realistic setting remain major issues. Simulations and phantoms are often unrealistic, whereas in vivo measurements often lack crucial hemodynamic parameters or ground truth data, or suffer from the large physiological and clinical variation between patients when attempting clinical validation...
October 20, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29050685/renal-function-changes-following-left-ventricular-assist-device-implantation
#3
Usama A Daimee, Meng Wang, Anna Papernov, Saadia Sherazi, Scott McNitt, Himabindu Vidula, Leway Chen, Jeffrey D Alexis, Valentina Kutyifa
Limited data assessing the clinical significance of post-left ventricular assist device (LVAD) in renal function are available. We aimed to investigate the impact of changes in renal function after LVAD implantation on subsequent long-term outcomes. We followed 184 patients with HeartMate II LVADs implanted between May 2008 and November 2014. Serial assessment of renal function, was performed at baseline and at day 1, day 7, 1 month, 3 months, 6 months, 1 year, and 2 years after implantation. Effects of 1-month GFR and changes in GFR from baseline to 1 month on long-term mortality and hospital re-admission were evaluated...
September 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29049782/rotational-speed-modulation-used-with-continuous-flow-left-ventricular-assist-device-provides-good-pulsatility
#4
Noritsugu Naito, Takashi Nishimura, Kei Iizuka, Yoshiaki Takewa, Akihide Umeki, Masahiko Ando, Minoru Ono, Eisuke Tatsumi
OBJECTIVES: Continuous-flow left ventricular assist devices (CF-LVADs) are widely used to treat patients with end-stage heart failure. Although continuous flow is different from physiological flow, patients show improved outcomes after CF-LVAD implantation. A novel rotational speed (RS) modulation system used with CF-LVAD (EVAHEART) has been developed, which can change RS in synchronization with the native cardiac cycle. We conducted the present study to investigate the influence of the system on pulsatility in peripheral perfusion...
August 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049683/ventricular-assist-device-in-a-failing-total-cavopulmonary-connection-a-new-step-by-step-approach
#5
Carlo Pace Napoleone, Maria Teresa Cascarano, Luca Deorsola, Andrea Valori
The management of failing Fontan patients with mechanical circulatory support has been reported with unsatisfactory results. A 5-year-old girl, listed for heart transplantation for failing Fontan, underwent rescue extracorporeal membrane oxygenation support. As it was necessary to move the patient to the Berlin Heart Excor, a step-by-step approach was designed to obtain a gradual adaptation to this form of support. A central extracorporeal membrane oxygenation, with a Berlin Heart apical and aortic cannulae, was implanted leaving the previously positioned femoral vein cannula in parallel with the outflow apical one...
September 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049673/incidence-and-echocardiographic-predictors-of-early-postoperative-right-ventricular-dysfunction-following-left-ventricular-assist-implantation-in-paediatric-patients
#6
Mathias Redlin, Oliver Miera, Helmut Habazettl, Joachim Photiadis, María Irene Carísimo-Cresta, Mathias Hommel, Benjamin O'Brien, Marian Kukucka
OBJECTIVES: Left ventricular assist device implantation is an established therapy for paediatric patients with end-stage heart failure. Early right ventricular dysfunction (RVD) after implantation still remains a challenge in the postoperative period. This study sought to determine the incidence of RVD and to identify echocardiographic predictors of RVD in paediatric patients, as well describing associated clinical outcome. METHODS: Prospectively collected preoperative echocardiographic, haemodynamic, demographic and biochemical data from 48 patients scheduled for left ventricular assist device implantation were evaluated...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049666/bivalirudin-anticoagulation-for-left-ventricular-assist-device-implantation-on-an-extracorporeal-life-support-system-in-patients-with-heparin-induced-thrombocytopenia-antibodies
#7
Edis Ljajikj, Armin Zittermann, Michiel Morshuis, Jochen Börgermann, Maria Ruiz-Cano, Michael Schoenbrodt, Jan Gummert, Andreas Koster
OBJECTIVES: Heparin-induced thrombocytopenia (HIT) requires alternative anticoagulation strategies. We investigated outcomes in patients with HIT antibodies undergoing low-dose bivalirudin anticoagulation during left ventricular assist device implantation on an extracorporeal life support system (ECLS) and compared the results with non-HIT patients treated with heparin and receiving left ventricular assist device implantation with ECLS support. METHODS: The institutional ventricular assist device database was searched for the period from March 2012 to March 2016...
July 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049614/anticoagulation-management-following-left-ventricular-assist-device-implantation-is-similar-across-all-provider-strategies
#8
Asia McDavid, Kelly MacBrair, Sitaramesh Emani, Lianbo Yu, Peter H U Lee, Bryan A Whitson, Brent C Lampert, Riddhima Agarwal, Ahmet Kilic
OBJECTIVES: Thromboembolic and bleeding events are potential complications following left ventricular assist device implantation. A tight control of the international normalized ratio (INR) is believed to be crucial in the reduction of postimplant complications. There is significant variability among institutions as to whether a device implanting centre should be managing the INR. In this study, we evaluated the effect of INR management strategies in maintaining a therapeutic INR. METHODS: A retrospective review was utilized to identify patients implanted with either the HeartMate II or the HeartWare HVAD between January 2011 and February 2016...
August 14, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29048703/a-pilot-study-on-the-efficacy-and-safety-of-a-minimally-invasive-surgical-and-anesthetic-approach-for-ventricular-assist-device-implantation
#9
Jonida Bejko, Demetrio Pittarello, Gianclaudio Falasco, Guido Di Gregorio, Vincenzo Tarzia, Giulio Rizzoli, Dario Gregori, Gino Gerosa, Tomaso Bottio
BACKGROUND: The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation. METHODS: 68 patients (50.4 ± 17.1 years old) were supported with the HeartWare® HVAD (32 patients) and the Jarvik 2000 VAD (36 patients) between January 2010 and August 2016. Two surgical techniques were applied: a minimally invasive approach with the aid of paravertebral-block (mini-invasive group, 41 patients) and a standard-surgical-approach with the aid of general anesthesia (27 patients)...
October 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29045747/extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#10
Julia Riebandt, Thomas Haberl, Dominik Wiedemann, R Moayedifar, Thomas Schloeglhofer, Stéphane Mahr, Kamen Dimitrov, Philipp Angleitner, Guenther Laufer, Daniel Zimpfer
OBJECTIVES: Right ventricular (RV) failure complicating left ventricular assist device implantation is associated with increased mortality. Despite a lack of supporting evidence, venoarterial extracorporeal membrane oxygenation (ECMO) support is increasingly being used as an alternative to traditional temporary RV support. We report our institutional experience with ECMO-facilitated RV support after left ventricular assist device implantation. METHODS: We retrospectively reviewed the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29045467/the-dose-of-hydroxyethyl-starch-6-130-0-4-for-fluid-therapy-and-the-incidence-of-acute-kidney-injury-after-cardiac-surgery-a-retrospective-matched-study
#11
Mona Momeni, Lompoli Nkoy Ena, Michel Van Dyck, Amine Matta, David Kahn, Dominique Thiry, André Grégoire, Christine Watremez
The safety of hydroxyethyl starches (HES) is still under debate. No studies have compared different dosing regimens of HES in cardiac surgery. We analyzed whether the incidence of Acute Kidney Injury (AKI) differed taking into account a weight-adjusted cumulative dose of HES 6% 130/0.4 for perioperative fluid therapy. This retrospective cohort study included all adult patients undergoing elective or emergency cardiac surgery with or without cardiopulmonary bypass. Exclusion criteria were patients on renal replacement therapy (RRT), cardiac trauma surgery, heart transplantation, patients with ventricular assist devices, subjects who required a surgical revision for bleeding and those whose medical records were incomplete...
2017: PloS One
https://www.readbyqxmd.com/read/29045282/prediction-model-for-wait-times-in-cardiac-transplantation
#12
David L Joyce, Brian D Lahr, Lyle D Joyce, Sudhir S Kushwaha, Richard C Daly
Wait times have increased for patients approved for heart transplants. We reviewed United Network for Organ Sharing (UNOS) data for 14,242 patients listed for isolated heart transplant (2009-2013) to develop a risk score model for timing left ventricular assist device (LVAD) implantation in bridge-to-transplant patients. We used a multivariable Cox proportional hazards regression model with subsequent bootstrap resampling for internal validation to develop a scoring system that combined risk factors, weighted by the corresponding regression coefficients, to define an individual's risk score...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29045281/pharmacokinetics-of-amikacin-in-critical-care-patients-on-extracorporeal-device
#13
Jesus Ruiz-Ramos, Ricardo Gimeno, Francisca Pérez, Paula Ramirez, Esther Villarreal, Monica Gordon, Carlos Vicent, María Remedios Marqués, Álvaro Castellanos-Ortega
In this study, we evaluate the effect of extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (Levitronix) on the pharmacokinetic of amikacin in critically ill patients. Twelve patients with ECMO and three with Levitronix devices who started treatment with amikacin were included. Amikacin pre (Cmax) and post (Cmin) dose serum concentrations were measured during the first 72-96 hours of treatment initiation. Pharmacokinetic parameters were performed by Bayesian adjustment. The median initial dose was 1,000 mg (range: 600-1,400 mg)...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29045277/determinants-of-improvement-in-cardiopulmonary-exercise-testing-after-left-ventricular-assist-device-implantation
#14
Andrew N Rosenbaum, Shannon M Dunlay, Naveen L Pereira, Thomas G Allison, Simon Maltais, John M Stulak, Lyle D Joyce, Sudhir S Kushwaha
Although improvement in cardiac output and hemodynamic parameters is routinely demonstrated in patients implanted with continuous-flow left ventricular assist devices (CF-LVADs), improvement in exercise capacity is inconsistently seen. Our purpose was to determine whether native cardiac factors, LVAD factors, or comorbid factors were associated with lack of improvement. Review of all patients undergoing preimplant cardiopulmonary exercise testing (CPET) and CPET on LVAD therapy at one institution was performed between 2007 and 2014 (n = 49)...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29043581/the-unique-blood-pressures-and-pulsatility-of-lvad-patients-current-challenges-and-future-opportunities
#15
REVIEW
Francesco Castagna, Eric J Stöhr, Alberto Pinsino, John R Cockcroft, Joshua Willey, A Reshad Garan, Veli K Topkara, Paolo C Colombo, Melana Yuzefpolskaya, Barry J McDonnell
An increasing number of end-stage heart failure patients are now implanted with continuous-flow left ventricular assist devices (CF-LVADs). Although this therapeutic approach is associated with improved clinical outcomes, continuous flow physiology reduces arterial pulse pressure and pulsatility to an extent that is unique to this population. Recent data suggest that high blood pressure (BP) contributes to life-threatening complications such as pump thrombosis and stroke of CF-LVAD patients. However, limited understanding of the distinct hemodynamics of these pumps makes measurement and, consequently, medical management of BP quite challenging...
October 18, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/29042831/the-impact-of-antithrombin-iii-use-in-achieving-anticoagulant-goals-in-pediatric-patients
#16
Allison J Jones, Keliana L O'Mara, Brian J Kelly, Ravi S Samraj
OBJECTIVES: To determine the percentage of patients with >10% reduction in heparin infusion rate within 48 hours of antithrombin III (ATIII) administration. Secondary objectives include the achievement of therapeutic anticoagulation and determining the days of subtherapeutic infusion prior to supplementation. METHODS: Retrospective chart review of 12 patients younger than 18 years of age who received ATIII concentrate supplementation while on continuous heparin infusion...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29042104/extending-the-perspective-on-left-ventricular-assist-device-pump-thrombosis-to-left-ventricular-assist-device-system-thrombosis
#17
EDITORIAL
Robert L Kormos
No abstract text is available yet for this article.
September 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29040106/noninvasive-blood-pressure-determination-in-left-ventricular-assist-device-patients
#18
David W Barbara, Troy G Seelhammer, William J Mauermann
No abstract text is available yet for this article.
November 2017: Anesthesiology
https://www.readbyqxmd.com/read/29040105/when-managing-patients-with-left-ventricular-assist-devices-undergoing-noncardiac-surgery-less-is-not-more
#19
Robert E Freundlich, Adam J Kingeter
No abstract text is available yet for this article.
November 2017: Anesthesiology
https://www.readbyqxmd.com/read/29037445/effect-of-age-and-renal-function-on-survival-after-left-ventricular-assist-device-implantation
#20
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Yunus E Yasar, Kavita Sharma, Nisha A Gilotra, Isabella Kardys, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Olivier C Manintveld, Stuart D Russell
Left ventricular assist devices (LVAD) are increasingly used, especially as destination therapy in in older patients. The aim of this study was to evaluate the effect of age on renal function and mortality in the first year after implantation. A retrospective multicenter cohort study was conducted, evaluating all LVAD patients implanted in the 2 participating centers (age ≥18 years). Patients were stratified according to the age groups <45, 45-54, 55-64, and ≥65 years old. Overall, 241 patients were included (mean age 52...
September 20, 2017: American Journal of Cardiology
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