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https://www.readbyqxmd.com/read/28109384/failing-systemic-right-ventricles-with-persistent-pulmonary-hypertension-candidates-for-ventricular-assist-devices-as-destination-therapy
#1
Ophelie Loup, Kerstin Wustmann, Michele Vittorio Martinelli, Markus Schwerzmann, Paul Mohacsi, Thierry Pierre Carrel, Alexander Kadner
Dysfunction of the systemic right ventricle is common after the atrial switch procedure for transposition of the great arteries. Cardiac transplantation remains the only long-term solution in terminal systemic right ventricular (RV) failure, but concomitant pulmonary hypertension (PHT) may preclude it. The increasing number of such patients, together with the concerns related to combined heart-lung transplantation (HLTx), urge us to consider other therapeutic options.
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28107271/perioperative-care-of-the-patient-with-the-total-artificial-heart
#2
Jill Yaung, Francisco A Arabia, Michael Nurok
Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28105542/hospice-in-heart-failure-why-when-and-what-then
#3
Jeffrey L Spiess
Hospice is a model of care for patients nearing the end of their lives that emphasizes symptom management, quality of life (QOL), and support of the patient and caregiving family through the death of the patient and the family's bereavement. It is associated with high patient and caregiver satisfaction and appears to not shorten lifespan for appropriately referred patients. Patients with advanced heart failure are being referred to hospice care more often than in the past, but the majority of deaths occur without this benefit...
January 20, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28104669/sex-specific-outcomes-with-addition-of-defibrillation-to-resynchronisation-therapy-in-patients-with-heart-failure
#4
Sérgio Barra, Rui Providência, Rudolf Duehmke, Serge Boveda, Eloi Marijon, Christian Reitan, Rasmus Borgquist, Didier Klug, Pascal Defaye, Nicolas Sadoul, Jean-Claude Deharo, Iannish Sadien, Kiran Patel, Khang-Li Looi, David Begley, Anthony W Chow, Jean-Yves Le Heuzey, Sharad Agarwal
OBJECTIVE: Among primary prevention patients with heart failure receiving cardiac resynchronisation therapy (CRT), the impact of additional implantable cardioverter defibrillator (ICD) treatment on outcomes and its interaction with sex remains uncertain. We aim to assess whether the addition of the ICD functionality to CRT devices offers a more pronounced survival benefit in men compared with women, as previous research has suggested. METHODS: Observational multicentre cohort study of 5307 consecutive patients with ischaemic or non-ischaemic dilated cardiomyopathy and no history of sustained ventricular arrhythmias having CRT implantation with (cardiac resynchronisation therapy defibrillator (CRT-D), n=4037) or without (cardiac resynchronisation therapy pacemaker (CRT-P), n=1270) defibrillator functionality...
January 19, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28103510/exo-organoplasty-interventions-a-brief-review-of-past-present-and-future-directions-for-advance-heart-failure-management
#5
REVIEW
Waqas Nawaz, Farhan Ullah Khan, Muhammad Zahid Khan, Wang Gang, Mengqi Yang, Xiaoqian Liao, Li Zhang, Awais Ullah Ihsan, Amjad Khan, Lei Han, Xiaohui Zhou
Heart failure (HF) is a debilitating disease in which abnormal function of the heart leads to imbalance of blood demand to tissues and organs. The pathogenesis of HF is very complex and various factors can contribute including myocardial infarction, ischemia, hypertension and genetic cardiomyopathies. HF is the leading cause of death and its prevalence is expected to increase in parallel with the population age. Different kind of therapeutic approaches including lifestyle modification, medication and pacemakers are used for HF patients in NYHA I-III functional class...
January 16, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28100834/soft-robotic-sleeve-supports-heart-function
#6
Ellen T Roche, Markus A Horvath, Isaac Wamala, Ali Alazmani, Sang-Eun Song, William Whyte, Zurab Machaidze, Christopher J Payne, James C Weaver, Gregory Fishbein, Joseph Kuebler, Nikolay V Vasilyev, David J Mooney, Frank A Pigula, Conor J Walsh
There is much interest in form-fitting, low-modulus, implantable devices or soft robots that can mimic or assist in complex biological functions such as the contraction of heart muscle. We present a soft robotic sleeve that is implanted around the heart and actively compresses and twists to act as a cardiac ventricular assist device. The sleeve does not contact blood, obviating the need for anticoagulation therapy or blood thinners, and reduces complications with current ventricular assist devices, such as clotting and infection...
January 18, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28097793/living-with-cardiac-resynchronization-therapy-challenges-for-people-with-heart-failure
#7
Shadi Dehghanzadeh, Nahid Dehghan Nayeri, Shokoh Varaei, Jalal Kheirkhah
The number of people with heart failure requiring implantation of a cardiac resynchronization device is increasing in Iran. Although this intervention is an effective life-saving treatment, several challenges are associated with patients' lifestyle after insertion. This study identified the challenges and coping mechanisms of Iranians with heart failure living with cardiac resynchronization therapy. A qualitative approach using conventional content analysis was adopted. Seventeen people with heart failure and three nurses were recruited between December 2014 and November 2015 from a teaching hospital and a private clinic in Rasht, Iran...
January 18, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28096288/mid-regional-pro-atrial-natriuretic-peptide-to-predict-clinical-course-in-heart-failure-patients-undergoing-cardiac-resynchronization-therapy
#8
Mattia Arrigo, Quynh A Truong, Jackie Szymonifka, Mercedes Rivas-Lasarte, Heli Tolppanen, Malha Sadoune, Etienne Gayat, Alain Cohen-Solal, Frank Ruschitzka, James L Januzzi, Jagmeet P Singh, Alexandre Mebazaa
AIMS: Cardiac resynchronization therapy (CRT) induces reverse cardiac remodelling in heart failure (HF), but many patients receiving CRT remain non-responders. This study assessed the role of amino-terminal-pro-B-type natriuretic peptide (NT-proBNP), mid-regional-pro-atrial natriuretic peptide (MR-proANP), and mid-regional-pro-adrenomedullin (MR-proADM) at the time of device implantation to predict favourable clinical course (CRT response and/or risk of MACE) in HF patients receiving CRT...
January 16, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28093312/palliative-medicine-and-preparedness-planning-for-patients-receiving-left-ventricular-assist-device-as-destination-therapy-challenges-to-measuring-impact-and-change-in-institutional-culture
#9
Brandon P Verdoorn, Angela J Luckhardt, Sara E Wordingham, Shannon M Dunlay, Keith M Swetz
CONTEXT: While left ventricular assist devices as destination therapy (DT-LVAD) can improve survival, quality of life, and functional capacity in well-selected patients with advanced heart failure, there remain unique challenges to providing quality end-of-life care in this population. Palliative care involvement is universally recommended, but how to best operationalize this care and measure success is unknown. OBJECTIVES: To characterize the process of preparedness planning (PP) for patients receiving DT-LVAD at our institution and better understand opportunities for quality improvement or procedural transferability...
January 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28092289/the-impact-of-obesity-on-heart-failure
#10
Alexander B Zhai, Haissam Haddad
PURPOSE OF REVIEW: Obesity, a growing global health problem, contributes to the development of heart failure. However, increased BMI seems protective for those with established disease, a phenomenon known as the 'obesity paradox'. In this review, we outline the mechanism through which obesity can contribute to the development of heart failure, explore the concept of obesity paradox, and highlight the challenges that obesity presents for advanced heart failure therapy. RECENT FINDINGS: Although the mechanism underlying the obesity paradox is complex, meta-analysis shows that intentional weight loss through bariatric surgery can indeed improve cardiac structure and function...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#11
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28079553/end-of-life-decisions-in-heart-failure-to-turn-off-the-intracardiac-device-or-not
#12
Bilal Ayach, Amrit Malik, Colette Seifer, Shelley Zieroth
PURPOSE OF REVIEW: Heart failure is a significant public health concern around the world. Implantable cardioverter defibrillators with or without cardiac resynchronization therapy (CRT-D) have proven survival benefit. As patients progress to end-stage disease, management shifts to palliative care, and cardiologists are often confronted with how to best manage these devices. RECENT FINDINGS: Studies suggest that up to one-third of patients with an implantable cardioverter defibrillator receive painful shocks in the last 24 h of life...
January 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28075307/chronic-heart-failure-part-2-treatment-and-management
#13
Rebecca Brake, Ian David Jones
Chronic heart failure is a common and complex clinical syndrome that results from impaired cardiac relaxation or contraction. There have been considerable advances in the management of chronic heart failure; however, the mortality rate remains high. Patients with chronic heart failure may experience multiple debilitating symptoms, such as fatigue, pain, and peripheral oedema. However, breathlessness may be considered the most debilitating symptom. The management of chronic heart failure aims to improve the patient's quality of life by reducing symptoms and supporting the patient to manage their condition...
January 11, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28070237/to-ventricular-assist-devices-or-not-when-is-implantation-of-a-ventricular-assist-device-appropriate-in-advanced-ambulatory-heart-failure
#14
EDITORIAL
Emily Cerier, Brent C Lampert, Arman Kilic, Asia McDavid, Salil V Deo, Ahmet Kilic
Advanced heart failure has been traditionally treated via either heart transplantation, continuous inotropes, consideration for hospice and more recently via left ventricular assist devices (LVAD). Heart transplantation has been limited by organ availability and the futility of other options has thrust LVAD therapy into the mainstream of therapy for end stage heart failure. Improvements in technology and survival combined with improvements in the quality of life have made LVADs a viable option for many patients suffering from heart failure...
December 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/28063800/gene-therapy-for-heart-failure
#15
REVIEW
Barry Greenberg
Novel strategies are needed to treat the growing population of heart failure patients. While new drug and device based therapies have improved outcomes over the past several decades, heart failure patients continue to experience amongst the lowest quality of life of any chronic disease, high likelihood of being hospitalized and marked reduction in survival. Better understanding of many of the basic mechanisms involved in the development of heart failure has helped identify abnormalities that could potentially be targeted by gene transfer...
November 5, 2016: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28059841/insights-into-cardiorenal-interactions-in-acute-decompensated-heart-failure
#16
Feras M Bader, Nizar Attallah
PURPOSE OF REVIEW: Acute decompensated heart failure (ADHF) is one of the biggest challenges in the management of chronic heart failure. Despite the advances in medical and device therapy, high readmission and mortality rates continue to be a burden on healthcare systems worldwide. One of the strongest predictors of adverse outcomes in ADHF is renal dysfunction, referred to as cardiorenal syndrome (CRS) type 1. This review discusses some of the recently introduced findings related to the pathophysiology, diagnosis, and management of this disorder...
January 3, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28058856/effective-treatment-with-a-new-protocol-using-tissue-type-plasminogen-activator-thrombolysis-for-pump-thrombosis-with-the-hvad-device
#17
Benedikt Schrage, Hanno Grahn, Florian M Wagner, Alexander Bernhardt, Meike Rybczynski, Stefan Blankenberg, Hermann Reichenspurner, Markus J Barten
BACKGROUND: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis. METHODS: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#18
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/28033201/right-ventricular-failure-post-lvad-implantation-corrected-with-biventricular-support-an-in-vitro-model
#19
Sajad Shehab, Sabine M Allida, Patricia M Davidson, Phillip J Newton, Desiree Robson, Paul C Jansz, Christopher S Hayward
Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. Management remains limited to pharmacologic therapy and temporary mechanical support. Delayed right ventricular assist device (RVAD) support after LVAD implantation is associated with poorer outcomes. With the advent of miniaturized, durable, continuous flow ventricular assist device systems, chronic RVAD and biventricular assist device (BiVAD) support has been used with some success. The purpose of this study was to assess combined BiVAD and LVAD with delayed RVAD support within a four-elemental mock circulatory loop (MCL) simulating the human cardiovascular system...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28033200/lvad-outflow-graft-angle-and-thrombosis-risk
#20
Alberto Aliseda, Venkat Keshav Chivukula, Patrick Mcgah, Anthony R Prisco, Jennifer A Beckman, Guilherme J M Garcia, Nahush A Mokadam, Claudius Mahr
This study quantifies thrombogenic potential (TP) of a wide range of left ventricular assist device (LVAD) outflow graft anastomosis angles through state-of-the-art techniques: 3D imaged-based patient-specific models created via virtual surgery and unsteady computational fluid dynamics with Lagrangian particle tracking. This study aims at clarifying the influence of a single parameter (outflow graft angle) on the thrombogenesis associated with flow patterns in the aortic root after LVAD implantation. This is an important and poorly-understood aspect of LVAD therapy, because several studies have shown strong inter and intrapatient thrombogenic variability and current LVAD implantation strategies do not incorporate outflow graft angle optimization...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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