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heart failure device therapy

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https://www.readbyqxmd.com/read/27922885/ventricular-assist-device-implantation-configurations-impact-overall-mechanical-circulatory-support-system-thrombogenic-potential
#1
Wei-Che Chiu, Yared Alemu, Allison J McLarty, Shmuel Einav, Marvin J Slepian, Danny Bluestein
Ventricular assist devices (VAD) became in recent years the standard of care therapy for advanced heart failure with hemodynamic compromise. With the steadily growing population of device recipients, various post-implant complications have been reported, mostly associated with the hyper-shear generated by VADs that enhance their thrombogenicity by activating platelets. While VAD design optimization can significantly improve its thromboresistance, the implanted VAD need to be evaluated as part of a system. Several clinical studies indicated that variability in implantation configurations may contribute to the overall system thrombogenicity...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922882/exercise-hemodynamics-as-a-predictor-of-myocardial-recovery-in-lvad-patients
#2
Louise Segan, Shane Nanayakkara, Angeline Leet, Donna Vizi, David M Kaye
Mechanical circulatory support using left ventricular assist devices (LVADs) has been demonstrated to improve survival in patients with advanced heart failure. LVAD therapy also promotes reverse ventricular remodeling, which in some cases has led to sufficient myocardial recovery to allow LVAD removal. Identification of suitable patients for LVAD removal however remains challenging. We investigated the hypothesis that invasive assessment of exercise hemodynamics may provide additional information in relation to the assessment of contractile reserve in potential candidates for LVAD explant...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27920834/trends-and-determinant-factors-in-the-use-of-cardiac-resynchronization-therapy-devices-in-japan-analysis-of-the-japan-cardiac-device-treatment-registry-database
#3
Hisashi Yokoshiki, Akihiko Shimizu, Takeshi Mitsuhashi, Hiroshi Furushima, Yukio Sekiguchi, Tetsuyuki Manaka, Nobuhiro Nishii, Takeshi Ueyama, Norishige Morita, Takashi Nitta, Ken Okumura
BACKGROUND: The choice of cardiac resynchronization therapy device, with (CRT-D) or without (CRT-P) a defibrillator, in patients with heart failure largely depends on the physician׳s discretion, because it has not been established which subjects benefit most from a defibrillator. METHODS: We examined the annual trend of CRT device implantations between 2006 and 2014, and evaluated the factors related to the device selection (CRT-D or CRT-P) for primary prevention of sudden cardiac death in patients with heart failure by analyzing the Japan Cardiac Device Treatment Registry (JCDTR) database from January 2011 and August 2015 (CRT-D, n=2714; CRT-P, n=555)...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27916592/new-developments-in-cardiac-regeneration
#4
REVIEW
Thi Yen Loan Le, Sujitha Thavapalachandran, Eddy Kizana, James Jh Chong
Numerous pharmacological and device therapies have improved adverse cardiac remodelling and mortality in heart failure. However, none are able to regenerate damaged cardiac tissue. Stem cell based therapies using multipotent (adult) stem cells and pluripotent stem cells are new approaches that could potentially achieve the elusive goal of true cardiac regeneration. Over the past two decades, various stem cell based approaches have been shown to improve left ventricular function in pre-clinical animal models...
November 19, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27910056/cardiac-gene-delivery-using-recirculating-devices
#5
Melissa J Byrne, David M Kaye
Cardiac gene delivery has become an important issue following the emergence of gene therapy for the possible treatment of heart failure. Despite many advances in the management of heart failure (HF), treatment options for many patients with advanced HF remain limited. At a cellular and molecular level, many of the fundamental alterations that contribute to the pathogenesis of HF are becoming better understood and this has resulted in the discovery of new therapeutic targets in animal models of HF, in particular in the area of gene therapy...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27909498/shock-lead-dislodgement-related-to-its-small-hair-pin-curve-in-a-pocket-a-case-of-ratchet-syndrome
#6
Yuka Taguchi, Kohei Matsushita, Toshiyuki Ishikawa, Yutaka Ogino, Hirooki Matsushita, Junya Hosoda, Katsumi Matsumoto, Satoshi Umemura
There have been few reports about ratchet syndrome. We report a case of ratchet syndrome caused by small hair-pin curve of lead that triggered the lead retract itself. A 69-year-old man with a past history of inferior wall myocardial infarction, presented with progressive congestive heart failure. He underwent implantation of cardiac resynchronization therapy with an implantable cardiac defibrillator (CRTD) at our hospital. At 33 days after implantation, shock lead dislodgement was revealed. X-ray showed that the lead tip was in left subclavian vein, leaving its screw out, and a large part of the proximal portion of the lead was retracted into the pocket, while the other two leads remained in appropriate positions and the device had not rotated...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908653/molecular-changes-in-children-with-heart-failure-undergoing-left-ventricular-assist-device-therapy
#7
Elizabeth Medina, Carmen C Sucharov, Penny Nelson, Shelley D Miyamoto, Brian L Stauffer
OBJECTIVE: To determine whether left ventricular assist device (LVAD) treatment in children with heart failure would result in the modification of molecular pathways involved in heart failure pathophysiology. STUDY DESIGN: Forty-seven explanted hearts from children were studied (16 nonfailing control, 20 failing, and 11 failing post-LVAD implantation [F-LVAD]). Protein expression and phosphorylation states were determined by receptor binding assays and Western blots...
November 29, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27906824/selection-of-patients-for-initial-clinical-trials-of-solid-organ-xenotransplantation
#8
David K C Cooper, Martin Wijkstrom, Sundaram Hariharan, Joshua L Chan, Avneesh Singh, Keith Horvath, Muhammad Mohiuddin, Arielle Cimeno, Rolf N Barth, John C LaMattina, Richard N Pierson
Several groups have reported extended survival of genetically-engineered pig organs in nonhuman primates, varying from almost 10 months for life-supporting kidney grafts and >2 years for nonlife-supporting heart grafts to less than 1 month for life-supporting liver and lung grafts. We have attempted to define groups of patients who may not have an option to wait for an allograft. These include kidney, heart, and lung candidates who are highly-allosensitized. In addition, some kidney candidates (who have previously lost at least 2 allografts from rapid recurrence of native kidney disease) have a high risk of further recurrence and will not be offered a repeat allotransplant...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27905492/high-fidelity-computational-simulation-of-thrombus-formation-in-thoratec-heartmate-ii-continuous-flow-ventricular-assist-device
#9
Wei-Tao Wu, Fang Yang, Jingchun Wu, Nadine Aubry, Mehrdad Massoudi, James F Antaki
Continuous flow ventricular assist devices (cfVADs) provide a life-saving therapy for severe heart failure. However, in recent years, the incidence of device-related thrombosis (resulting in stroke, device-exchange surgery or premature death) has been increasing dramatically, which has alarmed both the medical community and the FDA. The objective of this study was to gain improved understanding of the initiation and progression of thrombosis in one of the most commonly used cfVADs, the Thoratec HeartMate II...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27903010/heartmate-ii-left-ventricular-assist-device-pump-exchange-a-single-institution-experience
#10
Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
November 30, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27898502/-full-metal-jacket-treatment-of-multiple-paravalvular-leaks
#11
Giuseppe Santoro, Giancarlo Scognamiglio, Maria T Palladino, Carola Iacono, Giampiero Gaio, Maria G Russo
A 40-year-old man with osteogenesis imperfecta type I submitted to multiple procedures of surgical mitral and aortic valve replacement was referred for refractory congestive heart failure due to significant paravalvular leaks (PVLs) of both mitral and aortic prostheses. Due to perceived very high risk of a further mitroaortic surgery, transcatheter closure of PVLs under three-dimensional echocardiographic guide was performed. Thus, four Amplatzer Vascular Plug type II (St. Jude Medical Corp, St. Paul, Minnesota, USA) devices were implanted into the aortic PVLs, and three Amplatzer Vascular Plug type II devices were used to occlude a huge mitral PVL...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27898337/complications-and-1-year-benefit-of-cardiac-resynchronization-therapy-in-patients-over-75-years-of-age-insights-from-the-german-device-registry
#12
Julia Köbe, Dietrich Andresen, Sebastian Maier, Christoph Stellbrink, Thomas Kleemann, Bernd-Dieter Gonska, Sebastian Reif, Matthias Hochadel, Jochen Senges, Lars Eckardt
OBJECTIVE: Evidence on cardiac resynchronization therapy (CRT) in older patients is scarce and conflicting. Nevertheless, CRT in the elderly is of major practical relevance as heart failure prevalence increases with age. METHODS: The German Device Registry (DEVICE) is a nationwide, prospective registry with a longitudinal follow-up design investigating device implantations in 60 German centres. The present analysis of DEVICE focussed on perioperative complication rates and 1-year outcome of patients ≥75years (n=320) compared to younger patients (n=879) receiving a CRT device...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27886929/cardiac-resynchronization-therapy-follow-up-role-of-remote-monitoring
#13
REVIEW
Cecilia Linde, Frieder Braunschweig
Cardiac resynchronization therapy (CRT) is increasingly used in heart failure treatment and management of these patients imposes significant challenges. Remote monitoring is becoming essential for CRT follow-up and allows close surveillance of device function and patient condition. It is helpful to reduce clinic visits, increase device longevity and provide early detection of device failure. Clinical effects include prevention of appropriate and inappropriate shocks and early detection of arrhythmias, such as atrial fibrillation...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886923/atrioventricular-node-ablation
#14
REVIEW
Maurizio Gasparini
Cardiac resynchronization therapy (CRT) is a device-based, nonpharmacologic approach that has shown to improve the outcome in patients with heart failure in terms of mortality and morbidity reduction. Large randomized trials have virtually enrolled patients in New York Heart Association class III-IV, with reduced left ventricular ejection fraction, with evidence of electrical dyssynchrony, and receiving optimal medical therapy and who were in sinus rhythm. Guidelines remain imprecise as to defining differentiated approaches according to the forms of atrial fibrillation other than permanent...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886920/why-we-have-to-use-cardiac-resynchronization-therapy-pacemaker-more
#15
REVIEW
Jean-Claude Daubert, Raphaël Martins, Christophe Leclercq
Both cardiac resynchronization therapy with a pacemaker (CRT-P) and with a biventricular implantable cardioverter-defibrillator (CRT-D) are electrical treatment modalities validated for the management of chronic heart failure. There is no strong scientific evidence that a CRT-D must be offered to all candidates. Common sense should limit the prescription of these costly and complicated devices. The choice of CRT-P is currently acceptable. A direction to explore could be to downgrade from CRT-D to CRT-P at the time of battery depletion in patients with large reverse remodeling and no ventricular tachycardia and ventricular fibrillation detected...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27884156/targeted-myocardial-gene-expression-in-failing-hearts-by-rna-sequencing
#16
Kajari Dhar, Alexandra M Moulton, Eric Rome, Fang Qiu, Jeff Kittrell, Eugenia Raichlin, Ronald Zolty, John Y Um, Michael J Moulton, Hesham Basma, Daniel R Anderson, James D Eudy, Brian D Lowes
BACKGROUND: Myocardial recovery with left ventricular assist device (LVAD) therapy is highly variable and difficult to predict. Next generation ribonucleic acid (RNA) sequencing is an innovative, rapid, and quantitative approach to gene expression profiling in small amounts of tissue. Our primary goal was to identify baseline transcriptional profiles in non-ischemic cardiomyopathies that predict myocardial recovery in response to LVAD therapy. We also sought to verify transcriptional differences between failing and non-failing human hearts...
November 25, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#17
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27875738/heart-rate-response-to-exercise-in-heart-failure-patients-the-prognostic-role-of-metabolic-chronotropic-relation-and-heart-rate-recovery
#18
Pavel Hajdusek, Martin Kotrc, Josef Kautzner, Vojtech Melenovsky, Eva Benesova, Petr Jarolim, Jan Benes
BACKGROUND: The dynamics of the sinus node response to exercise is linked to functional capacity and outcome in heart failure (HF). The goal of the work was to analyze determinants and impacts of cardio-acceleration, described by the concept of metabolic-chronotropic relation (MCR) and of cardio-deceleration, described by heart rate recovery (HRR). METHODS: A cohort of 25 healthy controls and 78 patients with advanced systolic HF and optimized medical and/or device therapy (97% receiving beta-blockers, 54% ICD) underwent maximal cardiopulmonary exercise test and were prospectively followed...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27871197/left-ventricular-assist-device-induced-reverse-remodeling-it-s-not-just-about-myocardial-recovery
#19
Karolina K Marinescu, Nir Uriel, Douglas L Mann, Daniel Burkhoff
The abnormal structure, function and molecular makeup of dilated cardiomyopathic hearts can be partially normalized in patients supported by a left ventricular assist device (LVAD), a process called reverse remodeling. This leads to recovery of function in many patients, though the rate of full recovery is low and in many cases is temporary, leading to the concept of heart failure remission, rather than recovery. Areas covered: We summarize data indicative of ventricular reverse remodeling, recovery and remission during LVAD support...
November 22, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27869075/-cell-therapies-for-cardiopathies-the-shift-of-paradigms
#20
Jean-Thomas Vilquin, Jessy Etienne
Heart failure is a major concern for public health systems, and several approaches of cellular therapy are being investigated with the goal of improving the function of these failing hearts. Many cell types have been used (skeletal myoblasts, hematopoietic, endothelial or mesenchymal progenitors, cardiac cells…), most often in the indication of post-ischemic heart failure rather than in the indication of genetic dilated cardiomyopathy. It is easier, indeed, to target a restricted area than the whole myocardium...
November 2016: Médecine Sciences: M/S
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