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HeartMate II

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https://www.readbyqxmd.com/read/29141860/multicenter-evaluation-of-octreotide-as-secondary-prophylaxis-in-patients-with-left-ventricular-assist-devices-and-gastrointestinal-bleeding
#1
Keyur B Shah, Sampath Gunda, Sitaramesh Emani, Manreet K Kanwar, Nir Uriel, Paolo C Colombo, Patricia A Uber, Melissa L Sears, Joyce Chuang, David J Farrar, Donald F Brophy, George B Smallfield
BACKGROUND: Gastrointestinal (GI) bleeding is one of the most common complications after continuous-flow left ventricular assist device implantation. More than one third of patients with incident bleed go on to develop recurrent GI bleeding. Octreotide, a somatostatin analog, is proposed to reduce the risk of recurrent GI bleeding in this population. METHODS AND RESULTS: This multicenter, retrospective analysis evaluated 51 continuous-flow left ventricular assist device patients who received secondary prophylaxis with octreotide after their index GI bleed from 2009 to 2015...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29117041/repeated-ramp-tests-on-stable-lvad-patients-reveal-patient-specific-hemodynamic-fingerprint
#2
Teruhiko Imamura, Daniel Burkhoff, Daniel Rodgers, Sirtaz Adatya, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, Colleen Juricek, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
Hemodynamic speed ramp tests are used in left ventricular assist device (LVAD) patients to guide speed adjustment and medical therapies. However, the reproducibility of these tests is unknown. In this prospective study, clinically stable LVAD patients underwent echocardiography and right heart catheterization ramp tests followed by a repeat test within 2 years as per institutional protocol. Sixteen patients (61.8 ± 10.5 years old, 50% male, eight with HeartMate II and eight with HVAD) underwent repeated ramp testing...
November 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29095735/single-versus-multidrug-regimen-for-surgical-infection-prophylaxis-in-left-ventricular-assist-device-implantation
#3
Nana Aburjania, Brennan M Ertmer, Saira Farid, Melody Berg, Juhsien J C Nienaber, Vakhtang Tchantchaleishvili, John M Stulak, Muhammad R Sohail
Infection is a serious complication of left ventricular assist device (LVAD) therapy. However, an optimal antimicrobial surgical infection prophylaxis (SIP) regimen for LVAD implantation is not well established. We retrospectively reviewed all adults who underwent continuous-flow LVAD implantation from February 2007 to March 2015 at Mayo Clinic Rochester. Left ventricular assist device infection (LVADI) was defined using criteria published by the International Society for Heart and Lung Transplant. Patients excluded from the analysis included those who did not have HeartMate II or HeartWare device, patients with incomplete documentation of SIP, and those with an actively treated infection at the time of LVAD implantation...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29093975/case-report-of-multiembolic-cerebrovascular-event-associated-with-ramp-study-echocardiogram
#4
Brian C Butera, Luanda P Grazette, Tracy Lawrence, Michael E Bowdish, Andrew J Yoon
The incidence of ramp test echocardiogram-associated embolic events in the setting of therapeutic anticoagulation is likely rare and has not been reported. We present such a case in a patient with a HeartMate II left ventricular assist device (LVAD) whose serial head computed tomography images, deteriorating clinical course, and the multiembolic nature of the event suggest causality. If the pretest probability of pump thrombosis in an individual LVAD patient is sufficiently high, the potential risks of performing a ramp study echocardiogram may not be warranted, even in the setting of adequate anticoagulation...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29050685/renal-function-changes-following-left-ventricular-assist-device-implantation
#5
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/29049614/anticoagulation-management-following-left-ventricular-assist-device-implantation-is-similar-across-all-provider-strategies
#6
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/29045747/extracorporeal-membrane-oxygenation-support-for-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#7
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/29045277/determinants-of-improvement-in-cardiopulmonary-exercise-testing-after-left-ventricular-assist-device-implantation
#8
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/29035899/driveline-site-is-not-a-predictor-of-infection-after-ventricular-assist-device-implantation
#9
Billie-Jean Martin, Jessica G Y Luc, Michiko Maruyama, Roderick MacArthur, Angela R Bates, Holger Buchholz, Darren H Freed, Jennifer Conway
Driveline infections (DLIs) remain a major source of morbidity for patients requiring long-term ventricular assist device (VAD) support. We aimed to assess whether VAD driveline exit site (DLES) (abdomen versus chest wall) is associated with DLI. All adult patients who underwent insertion of a HeartWare HVAD or HeartMate II (HMII) between 2009 and 2016 were included. Driveline infection was defined as clinical evidence of DLI accompanied by a positive bacterial swab and need for antibiotics. Competing risks analysis was used to assess the association between patient characteristics and DLI...
October 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28987395/abciximab-heparin-therapy-for-left-ventricular-assist-device-implantation-in-patients-with-heparin-induced-thrombocytopenia
#10
Chia-Ling Lee, Paolo C Colombo, Andrew Eisenberger, David Diuguid, Douglas L Jennings, Jiho Han, Michael P Salna, Koji Takeda, Paul A Kurlansky, Melana Yuzefpolskaya, Arthur R Garan, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Optimal anticoagulation strategy remains uncertain in patients with heparin-induced thrombocytopenia (HIT) and undergoing left ventricular assist device (LVAD) implantation. We describe our protocol of abciximab and heparin in these patients. METHODS: Our protocol is to administer abciximab, 0.25 mg/kg loading dose, followed by continuous infusion of 0.125 μg · kg(-1) · min(-1) throughout cardiopulmonary bypass. Full-dose heparin is then given with subsequent additional doses to maintain an activated clotting time of 400 seconds or longer...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28982636/cannula-and-pump-positions-are-associated-with-left-ventricular-unloading-and-clinical-outcome-in-patients-with-heartware-left-ventricular-assist-device
#11
Teruhiko Imamura, Sirtaz Adatya, Ben Chung, Ann Nguyen, Daniel Rodgers, Gabriel Sayer, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, Colleen Juricek, Diego Medvedofsky, Valluvan Jeevanandam, Roberto Lang, Jerry D Estep, Daniel Burkhoff, Nir Uriel
BACKGROUND: Cannula and pump positions are associated with clinical outcomes such as device thrombosis in patients with HeartMate II. However, clinical implications of HVAD cannula position are unknown. This study aims to assess the relationship between cannula position, left ventricular (LV) unloading and patient prognosis. METHODS AND RESULTS: Twenty-seven HVAD patients (60.0 ± 12.6 years old and 19 male [70%]) underwent ramp test. Device position was quantified from chest X-ray parameters obtained at time of hemodyamic ramp test: (1) cannula coronal angle, (2) pump depth, (3) cannula sagittal angle and (4) pump area...
October 2, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28962504/impact-of-concomitant-mitral-valve-repair-for-severe-mitral-regurgitation-at-the-time-of-continuous-flow-left-ventricular-assist-device-insertion
#12
Elena Sandoval, Steve K Singh, Julius A Carillo, Andrew C W Baldwin, Masahiro Ono, Jatin Anand, O H Frazier, Hari R Mallidi
OBJECTIVES: Mitral regurgitation (MR) is common in patients with end-stage heart failure. We assessed the effect of performing concomitant mitral valve repair during continuous-flow left ventricular assist device (CF-LVAD) implantation in patients with severe preoperative MR. METHODS: We performed a single-centre, retrospective review of all patients who underwent CF-LVAD implantation between December 1999 and December 2013 (n = 469). Patients with severe preoperative MR (n = 78) were identified and then stratified according to whether they underwent concomitant valve repair...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28958451/preoperative-prealbumin-level-as-a-predictor-of-outcomes-in-patients-who-underwent-left-ventricular-assist-device-implantation
#13
Andre C Critsinelis, Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Malnutrition has been associated with an increased risk of morbidity and mortality in patients who undergo cardiac surgery. However, many measurements of malnutrition have been inadequate prognostic markers. In this study, we sought to determine whether low preoperative serum prealbumin level was associated with morbidity and mortality in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. From November 2003 to March 2016, 526 patients with chronic heart failure underwent implantation of a CF-LVAD (HeartMate II, n = 403; HeartWare HVAD, n = 123)...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28958073/five-year-results-of-patients-supported-by-heartmate-ii-outcomes-and-adverse-events
#14
Jasmin S Hanke, Sebastian V Rojas, Claudius Mahr, Anja-Franziska Schmidt, Amelie Zoch, Günes Dogan, Christina Feldmann, Ezin Deniz, Ullrich Molitoris, Christoph Bara, Martin Strüber, Axel Haverich, Jan D Schmitto
OBJECTIVES: Improved outcomes over the past decade have increased confidence of physicians and patients in extended duration of left ventricular assist device (LVAD) support. This single-centre cohort study reports 5-year outcomes with the HeartMate II (HMII) LVAD. METHODS: We describe a cohort of 89 patients who received a HMII LVAD between February 2004 and December 2010. The causes of death and adverse events were assessed by examination of medical records. A total of 202...
September 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28957820/risk-factors-of-gastrointestinal-bleeding-after-continuous-flow-left-ventricular-assist-device
#15
Ozlem Balcioglu, Hatice S Kemal, Serkan Ertugay, Pelin Ozturk, Yaprak Engin, Sanem Nalbantgil, Cagatay Engin, Tahir Yagdi, Mustafa Ozbaran
This study aimed to compare von Willebrand factor (vWF) levels, ristocetin cofactor levels, platelet counts, aortic valve movements, and right heart failure (RHF) as risk factors of gastrointestinal (GI) bleeding in patients with continuous flow left ventricular assist device (cf-LVAD). In a single centre, 90 patients (mean age 52.0 ± 10.5 years), of which 59 were male and 31 were female, had cf-LVAD implantation from October 2010 to November 2012. Seventy-six (84.4%) patients had HeartWare (Medtronic, Mounds View, MN) and 14 (15...
September 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28953485/long-term-mechanical-durability-of-left-ventricular-assist-devices-an-urgent-call-for-periodic-assessment-of-technical-integrity
#16
Rahatullah Muslem, Sakir Akin, Alina A Constantinescu, Olivier Manintveld, Jasper J Brugts, Cees W van der Heiden, Ozcan Birim, Ad J J C Bogers, Kadir Caliskan
Long-term durability and incidence of potential mechanical device failure (MDF) are largely unknown. In this study, we investigated the incidence and potential predictors of MDF in continuous flow left ventricular assist device (CF-LVAD) patients. We conducted a retrospective study of all CF-LVADs (type HeartMate II) implanted in our center. MDF was defined as a failure of driveline, inflow-outflow graft, electrical power, drive unit, or motor failure, excluding device failure because of a biologic complication (e...
September 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28947307/prognostic-implications-of-changes-in-albumin-following-left-ventricular-assist-device-implantation-in-patients-with-severe-heart-failure
#17
Dipika J Gopal, Thomas C Hanff, Jeremy A Mazurek, Wilson E Grandin, Jessica Howard, Rhondalyn Forde-McLean, Joyce Wald, Kathie King, Michael A Acker, Lee R Goldberg, Mariell Jessup, Pavan Atluri, Kenneth B Margulies, Eduardo J Rame, Edo Y Birati
Mechanical assist devices have emerged as an established therapeutic option for patients with end-stage heart failure. Because preimplant hypoalbuminemia is a known risk factor for adverse outcomes, we hypothesized that change in albumin may be a prognostic indicator in patients with continuous-flow left ventricular assist devices (cfLVADs). This is a retrospective single-center study of patients who underwent cfLVAD implantation (HeartMate II and HeartWare HVAD) at an academic center from 2008 to 2014. After excluding those who died, were transplanted, or hospitalized during the first 3 months post-implant, albumin values were obtained and stratified by an increase or a decrease from pre-implant to 3 months post-implant on 171 (81% male, mean age 57 ± 16 years) patients (139 for the survival analysis and 90 for the hospitalization analysis)...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28938306/different-clinical-course-and-complications-in-interagency-registry-for-mechanically-assisted-circulatory-support-1-patients-managed-with-or-without-extracorporeal-membrane-oxygenation
#18
Jason J Han, Jennifer Chung, Carol W Chen, Ann C Gaffey, Alex Sotolongo, Christyna Justice, Alyse E Ameer, J Eduardo Rame, Christian Bermudez, Michael A Acker, Pavan Atluri
Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28932915/outcomes-in-patients-with-advanced-heart-failure-and-small-body-size-undergoing-continuous-flow-left-ventricular-assist-device-implantation
#19
Nastasya Volkovicher, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Andrew B Civitello, Jeffrey A Morgan
Left ventricular assist devices (LVADs) have become a preferred treatment option for patients with end-stage heart failure when used as a bridge to transplant or as a destination therapy. However, the association between small body size and postoperative outcomes for continuous-flow (CF) LVAD recipients is still being studied. We sought to determine whether body surface area (BSA) is associated with patient outcomes after CF-LVAD implantation. The study cohort of our single-center, retrospective review consisted of all patients (n = 526) who underwent CF-LVAD implantation (n = 403 HeartMate II, n = 123 HeartWare) between November 2003 and March 2016 regardless of indication...
September 20, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28912261/preoperative-pectoralis-muscle-quantity-and-attenuation-by-computed-tomography-are-novel-and-powerful-predictors-of-mortality-after-left-ventricular-assist-device-implantation
#20
Levi M Teigen, Ranjit John, Adam J Kuchnia, Emily M Nagel, Carrie P Earthman, Jessica Kealhofer, Cindy Martin, Rebecca Cogswell
BACKGROUND: Skeletal muscle mass decreases in end-stage heart failure and is predictive of clinical outcomes in several disease states. Skeletal muscle attenuation and quantity as quantified on preoperative chest computed tomographic scans may be predictive of mortality after continuous flow (CF) left ventricular assist device (LVAD) implantation. METHODS AND RESULTS: A single-center continuous flow-LVAD database (n=354) was used to identify patients with chest computed tomographies performed in the 3 months before LVAD implantation (n=143)...
September 2017: Circulation. Heart Failure
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