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mechanical circulatory assist device

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https://www.readbyqxmd.com/read/28586149/comparative-analysis-of-von-willebrand-factor-profiles-after-implantation-of-left-ventricular-assist-device-and-total-artificial-heart
#1
H J Reich, J Morgan, F Arabia, L Czer, J Moriguchi, D Ramzy, F Esmailian, L Lam, J Dunhill, O Volod
BACKGROUND: Bleeding remains a challenge during mechanical circulatory support and underlying mechanisms are incompletely understood. Functional von Willebrand Factor (VWF) impairment due to loss of high molecular weight multimers (MWM) produces acquired von Willebrand Disease (VWD) after left ventricular assist device (LVAD). Little is known about VWF multimers with total artificial hearts (TAHs). Here, VWF profiles with LVADs and TAHs are compared using a VWD panel. METHODS: VWD evaluations for patients with LVAD or TAH (2013-14) were retrospectively analyzed and included: VWF activity (Ristocetin Cofactor, VWF:RCo), VWF antigen (VWF:Ag), ratio of VWF:RCo to VWF:Ag, and quantitative VWF multimeric analysis...
June 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28567581/temporary-biventricular-support-with-extracorporeal-membrane-oxygenation-a-feasible-therapeutic-approach-for-cardiogenic-shock-with-multiple-organ-failure
#2
Osamu Seguchi, Tomoyuki Fujita, Takuya Watanabe, Kensuke Kuroda, Eriko Hisamatsu, Seiko Nakajima, Takuma Sato, Haruki Sunami, Masanobu Yanase, Hiroki Hata, Junjiro Kobayashi, Takeshi Nakatani, Norihide Fukushima
Various strategies using a ventricular assist device (VAD) are applied to rescue Interagency Registry for Mechanically Assisted Circulatory Support profile 1 (Profile-1) patients. However, the optimal use of VAD in Profile-1 patients has not been completely elucidated. We retrospectively reviewed 23 Profile-1 patients [mean age 36.9 ± 16.6 years, 14 males; 11 with non-ischemic cardiomyopathy (NICM), 9 with fulminant myocarditis (FM), 2 with ischemic cardiomyopathy (ICM), and 1 with peripartum cardiomyopathy (PPCM); 18 with pre-operative percutaneous extracorporeal membrane oxygenation (p-ECMO) support] who underwent VAD implantation from 2011 to 2015 at our institution...
May 31, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28546755/pediatric-ventricular-assist-devices-current-challenges-and-future-prospects
#3
REVIEW
Sarah Burki, Iki Adachi
The field of mechanical circulatory support has made great strides in the preceding 2 decades. Although pediatric mechanical circulatory support has lagged behind that of adults, the gap between them is expected to close soon. The only device currently approved by the US Food and Drug Administration for use in children is the Berlin Heart EXCOR ventricular assist device (VAD). The prospective Berlin Heart Investigational Device Exemption Trial demonstrated good outcomes, such as bridge to transplantation or recovery, in ~90% of children supported with this device...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28543744/repetitive-supra-physiological-shear-stress-impairs-red-blood-cell-deformability-and-induces-hemolysis
#4
Jarod T Horobin, Surendran Sabapathy, Michael J Simmonds
The supra-physiological shear stress that blood is exposed to while traversing mechanical circulatory assist devices affects the physical properties of red blood cells (RBCs), impairs RBC deformability, and may induce hemolysis. Previous studies exploring RBC damage following exposure to supra-physiological shear stress have employed durations exceeding clinical instrumentation, thus we explored changes in RBC deformability following exposure to shear stress below the reported "hemolytic threshold" using shear exposure durations per minute (i...
May 23, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28533303/cardiopulmonary-resuscitation-in-adults-and-children-with-mechanical-circulatory-support-a-scientific-statement-from-the-american-heart-association
#5
REVIEW
Mary Ann Peberdy, Jason A Gluck, Joseph P Ornato, Christian A Bermudez, Russell E Griffin, Vigneshwar Kasirajan, Richard E Kerber, Eldrin F Lewis, Mark S Link, Corinne Miller, Jeffrey J Teuteberg, Ravi Thiagarajan, Robert M Weiss, Brian O'Neil
Cardiac arrest in patients on mechanical support is a new phenomenon brought about by the increased use of this therapy in patients with end-stage heart failure. This American Heart Association scientific statement highlights the recognition and treatment of cardiovascular collapse or cardiopulmonary arrest in an adult or pediatric patient who has a ventricular assist device or total artificial heart. Specific, expert consensus recommendations are provided for the role of external chest compressions in such patients...
May 22, 2017: Circulation
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#6
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28532240/ventricular-assist-devices-for-the-failing-univentricular-circulation
#7
Edward Buratto, William Y Shi, Xin Tao Ye, Igor E Konstantinov
Improved survival following single ventricle palliation has led to a large population of patients with a univentricular circulation, many of whom develop heart failure. Increasing experience with ventricular assist devices (VAD) in children has paved the way for VAD support in those with failing univentricular circulation. Areas covered: The use of VADs to support the failing univentricular circulation is a relatively new concept. Most studies have focused on supporting patients with the failing systemic ventricle...
June 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28526500/pulmonary-function-tests-do-not-predict-mortality-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation
#8
Edo K S Bedzra, Todd F Dardas, Richard K Cheng, Jay D Pal, Claudius Mahr, Jason W Smith, Kent Shively, S Carolina Masri, Wayne C Levy, Nahush A Mokadam
OBJECTIVES: To investigate the effect of pulmonary function testing on outcomes after continuous flow left ventricular assist device implantation. METHODS: A total of 263 and 239 patients, respectively, had tests of forced expiratory volume in 1 second and diffusing capacity of the lungs for carbon monoxide preoperatively for left ventricular assist device implantations between July 2005 and September 2015. Kaplan-Meier analysis and multivariable Cox regressions were performed to evaluate mortality...
April 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28525417/assessing-frailty-in-patients-undergoing-destination-therapy-left-ventricular-assist-device-observations-from-interagency-registry-for-mechanically-assisted-circulatory-support
#9
Lauren B Cooper, Bradley G Hammill, Larry A Allen, JoAnn Lindenfeld, Robert J Mentz, Joseph G Rogers, Carmelo A Milano, Chetan B Patel, Karen P Alexander, Adrian F Hernandez
Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data of destination therapy (DT) LVAD patients from January 1, 2012, to March 31, 2014, we examined preimplantation provider-assessed frailty and gait speed testing and the association with 1 year postimplantation outcomes. Of 2,469 patients, 227 (9...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28521795/ex-vivo-recruitment-and-x-ray-assessment-of-donor-lungs-in-a-challenging-retrieval-from-a-donor-supported-by-lvad-using-the-portable-normothermic-perfusion-system-a-case-report
#10
Marco Schiavon, Francesca Calabrese, Guido Di Gregorio, Monica Loy, Giuseppe Marulli, Alessandro Rebusso, Fiorella Calabrese, Federico Rea
BACKGROUND: Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#11
Remigiusz Antończyk, Ewa Trejnowska, Jerzy Pacholewicz, Tomasz Wolny, Paweł Nadziakiewicz, Karolina Antończyk, Izabela Copik, Magdalena Piontek, Małgorzata Jasińska, Krzysztof Filipiak, Maciej Głowacki, Maciej Gawlikowski, Marcin Borowicz, Roman Kustosz, Jacek Waszak, Piotr Przybyłowski, Marian Zembala, Michał Zakliczyński, Michał Oskar Zembala
Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514261/doppler-ultrasound-evaluation-of-circulatory-support-devices
#12
Zachary Nuffer, Andrey Rupasov, Shweta Bhatt
In the setting of mechanical circulatory support devices, including ventricular assist devices, extracorporeal membrane oxygenation, intraaortic balloon pumps, and the total artificial heart, the spectral Doppler waveform is significantly altered, reflecting systemic hemodynamic changes. As the prevalence of these devices increases, a better understanding of both the devices themselves and their associated Doppler ultrasound findings is necessary for accurate image interpretation. This article reviews the clinical indications, pathophysiology, and sonographic findings of these devices, with emphasis on the variation in arterial Doppler waveforms that can be seen with normal function, as well as the major complications...
May 16, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28512702/an-intracardiac-soft-robotic-device-for-augmentation-of-blood-ejection-from-the-failing-right-ventricle
#13
Markus A Horvath, Isaac Wamala, Eric Rytkin, Elizabeth Doyle, Christopher J Payne, Thomas Thalhofer, Ignacio Berra, Anna Solovyeva, Mossab Saeed, Sara Hendren, Ellen T Roche, Pedro J Del Nido, Conor J Walsh, Nikolay V Vasilyev
We introduce an implantable intracardiac soft robotic right ventricular ejection device (RVED) for dynamic approximation of the right ventricular (RV) free wall and the interventricular septum (IVS) in synchrony with the cardiac cycle to augment blood ejection in right heart failure (RHF). The RVED is designed for safe and effective intracardiac operation and consists of an anchoring system deployed across the IVS, an RV free wall anchor, and a pneumatic artificial muscle linear actuator that spans the RV chamber between the two anchors...
May 16, 2017: Annals of Biomedical Engineering
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
#14
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
https://www.readbyqxmd.com/read/28509676/isolated-right-ventricular-mechanical-support-outcomes-and-prognosis
#15
Teresa A Mulaikal, Laura H Bell, Boyangzi Li, Gebhard Wagener, Hiroo Takayama
Right ventricular (RV) failure that necessitates isolated mechanical support is extremely rare. Outcomes have not been described and are limited to case reports. We sought to evaluate this select group of patients and determine their 30 day and 1 year survival. We retrospectively reviewed the Mechanical Assist Device Database at Columbia University from 2007 to 2015. Inclusion criteria consisted of patients who received isolated RV assist devices (RVADs) without mechanical support of the left ventricle. We evaluated survival, duration of support, intensive care unit (ICU) length of stay, and adverse events...
May 12, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28504984/melding-a-high-risk-patient-for-continuous-flow-left-ventricular-assist-device-into-a-low-risk-patient
#16
Javier Amione-Guerra, Ana S Cruz-Solbes, Hilda Gonzalez Bonilla, Jerry D Estep, Ashrith Guha, Arvind Bhimaraj, Erik E Suarez, Brian A Bruckner, Guillermo Torre-Amione, Myung H Park, Barry H Trachtenberg
The model for end-stage liver disease (MELD) has been used as a predictor of mortality after left ventricular assist device (LVAD) placement. However, improvement or worsening of MELD and how those changes affect outcomes is unknown. We performed a retrospective analysis of 244 patients implanted with a continuous flow (CF) LVAD. Patients were dichotomized at admission into low- or high-risk categories using a cutoff of MELD ≥ 19, and they were reclassified at day of implant forming four groups: Group LL (remained low risk), LH (worsened to high risk), HH (remained high risk), and HL (improved to low risk)...
May 10, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28491184/feasibility-of-transfemoral-hepatic-vein-wedged-portal-venous-pressure-measurement-in-total-artificial-heart
#17
Ashwani Kumar Sharma, Jonathan Huang, Himabindu Vidula, Jeffrey Alexis, Juan M Lehoux
The development of technology and limitation of numerous ventricular assist devices has increased usage of the total artificial heart (TAH) for mechanical circulatory support. A primary important feature of TAH is that it is one of the few mechanical circulatory support devices that provides biventricular support. As the number of patients with TAH rises, spreading awareness about the device in the interventional radiology community is important.
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489217/intra-aortic-balloon-pump-in-cardiogenic-shock-state-of-the-art
#18
Petronio Generoso Thomaz, Leonel Adelino Moura, Giovana Muramoto, Renato Samy Assad
The clinical definition of cardiogenic shock is that of a low cardiac output and evidence of tissue hypoxia in the presence of adequate blood volume. Cardiogenic shock is the main cause of death related to acute myocardial infarction (AMI), with a mortality rate of 45-70% in the absence of aggressive and highly specialized technical care. The intra-aortic balloon pump (IABP) is one of the most widely used mechanical assisting devices. During the last two decades, about 42% of patients with AMI who evolved with cardiogenic shock received mechanical circulatory assistance with IABP...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28472406/short-term-mechanical-circulatory-support-as-a-bridge-to-durable-left-ventricular-assist-device-implantation-in-refractory-cardiogenic-shock-a-systematic-review-and-meta-analysis
#19
Corstiaan A den Uil, Sakir Akin, Lucia S Jewbali, Dinis Dos Reis Miranda, Jasper J Brugts, Alina A Constantinescu, Arie Pieter Kappetein, Kadir Caliskan
Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016...
May 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28467129/heartware-hvad-for-end-stage-heart-failure-a-review-of-clinical-experiences-with-%C3%A2-50-patients
#20
Luca Botta, Benedetta De Chiara, Francesca Macera, Aldo Cannata, Alessandro Costetti, Alessandra Voltolini, Antonella Moreo, Manlio Cipriani, Maria Frigerio, Claudio Francesco Russo
Despite the improvements in medical and surgical treatments, the incidence of end-stage heart failure (ESHF) continues to increase. Different mechanical systems have been adopted to support failing left ventricles. Among continuous-flow devices, the HeartWare-HVAD was the first to use a centrifugal pump rather than an axial one. Areas covered: In this review article, we provide an overview of the HeartWare-HVAD as a ventricular assist device for ESHF, discussing indications, echocardiographic assessment, surgical techniques, outcomes, concerns and controversies...
June 2017: Expert Review of Medical Devices
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