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mechanical circulatory assist device

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https://www.readbyqxmd.com/read/29324511/evolutionary-improvements-in-the-jarvik-2000-left-ventricular-assist-device
#1
Craig H Selzman, Antigone Koliopoulou, Jason P Glotzbach, Stephen H McKellar
Mechanical circulatory support devices experience a wide range of operating conditions during patient use. Since its first implant in June 2000, the Jarvik 2000 left ventricular assist device has witnessed systematic stepwise modifications to reduce the risk of serious adverse events and improve patient outcomes. Over time, clinical experience revealed a number of low-incidence failure modes that presented opportunities for improvement. Design changes have included, but are not limited to, a Y cable to permit battery changes without pump stoppage, increased pull strength of external cables from 35 to 200 lbs, an intermittent low-speed controller to improve aortic root washout, sintered titanium microsphere surface on the pump housing to prevent apical thrombus, and novel cone bearings to reduce thrombus formation...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29274191/acquired-coagulopathy-in-patients-with-left-ventricular-assist-devices
#2
REVIEW
R Muslem, K Caliskan, F W G Leebeek
Chronic heart failure (HF) is a major emerging health care problem, associated with a high morbidity and mortality. Left ventricular assist devices (LVADs) have emerged as a successful treatment option for patients with end-stage HF. Despite its great benefit, the use of LVAD is associated with a high risk for complications. Bleeding, pump thrombosis, and thrombo-embolic events are frequently observed complications, with bleeding complications occurring in over a third of the patients. Although the design of the third generation LVAD has improved greatly, these hemostatic complications still occur...
December 23, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29273199/linkage-of-medicare-records-to-the-interagency-registry-of-mechanically-assisted-circulatory-support
#3
Qixing Liang, Sarah Ward, Francis D Pagani, Shashank S Sinha, Min Zhang, Robert Kormos, Keith D Aaronson, Andrew D Althouse, James K Kirklin, David Naftel, Donald S Likosky
BACKGROUND: The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) is a U.S. registry for adults receiving durable U.S. Food and Drug Administration approved mechanical circulatory support devices (MCSDs). We merged INTERMACS records with Medicare claims to investigate the uncertainty of penetrance of Medicare beneficiaries within INTERMACS. METHODS: INTERMACS records and Medicare claims (January 1, 2008 through December 31, 2013) from the Centers for Medicare and Medicaid (CMS) were linked using a deterministic matching methodology...
December 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29259511/tolerance-of-sustained-ventricular-fibrillation-during-continuous-flow-left-ventricular-assist-device-support
#4
Andrew C W Baldwin, Courtney J Gemmato, Elena Sandoval, William E Cohn, Jeffrey A Morgan, O H Frazier
The widespread use of continuous-flow left ventricular assist devices for mechanical circulatory support has shown that long-term hemodynamic support is possible, even when a clinical "pulse" cannot be detected. We present the incidental discovery of ventricular fibrillation in 6 alert, hemodynamically stable patients supported only by a continuous-flow device (HeartMate II, n=5; Jarvik 2000, n=1). Ventricular fibrillation was found in 3 patients during routine outpatient follow-up visits and in 3 awaiting discharge from the hospital after device placement...
October 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29245181/revealing-a-new-mode-of-sensitization-induced-by-mechanical-circulatory-support-devices-impact-of-anti-at1-r-antibodies
#5
X Zhang, J Mirocha, T Aintablian, S Dimbil, J Moriguchi, F Arabia, J A Kobashigawa, N L Reinsmoen
BACKGROUND: Increased levels of angiotensin II type 1 receptor (AT1 R) antibody have been shown to be associated with allograft rejection. This study aims to determine the rate of development of antibody to AT1 R after Mechanical Circulatory Support Device (MCS) implantation, and if development of strong binding AT1 R antibodies is associated with survival. METHODS: 88 patients who had one MCS implantation were accessed based on serum availability. MCS in this cohort included pneumatic bilateral paracorporeal ventricular assist device, continuous flow left ventricular assist device, and total artificial heart...
December 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29240628/circulatory-support-with-extracorporeal-membrane-oxygenation-and-or-impella-for-cardiogenic-shock-during-myocardial-infarction
#6
Marc Mourad, Philippe Gaudard, Pablo De La Arena, Jacob Eliet, Norddine Zeroual, Philippe Rouvière, François Roubille, Bernard Albat, Pascal H Colson
Temporary mechanical circulatory support (TCS) is recommended for patients with profound cardiogenic shock (CS). Extracorporeal membrane oxygenation (ECMO) and Impella are possible TCS devices, but the device choice and the implantation timing are not definitely established, specifically during acute myocardial infarction. We have analyzed the respective use of ECMO or Impella (2.5, CP, or 5.0) for CS following acute myocardial infarction , from a cohort of patients who underwent TCS within 72 hours after admission for emergency percutaneous coronary intervention (PCI) from January 2009 to April 2015...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29236180/diagnosis-medical-treatment-and-stepwise-mechanical-circulatory-support-for-fulminat-myocarditis
#7
Shunsuke Saito, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Daisuke Yoshioka, Keitaro Domae, Yasumasa Tsukamoto, Yasushi Sakata, Yoshiki Sawa
Fulminant myocarditis is one of the most challenging diseases. We sought to examine the outcomes of our multidisciplinary treatment strategy for fulminant myocarditis. A retrospective review of consecutive 30 patients with fulminant myocarditis was conducted. Of the 30 patients, 25 required mechanical circulatory support (MCS). Percutaneous extracorporeal membrane oxygenation (ECMO) was the first-line therapy to rescue the patients and inserted in 23 of them. The other 2 were implanted with temporary ventricular assist device (t-VAD) with extracorporeal centrifugal pump(s)...
December 13, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29232275/complex-decision-making-in-heart-failure-a-systematic-review-and-thematic-analysis
#8
Aimee V Hamel, Joseph E Gaugler, Carolyn M Porta, Niloufar Niakosari Hadidi
BACKGROUND: Heart failure follows a highly variable and difficult course. Patients face complex decisions, including treatment with implantable cardiac defibrillators, mechanical circulatory support, and heart transplantation. The course of decision-making across multiple treatments is unclear yet integral to providing informed and shared decision-making. Recognizing commonalities across treatment decisions could help nurses and physicians to identify opportunities to introduce discussions and support shared decision-making...
December 11, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29222320/anticoagulation-with-vads-and-ecmo-walking-the-tightrope
#9
REVIEW
Leslie Raffini
The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, resulting in device failure or embolic stroke...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29210774/liberal-right-ventricular-assist-device-extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-implantable-left-ventricular-assist-device-placement
#10
Quentin Fischer, Matthias Kirsch
Refractory right ventricular failure (RVF) after implantation of left ventricular assist device (LVAD) is a dramatic complication. The addition of right ventricular assist device (RVAD) may improve RV recovery and lead to improve outcomes. From February 2012 to September 2014, 44 patients received a HeartMate II. These patients were retrospectively compared in two groups according to early liberal implantation of an extracorporeal membrane oxygenation (ECMO) used as a RVAD established between a femoral vein and the pulmonary artery...
November 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29198868/an-interagency-registry-for-mechanically-assisted-circulatory-support-intermacs-analysis-of-hospitalization-functional-status-and-mortality-after-mechanical-circulatory-support-in-adults-with-congenital-heart-disease
#11
Ari Cedars, Christina Vanderpluym, Devin Koehl, Ryan Cantor, Shelby Kutty, James K Kirklin
BACKGROUND: Adult congenital heart disease (ACHD) prevalence is increasing worldwide, with advanced heart failure (HF) as a leading cause of death. Limited data are available on durable mechanical circulatory support (MCS) in ACHD patients. METHODS: ACHD patients from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database were identified and propensity matched with non-ACHD patients using risk factors from the INTERMACS Seventh Annual Report...
November 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29193160/multicenter-experience-with-mechanical-circulatory-support-using-a-new-diagonal-pump-in-233-children
#12
Brigitte Stiller, Robert Jan Houmes, André Rüffer, Matthias Kumpf, Andreas Müller, Florian Kipfmüller, Harald Köditz, Susanne Herber Jonat, Claudia Schmoor, Christoph Benk, Dick Tibboel, Thilo Fleck
Technological innovations in pediatric extracorporeal life support circuits can reduce system-related complications and may improve patients' outcome. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a novel rotational pump with a diagonally streamed impeller that can be used over a broad range of flows. We collected patient data from seven pediatric centers to conduct a retrospective cohort study. We examined 233 patients whose median age was 1.9 (0-201) months. The DP3 system was used for cardiopulmonary support as veno-arterial extracorporeal membrane oxygenation (ECMO) in 162 patients...
November 29, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29191299/implantable-cardioverter-defibrillators-in%C3%A2-patients-with-a-continuous-flow-left%C3%A2-ventricular-assist-device-an-analysis-of%C3%A2-the-intermacs-registry
#13
Kevin J Clerkin, Veli K Topkara, Ryan T Demmer, Jose M Dizon, Melana Yuzefpolskaya, Justin A Fried, Xingchen Mai, Donna M Mancini, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, A Reshad Garan
OBJECTIVES: This study sought to determine if the presence of implantable cardioverter-defibrillators (ICD) provided a mortality benefit during continuous-flow left ventricular assist device (LVAD) support. BACKGROUND: An ICD decreases mortality in selected patients with advanced heart failure and have been associated with reduced mortality in patients with pulsatile LVAD. However, it is unclear whether that benefit extends to patients with a contemporary continuous-flow LVAD...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29189423/the-boy-in-the-bubble-and-the-baby-with-the-berlin-heart-the-dangers-of-bridge-to-decision-in-pediatric-mechanical-circulatory-support
#14
Seth A Hollander, Ethan J Hollander
On the day of his birth in 1971, David Vetter was "temporarily" placed in a sterile isolator to wait for a bone marrow donor who would cure his Severe Combined Immunodeficiency Syndrome. After enduring 12 years in isolation, David, now known to the world as "The Boy in the Bubble", received a bone marrow transplant from his unmatched sister and died 4 months later. Like Severe Combined Immunodeficiency Syndrome, pediatric heart failure is a rare and life-threatening condition for which organ transplantation is often the only option for survival...
November 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29174659/impact-of-a-monoplane-hemodynamic-tee-htee-monitoring-device-on-decision-making-in-a-heterogeneous-hemodynamically-unstable-intensive-care-unit-population-a-prospective-observational-study
#15
Maung Hlaing, Jianghua He, Nicholas Haglund, Hiroo Takayama, Brigid C Flynn
OBJECTIVE: This prospective observational study was undertaken to evaluate the utility of a miniature transesophageal echocardiography probe (ImaCor hemodynamic [hTEE]) in the management of hemodynamically unstable intensive care unit patients with and without various forms of mechanical circulatory support. DESIGN: A prospective observational study. SETTING: A single tertiary care cardiothoracic and surgical intensive care unit. PARTICIPANTS: Fifty-three cardiothoracic and surgical intensive care unit patients undergoing miniature transesophageal echocardiography examinations...
October 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29174220/outcomes-of-children-supported-with-devices-labeled-as-temporary-or-short-term-a-report-from-the-pediatric-interagency-registry-for-mechanical-circulatory-support
#16
Angela Lorts, Pirooz Eghtesady, Mary Mehegan, Iki Adachi, Chet Villa, Ryan Davies, Jeffrey G Gossett, Kirk Kanter, Juan Alejos, Devin Koehl, Ryan S Cantor, David L S Morales
BACKGROUND: Historically, the "temporary" or short-term ventricular assist device (VAD) was used only as a quick bridge to recovery for children with an acute process. In the current era, the devices that were originally used for temporary support are now being used to support children for longer durations and for a variety of indications. In this study we aimed to describe the overall use, patients' characteristics and outcomes of "temporary" VAD use in children. METHODS: The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a National Institutes of Health-supported national registry for United States Food and Drug Administration-approved VADs in patients <19 years of age at the time of VAD implantation (either durable or temporary VAD)...
January 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29168549/first-polish-analysis-of-the-treatment-of-advanced-heart-failure-in-children-with-the-use-of-berlinheart-excor-mechanical-circulatory-support
#17
Szymon Pawlak, Roman Przybylski, Janusz Skalski, Joanna Śliwka, Andrzej Kansy, Adam Grzybowski, Arkadiusz Wierzyk, Jacek Białkowski, Bohdan Maruszewski, Marian Zembala
BACKGROUND: The treatment of advanced heart failure in children and infants poses a serious management problem. Heart failure in that patient group is usually of congenital etiology. The treatment schedules for pediatric patients are in most cases adapted from the guidelines for treatment of adults. Up to 2009, the treatment of that extremely difficult group of patients was limited to pharmacological therapy and occasional heart transplantations. Constantly increasing problems with recruiting donors, especially for the pediatric group, contribute to the fact that mechanical support with the use of ventricular assist devices is for many children the only chance to survive the period of waiting for a heart donor...
November 23, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29156019/the-aspartate-transaminase-alanine-transaminase-deritis-ratio-predicts-mid-term-mortality-and-renal-and-respiratory-dysfunction-after-left-ventricular-assist-device-implantation
#18
Kevin Pilarczyk, Henning Carstens, Jens Heckmann, Ali Canbay, Achim Koch, Nikolaus Pizanis, Heinz Jakob, Markus Kamler
OBJECTIVES: Preoperative liver dysfunction is a well-known risk factor for adverse events after major surgery. However, there is only little data regarding the precise role of the Model of End-Stage Liver Disease (MELD) score and the De Ritis ratio (DRR, alanine transaminase/aspartate aminotransferase) as a predictor for outcome after left ventricular assist device (LVAD) implantation. METHODS: A retrospective analysis of all patients undergoing LVAD implantation at our institution between January 2012 and August 2014 was performed...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29153637/quality-of-life-and-functional-capacity-outcomes-in-the-momentum-3-trial-at-6-months-a-call-for-new-metrics-for-left-ventricular-assist-device-patients
#19
Jennifer A Cowger, Yoshifumi Naka, Keith D Aaronson, Douglas Horstmanshof, Sanjeev Gulati, Debbie Rinde-Hoffman, Sean Pinney, Sirtaz Adatya, David J Farrar, Ulrich P Jorde
BACKGROUND: The Multicenter Study of MAGLEV Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 (MOMENTUM 3) clinical trial demonstrated improved 6-month event-free survival, but a detailed analysis of health-related quality of life (HR-QOL) and functional capacity (FC) was not presented. Further, the effect of early serious adverse events (SAEs) on these metrics and on the general ability to live well while supported with a left ventricular assist system (LVAS) warrants evaluation...
October 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29150326/concomitant-mitral-valve-procedures-in-patients-undergoing-implantation-of-continuous-flow-left-ventricular-assist-devices-an-intermacs-database-analysis
#20
Jason O Robertson, David C Naftel, Susan L Myers, Ryan J Tedford, Susan M Joseph, James K Kirklin, Scott C Silvestry
BACKGROUND: Management of existing mitral valve (MV) disease in patients undergoing left ventricular assist device (LVAD) implantation remains controversial. METHODS: Among continuous-flow LVAD patients with moderate to severe mitral regurgitation entered into the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database between April 2008 and March 2014 (n = 4,930), outcomes were compared between patients who underwent MV repair (MVr, n = 252), MV replacement (MVR, n = 11) and no MV procedure (no MVP, n = 4,667)...
October 10, 2017: Journal of Heart and Lung Transplantation
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