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heart device

Debbie C Yen, Mara H Watson, Lindsey D Burgess, Maragatha Kuchibhatla, Chetan B Patel, Kristen B Campbell, Alyssa K Vora
STUDY OBJECTIVE: To evaluate the impact of continuous-flow left ventricular assist device (LVAD) implantation on glycemic control in patients with type 2 diabetes mellitus and advanced chronic systolic heart failure. DESIGN: Retrospective medical record review. SETTING: Large, academic, tertiary and quaternary care hospital. PATIENTS: Eighty-three adults with type 2 diabetes mellitus and advanced chronic systolic heart failure who underwent implantation of a continuous-flow LVAD between July 1, 2008, and June 30, 2013...
October 25, 2016: Pharmacotherapy
Sonja Fruhwald, Piero Pollesello, Friedrich Fruhwald
The later stages of heart failure are characterized by a steady decline in quality of life. Clinical priorities should be to maintain functional capacity and quality of life. In the absence of sufficient organs for transplantation, options include left ventricular assist devices and inotropic support. Areas covered: We examined data published in the last two decades on the use of inotropes and inodilators in advanced heart failure. Expert commentary: In the literature, use of conventional inotropes, including adrenergic agonists and phosphodiesterase inhibitors, appears to be suboptimal for achieving the clinical priorities of late-stage heart failure...
October 25, 2016: Expert Review of Cardiovascular Therapy
Antoni Bayes-Genis, Julio Núñez, Eduardo Núñez, Jaume Barallat Martínez, Maria-Cruz Pastor Ferrer, Marta de Antonio, Elisabet Zamora, Juan Sanchis, Josep Lupón Rosés
BACKGROUND: Despite advances in pharmacologic therapy and devices, patients with heart failure (HF) continue to have significant rehospitalization rates and risk prediction remains challenging. We sought to explore the value of a multi-biomarker panel [including NT-proBNP, high-sensitivity cardiac troponin T (hs-TnT), and ST2] on top of clinical assessment for long-term prediction of recurrent hospitalizations in HF. METHODS AND RESULTS: NT-proBNP, hs-TnT, and ST2 (suppression of tumorigenicity-2) levels were measured in 891 consecutive ambulatory HF patients...
2016: Frontiers in Cardiovascular Medicine
Aleksei A Filippov, Pedro J Del Nido, Nikolay V Vasilyev
In recent decades, significant progress has been made in the diagnosis and management of congenitally corrected transposition of the great arteries (ccTGA). Nevertheless, gradual dysfunction and failure of the right ventricle (RV) in the systemic circulation remain the main contributors to mortality and disability for patients with ccTGA, especially after adolescence. Anatomic repair of ccTGA effectively resolves the problem of failure of the systemic RV and has good early and midterm results. However, this strategy is applicable primarily in infants and children up to their teens and has associated risks and limitations, and new challenges can arise in the late postoperative period...
October 25, 2016: Circulation
Karl T Weber
Current dogma suggests patients with advanced systolic heart failure have an irreversible depression in myocardial contractility. Recent experience with improved ventricular function during continuous flow ventricular assist devices used as destination therapy would suggest otherwise. Herein, cellular and molecular signaling involved in reversing depressed myocardial contractility would be addressed. This includes cardiomyocyte thyroid hormone signaling responsible for the reexpression of fetal gene program that preserves cell efficiency (work and energy consumed) and the rescue of an endogenous population of atrophic myocytes bordering on microdomains of fibrosis to improve contractile mass...
October 2016: American Journal of the Medical Sciences
Athanasios Tsiouris, Lynn Wilson, Rajesh B Sekar, Abeel A Mangi, James J Yun
BACKGROUND: A lack of donor hearts remains a major limitation of heart transplantation. Hearts from Centers for Disease Control (CDC) high-risk donors can be utilized with specific recipient consent. However, outcomes of heart transplantation with CDC high-risk donors are not well known. We sought to define outcomes, including posttransplant hepatitis and human immunodeficiency virus (HIV) status, in recipients of CDC high-risk donor hearts at our institution. METHODS: All heart transplant recipients from August 2010 to December 2014 (n = 74) were reviewed...
October 23, 2016: Journal of Cardiac Surgery
Matteo Di Nardo, Graeme MacLaren, Marco Marano, Corrado Cecchetti, Paola Bernaschi, Antonio Amodeo
Extracorporeal life support (ECLS) is an important device in the management of children with severe refractory cardiac and or pulmonary failure. Actually, two forms of ECLS are available for neonates and children: extracorporeal membrane oxygenation (ECMO) and use of a ventricular assist device (VAD). Both these techniques have their own advantages and disadvantages. The intra-aortic balloon pump is another ECLS device that has been successfully used in larger children, adolescents, and adults, but has found limited applicability in smaller children...
2016: Frontiers in Pediatrics
Yuriy Pya, Makhabbat Bekbossynova, Saltanat Jetybayeva, Serik Bekbossynov, Saltanat Andossova, Roman Salov, Assel Medressova, Svetlana Novikova, Muradym Murzagaliyev
AIMS: The need for the left ventricular assist devices (LVAD) in patients with end-stage heart failure is well established, but prior to 2011, this was not available to patients in Kazakhstan. We describe the development of the sole LVAD programme in the context of a nascent heart transplantation programme and clinical outcomes for the first three years. METHODS AND RESULTS: From November 2011 to November 2014, 146 patients underwent implantation of 152 VADs (approximately 50 devices implanted per year)...
March 2016: ESC Heart Failure
Nir Uriel, Sirtaz Adatya, Jiří Malý, Eric Kruse, Daniel Rodgers, Gerald Heatley, Aleš Herman, Poornima Sood, Dominik Berliner, Johann Bauersachs, Axel Haverich, Michael Želízko, Jan D Schmitto, Ivan Netuka
BACKGROUND: The HeartMate 3 (HM3) is a Conformiteé Européenne (CE) mark-approved left ventricular assist device (LVAD) with a fully magnetically levitated rotor with features consisting of a wide range of operational speeds, wide flow paths and an artificial pulse. We performed a hemodynamic and echocardiographic evaluation of patients implanted with the HM3 LVAD to assess the speed range for optimal hemodynamic support. METHODS: Sixteen HM3 patients underwent pump speed ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP] and blood pressure [BP]) and 3-dimensional echocardiography (3DE)...
July 17, 2016: Journal of Heart and Lung Transplantation
Muath Bishawi, Asad A Shah, Richard L McCann, Carmelo A Milano
Improved quality of life for patients after left ventricular assist device (LVAD) implantation can be greatly limited by peripheral vascular disease even if heart failure symptoms are resolved by LVAD support. We present a case of concomitant thoracic aortobifemoral bypass and LVAD implantation in a patient with ischemic cardiomyopathy, severe peripheral vascular disease, and multiple previous failed revascularization attempts. In this patient, we used the LVAD outflow to provide the inflow to the femoral artery bypass graft...
November 2016: Annals of Thoracic Surgery
Maria Celeste Buompadre, Kathleen Andres, Lee-Anne Slater, Hadi Mohseni-Bod, Anne-Marie Guerguerian, Helen Branson, Suzanne Laughlin, Derek Armstrong, Mahendranath Moharir, Gabrielle deVeber, Tilman Humpl, Osami Honjo, Shaf Keshavjee, Rebecca Ichord, Vitor Pereira, Nomazulu Dlamini
The updated American Heart Association/American Stroke Association guidelines include recommendation for thrombectomy in certain adult stroke cases. The safety and efficacy of thrombectomy in children are unknown. An 8-year-old girl experienced acute stroke symptoms on two occasions while therapeutically anticoagulated on Novalung. Computed tomography scans showed proximal vessel thrombi, which were retrieved using a Trevo device without hemorrhagic complications. Postprocedural assessment found respective decreases in the National Institutes of Health Stroke Scale score from 10 to 4 and 12 to 7...
September 14, 2016: Pediatric Neurology
Riccardo Toninato, Silvia Scuri, Vincenzo Tarzia, Gino Gerosa, Francesca M Susin
PURPOSE: The gold standard therapy for patients with advanced heart failure is heart transplant. The gap between donors and patients in waiting lists promoted the development of circulatory support devices, such as the total artificial heart (TAH). Focusing on in vitro tests performed with CardioWest™ TAH (CW) driven by the SynCardia Freedom® portable driver (FD) the present study goals are: i) prove the reliability of a hydraulic circuit used as patient simulator to replicate a quasi-physiological scenario for various hydrodynamic conditions, ii) investigate the hydrodynamic performance of the CW FD, iii) help clinicians in possible interpretation of clinical cases outcomes...
October 15, 2016: International Journal of Artificial Organs
David Snipelisky, Yogesh N V Reddy, Kevin Manocha, Aalok Patel, Shannon M Dunlay, Paul A Friedman, Thomas M Munger, Samuel J Asirvatham, Douglas L Packer, Yong-Mei Cha, Suraj Kapa, Peter A Brady, Peter A Noseworthy, Joseph J Maleszewski, Siva K Mulpuru
BACKGROUND: Patients with advanced heart failure (HF) are predisposed to ventricular arrhythmias (VA), particularly following implantation of an LVAD. There is minimal evidence for appropriate management strategies. OBJECTIVES: This study aimed to compare the burden of VA and response to ablation performed either before or following left ventricular assist device (LVAD) implantation. METHODS: We created a retrospective cohort of patients who underwent both VA ablation and HeartMate II (Thoratec, CA) LVAD implantation at Mayo Clinic (Rochester, MN)...
October 21, 2016: Journal of Cardiovascular Electrophysiology
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Jessica Rimsans, Katelyn W Sylvester, Jean M Connors
Available options for the treatment of advanced heart failure have expanded to include the use of mechanical circulatory assist devices to improve quality of life in those both eligible and ineligible for heart transplant. Although there have been significant advancements in device technologies, anticoagulation protocols, and multidisciplinary team management, bleeding and thrombosis are the most common adverse effects. Management strategies for pump thrombosis and their outcomes vary considerably among mechanical circulatory support centers and include intensification of antithrombotic therapy (medical) and device exchange (surgical)...
October 7, 2016: Clinical and Applied Thrombosis/hemostasis
Ju H Kim, Ramesh Singh, Francis D Pagani, Shashank S Desai, Nicholas A Haglund, Shannon M Dunlay, Simon Maltais, Keith D Aaronson, John M Stulak, Mary E Davis, Christopher T Salerno, Jennifer A Cowger, Palak Shah
BACKGROUND: Limited data exist on outcomes in patients greater than 70 years of age supported with continuous flow left ventricular assist devices (LVAD). METHODS: Data on 1,149 continuous-flow LVAD recipients was queried from the Mechanical Circulatory Support Research Network. Groups were assigned based on age: ≥70 years ("older patients") and <70 years. The primary outcome was survival at one-year based on age grouping. RESULTS: Compared with younger patients, (54...
October 17, 2016: Journal of Cardiac Failure
J Trent Magruder, Joshua C Grimm, Todd C Crawford, Ryan J Tedford, Stuart D Russell, Christopher M Sciortino, Glenn J R Whitman, Ashish S Shah
BACKGROUND: Our objective was to determine whether the choice of a HeartWare HVAD as opposed to a Heartmate II left ventricular assist device (HMII LVAD), impacts survival after heart transplantation after controlling for patient, donor, and center characteristics. METHODS: We queried the United Network for Organ Sharing (UNOS) database, which has recently made pretransplantation device duration available, for all adult patients undergoing bridge to transplantation (BTT) between January 2011 and March 2016...
October 17, 2016: Annals of Thoracic Surgery
Marek Sramko, Dan Wichterle, Josef Kautzner
This study evaluated hemodynamic feasibility and reproducibility of a new method for in vivo simulation of human atrial fibrillation (AF). The method was tested during sinus rhythm in 10 patients undergoing catheter ablation for AF. A simple electronic device was assembled that allowed triggering a cardiac stimulator by predefined series of RR intervals. Irregular RR interval sequences with a mean heart rate of 90/min and 130/min were obtained from ECG recordings of another patients with AF. Simultaneous atrioventricular pacing was delivered by catheters placed inside the coronary sinus and at the His bundle region...
2016: PloS One
Rafael O Alvim, Andréa R V R Horimoto, Camila M Oliveira, Luiz A Bortolotto, José E Krieger, Alexandre C Pereira
BACKGROUND: Increased arterial stiffness is an important determinant of cardiovascular disease risk. In addition, it has been recognized that arterial stiffness has familial aggregation; however, there are no studies involving Brazilian families. Thus, the aim of this study was to evaluate the heritability of arterial stiffness in a Brazilian population. METHODS: In this study, 1675 eligible individuals (both sexes and aged 18-102 years) were distributed in 125 families resident in the municipality of Baependi, a city located in the southeast of Brazil...
October 19, 2016: Journal of Hypertension
Nina Lefeber, Eva Swinnen, Eric Kerckhofs
PURPOSE: The integration of sufficient cardiovascular stress into robot-assisted gait (RAG) training could combine the benefits of both RAG and aerobic training. The aim was to summarize literature data on the immediate effects of RAG compared to walking without robot-assistance on metabolic-, cardiorespiratory- and fatigue-related parameters. METHODS: PubMed and Web of Science were searched for eligible articles till February 2016. Means, SDs and significance values were extracted...
October 20, 2016: Disability and Rehabilitation. Assistive Technology
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