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https://www.readbyqxmd.com/read/28203425/false-positive-hepatitis-c-antibody-test-results-in-left-ventricular-assist-device-recipients-increased-risk-with-age-and-transfusions
#1
Grace Y Minamoto, Doreen Lee, Adriana Colovai, Dana Levy, Ljiljana Vasovic, Keith W Roach, Jonathan Shuter, Daniel Goldstein, David D'Alessandro, Ulrich P Jorde, Victoria A Muggia
Left ventricular assist devices (LVADs) have been successfully used in patients with heart failure. However, LVADs may trigger immune activation, leading to higher frequencies of autoantibodies. We describe the clinical, epidemiological, and laboratory characteristics of LVAD recipients with false positive hepatitis C (FPHC) serology among 39 consecutive adult LVAD recipients who bridged to heart transplantation from January 2007 to January 2013 at Montefiore Medical Center. FPHC patients were identified as those with post-LVAD positive hepatitis C ELISA antibody tests and negative confirmatory testing with hepatitis C RNA PCR and/or radioimmunoblot assay...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28191682/aortic-root-thrombus-complicated-by-left-main-coronary-artery-occlusion-visualized-by-3d-echocardiography-in-a-patient-with-continuous-flow-left-ventricular-assist-device
#2
Monique S Tanna, Alex Reyentovich, Leora B Balsam, John A Dodson, Alan F Vainrib, Ricardo J Benenstein, Barry P Rosenzweig, Muhamed Saric
Aortic root thrombus is an uncommon complication of continuous-flow left ventricular assist devices (LVAD). We present the case of a 71-year-old man with ischemic cardiomyopathy who underwent destination therapy HeartMate II LVAD placement. Eighteen months later, he presented with a cerebrovascular accident followed by myocardial infarction. Transesophageal echocardiography revealed an aortic root thrombus spanning the left and noncoronary cusps and obliterating the left main coronary artery. We discuss the incidence, risk factors, and management of aortic root thrombus in LVAD patients...
February 13, 2017: Echocardiography
https://www.readbyqxmd.com/read/28174391/-ventricular-assist-device
#3
Minoru Ono
In Japan the 1st paracorporeal ventricular assist device (VAD) was implanted in 1980. Since then, more than 2,000 VADs were used. Small size continuous-flow VAD (CFVAD) was developed in 1990s, which dramatically improved safety and efficacy of long-term support. EVAHEART and DuraHeart, both of which were developed in Japan, were approved for health insurance coverage in 2011, followed by approval of HeartMate II in 2013 and Jarvik 2000 in 2014. Although these approvals were limited for bridge to transplantation, CFVADs gained rapid acceptance for treatment of end-stage heart failure...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28169115/angiotensin-ii-antagonism-is-associated-with-reduced-risk-for-gastrointestinal-bleeding-caused-by-arteriovenous-malformations-in-patients-with-left-ventricular-assist-devices
#4
Brian A Houston, Andrea L C Schneider, Joban Vaishnav, David M Cromwell, P Elliott Miller, Kamil F Faridi, Ashish Shah, Chris Sciortino, Glenn Whitman, Ryan J Tedford, Gerin R Stevens, Daniel P Judge, Stuart D Russell, Rosanne Rouf
BACKGROUND: Angiogenesis is implicated in formation of gastrointestinal arteriovenous malformations (AVMs). Angiotensin II signaling is involved in angiogenesis through the vascular endothelial growth factor (VEGF) and angiopoietin-2 pathways. We hypothesized that angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) therapy would be associated with a reduced risk of all-cause gastrointestinal bleeding (GIB) and AVM-associated GIB in patients with left ventricular assist devices (LVADs)...
December 30, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28134659/assessment-of-bleeding-and-thrombosis-based-on-aspirin-responsiveness-after-continuous-flow-left-ventricular-assist-device-placement
#5
Catherine K Floroff, Krista L Rieger, Tara M Veasey, Sara E Strout, Walter F DeNino, Holly B Meadows, Martha R Stroud, John M Toole, Dawn P Heyward, Meredith A Brisco, Jennifer L Cook, John Lazarchick, Walter E Uber
Pump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding following LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial non-responders who were then titrated upward to achieve therapeutic response.Patients ≥ 18 years of age with initial placement of HeartMate II® (HMII) LVAD at our institution and at least one VerifyNow® Aspirin test performed during initial hospitalization were included...
January 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28125466/comparison-of-hemodynamic-performance-and-clinical-results-with-evaheart-versus-heartmate-ii
#6
Yorihiko Matsumoto, Tomoyuki Fujita, Satsuki Fukushima, Hiroki Hata, Yusuke Shimahara, Yuta Kume, Kizuku Yamashita, Kensuke Kuroda, Seiko Nakajima, Takuma Sato, Osamu Seguchi, Masanobu Yanase, Norihide Fukushima, Hideyuki Shimizu, Junjiro Kobayashi
This study aimed to compare the hemodynamic performance and clinical results of the EVAHEART and HeartMate II left ventricular assist devices (LVADs). From 2007 to 2016, 14 patients received EVAHEART and 28 received HeartMate II at our center. Early survival, driveline infection and neurological events were evaluated. Hemodynamic performance was evaluated with transthoracic echocardiography and right heart catheterization. Mean follow-up was 35.5 ± 14.8 months for EVAHEART, and 29.8 ± 6.5 months for HeartMate II...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28125463/percutaneous-driveline-fracture-following-implantation-of-the-heartmate-ii-left-ventricular-assist-device-how-durable-is-driveline-repair
#7
John M Stulak, Sarah Schettle, Nicholas Haglund, Shannon Dunlay, Jennifer Cowger, Palak Shah, Keith D Aaronson, Francis D Pagani, Simon Maltais
Durability of the percutaneous driveline is critical for the optimal long-term support of patients after left ventricular assist device (LVAD) implantation. There are no data specifically examining the durability of major repair for driveline fracture or its effect on patient outcomes.Between May 2004 and August 2014, 560 patients underwent implantation with the HeartMate II LVAD at our respective institutions. Median age at LVAD implantation was 59 years (range, 18-82 years) and 465 patients (83%) were male...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28114196/early-gains-in-renal-function-following-implantation-of-heartmate-ii-left-ventricular-assist-devices-may-not-persist-to-one-year
#8
Tal Hasin, Avishay Grupper, John J Dillon, Joseph J Maleszewski, Zhuo Li, Yan Topilsky, Robert P Frantz, Brooks S Edwards, Naveen L Pereira, Simon Maltais, John M Stulak, Lyle Joyce, Richard Daly, Soon J Park, Sudhir S Kushwaha
Renal function improves early after left ventricular assist device (LVAD) implantation but later decline has been observed. We sought to determine the occurrence and evaluate possible causes for this decline. In 62 consecutive patients with HeartMateII LVAD with available calculated glomerular filtration rate (GFR, ml/min/1.73m) one year after implant, GFR was assessed repeatedly and possible predictors for decline from 3 to 12 months were investigated. Post-mortem renal specimens for patients supported with an LVAD were evaluated...
January 19, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28110971/risk-factors-mortality-and-timing-of-ischemic-and-hemorrhagic-stroke-with-left-ventricular-assist-devices
#9
Jennifer A Frontera, Randall Starling, Sung-Min Cho, Amy S Nowacki, Ken Uchino, M Shazam Hussain, Maria Mountis, Nader Moazami
BACKGROUND: Stroke is a major cause of mortality after left ventricular assist device (LVAD) placement. METHODS: Prospectively collected data of patients with HeartMate II (n = 332) and HeartWare (n = 70) LVADs from October 21, 2004, to May 19, 2015, were reviewed. Predictors of early (during index hospitalization) and late (post-discharge) ischemic and hemorrhagic stroke and association of stroke subtypes with mortality were assessed. RESULTS: Of 402 patients, 83 strokes occurred in 69 patients (17%; 0...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28104118/cerebrovascular-accident-rate-is-different-between-centrifugal-and-axial-flow-pumps-but-survival-and-driveline-infection-rates-are-similar
#10
M Kimura, K Nawata, O Kinoshita, H Yamauchi, Y Itoda, T Imamura, M Hatano, K Kinugawa, M Ono
OBJECTIVES: We analyzed the outcome of patients with implantable left ventricular assist devices (LVADs) at the University of Tokyo Hospital to compare those with centrifugal pumps (CE group: Duraheart and Evaheart) and those with axial-flow pumps (AX group: Heartmate II and Jarvik 2000). METHODS: A total of 68 patients who underwent implantation of LVADs (Duraheart: n = 15; Evaheart: n = 23; Heartmate II: n = 22; Jarvik 2000: n = 8) as a bridge to transplantation at our institution from May 2011 to April 2015 were retrospectively reviewed...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28070902/a-modified-lvad-technique-to-augment-caval-and-pulmonary-arterial-blood-flow-in-the-failing-fontan-circulation
#11
Michael F Swartz, Louis DiVincenti, Karen Smith, Robin Westcott, Kevin Belmont, William Harris, Francisco Gensini, George M Alfieris
BACKGROUND: There are minimal circulatory support options for patients with a failing Fontan. The Heartmate II (HMII) left ventricular assist device (Thoratec, Bedford, MA) in its packaged state cannot augment caval/pulmonary arterial blood flow. AIM: We hypothesized that a modified HMII pump could augment caval and pulmonary arterial blood flow. METHODS: A bifurcated ringed Gore-Tex graft (W. L. Gore & Associates, Flagstaff, AZ) was sewn to the HMII inflow, and the outflow graft transected and tapered from 16 mm to 8 mm in diameter...
January 9, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28054898/pump-thrombosis-following-heartmate-ii-left-ventricular-assist-device-implantation-in-a-patient-with-aspirin-and-plavix-resistance
#12
Ali Ghodsizad, A Badiye, M Zeriouh, W Pae, M M Koerner, M Loebe
Despite advances in pump technology, thromboembolic events and pump thrombosis are potentially life-threatening complications in patients with continuous flow ventricular assist devices. Here we describe a patient with pump thrombosis following LVAD HeartMate II implantation presenting with Aspirin and Plavix resistance and signs of acute hemolysis as manifested by high LDH, changing pump power, pulse index and reduced pump flows.
14, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#13
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28033184/effect-of-outflow-graft-size-on-flow-in-the-aortic-arch-and-cerebral-blood-flow-in-continuous-flow-pumps-possible-relevance-to-strokes
#14
Sindhoor Bhat, Jayakala Mathews, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is a stroke, with a higher incidence in Heartware HVAD as compared to HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Since outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates.A Computational fluid structure interaction model was created from the CT scan of a patient. Pressures were used as the boundary condition and the flow through the cerebral vessels was derived as outputs...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28029574/the-axial-continuous-flow-blood-pump-bench-evaluation-of-changes-in-flow-associated-with-changes-of-inflow-cannula-angle
#15
Jamshid H Karimov, Michael Zhen-Yu Tong, Nicole Byram, Gengo Sunagawa, Raymond Dessoffy, Nader Moazami, Randall C Starling, Kiyotaka Fukamachi
BACKGROUND: Changes in the geometry of the HeartMate II (HMII) inflow cannula have been implicated in device thrombosis post-implant. The purpose of this in vitro study was to evaluate what effects changing the angle of the cannula in relation to the pump may have on pump flow and arterial pressure, under simulated inflow conditions. METHODS: The HMII with an inflow cannula was mounted on a mock loop consisting of a pulsatile pneumatic ventricle to simulate the native ventricle...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28029573/mechanical-circulatory-support-and-heart-transplantation-in-the-asia-pacific-region
#16
EDITORIAL
Cumaraswamy Sivathasan, Choon Pin Lim, Ka Lee Kerk, David K L Sim, Mandeep R Mehra
Globalization has resulted in epidemiologic transition in developing countries from infectious disease and nutritional deficiencies to non-communicable diseases. Epidemiologic data on heart failure (HF), particularly advanced HF therapy, in Asia are increasingly becoming available, although they remain sparse. Heart transplantation for advanced stage HF remains very low in Asia-approximately 0.075 heart transplants per 1 million population. North America, which comprises 7.5% of the world population, accounted for 55...
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28009711/surgical-technique-for-ventricular-device-exchange-from-heartmate-ii-to-hvad
#17
Michele Gallo, Jaimin R Trivedi, Michael A Sobieski, Todd H Massey, Allen Cheng, Mark S Slaughter
Implantable continuous-flow left ventricular assist devices (VAD) have improved the survival of end-stage heart failure patients. Recent studies have shown an increased occurrence of device replacement in the axial-flow pumps particularly for thrombosis. In some patients, to try and avoid recurrent pump thrombosis, it might be advantageous to switch from the axial flow LVAD to a newer generation centrifugal flow LVAD. Technically, this requires some adaption of the LVAD inflow and outflow connections. We describe our technique and outcomes in patients that underwent the conversion from an axial flow LVAD to a centrifugal flow LVAD...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28009710/subxiphoid-exchange-of-heartmate-ii-left-ventricular-assist-device
#18
Vakhtang Tchantchaleishvili, Jessica G Y Luc, Joshua Haswell, William Hallian, H Todd Massey
With increasing use of left ventricular assist devices (LVAD) for long-term circulatory support comes a growing need for device exchange. The conventional surgical approach for device exchanges has been a reoperative median resternotomy. Less invasive HeartMate II LVAD exchange via a non-muscle-dividing subxiphoid incision as an alternative to a left subcostal incision may reduce pain burden and facilitate recovery. From November 2006 through June 2015, 292 patients underwent HeartMate II LVAD placement, of which 30 (10...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28007258/outflow-graft-obstruction-treated-with-transcatheter-management-a-novel-therapy-for-a-new-diagnosis
#19
Castigliano M Bhamidipati, Jay D Pal, Thomas K Jones, James M McCabe, Mark Reisman, Jason W Smith, Claudius Mahr, Nahush A Mokadam
The duration of support in patients with HeartMate II implantation as a bridge to transplant or as destination therapy is rising. As clinical experience continues to grow, physiologic changes contributing to pump malfunction are becoming apparent. Once malfunction is noted with increased power spikes, rises in lactate dehydrogenase and low-flow alarms, thrombosis of the pump is at risk. We describe outflow graft compression and offer an expeditious and definitive management strategy. Our novel management stenting strategy for outflow graft compression will continue to evolve as experience is gained...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28003575/higher-body-mass-index-increases-risk-of-heartmate-ii-pump-thrombosis-but-does-not-adversely-affect-long-term-survival
#20
Jason J Han, Renganaden Sooppan, Adam P Johnson, Carol W Chen, Ann C Gaffey, Emily C Phillips, Jessica Howard, J Eduardo Rame, Michael A Acker, Pavan Atluri
BACKGROUND: Obesity has been correlated with various adverse events in patients who receive left ventricular assist devices (LVAD). In this study, we sought to further characterize the role of obesity in this patient population.Methods and Results:We performed a retrospective analysis of 164 patients implanted with a HeartMate II from August 2008 to December 2014. Patients were categorized into 2 BMI groups based on WHO guidelines: BMI 18.5-30 kg/m(2)(n=99) and BMI >30 kg/m(2)(n=65)...
January 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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