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Colleen K McIlvennan, JoAnn Lindenfeld, David P Kao
BACKGROUND: Mechanical circulatory support (MCS) is a widely available management strategy. No studies have described sex differences in both extracorporeal and durable MCS. We analyzed sex-related differences of in-hospital outcomes for extracorporeal and durable MCS using administrative hospital data. METHODS: In total, 134.5 million hospital records between 1994 and 2012 were screened for placement of MCS using procedure codes of the International Classification of Diseases-9, Clinical Modification...
August 20, 2016: Journal of Heart and Lung Transplantation
David M Turer, Kelly L Koch, Todd M Koelling, Audrey H Wu, Francis D Pagani, Jonathan W Haft
Centrifugal and axial flow left ventricular assist devices have different hydrodynamic properties that may impact the effectiveness of left ventricular unloading. We sought to determine if patients implanted with the HeartWare HVAD (HW) and HeartMate II (HMII) had a similar degree of hemodynamic support by comparing parameters measured using echocardiography and right heart catheterization. Using our prospectively collected database, we identified 268 patients implanted with the HMII and 93 with the HW. Demographic characteristics were similar between groups...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Omar Wever-Pinzon, Stavros G Drakos, Stephen H McKellar, Benjamin D Horne, William T Caine, Abdallah G Kfoury, Dean Y Li, James C Fang, Josef Stehlik, Craig H Selzman
BACKGROUND: The number of centers with left ventricular assist device (LVAD) research programs focused on cardiac recovery is very small. Therefore, this phenomenon has been reported in real-world multi-center registries as a rare event. OBJECTIVES: This study evaluated the incidence of cardiac recovery with an a priori LVAD implantation strategy of bridge-to-recovery (BTR) and constructed a recovery predictive model. METHODS: The study included LVAD recipients registered in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
October 4, 2016: Journal of the American College of Cardiology
Richard Cheng, Danny Ramzy, Babak Azarbal, Francisco A Arabia, Fardad Esmailian, Lawrence S Czer, Jon A Kobashigawa, Jaime D Moriguchi
For Interagency Registry for Mechanically Assisted Circulatory Support profiles 1 and 2 cardiogenic shock patients initially placed on extracorporeal membrane oxygenation (ECMO), whether crossover to more durable devices is associated with increased survival, and its optimal timing, are not established. Profiles 1 and 2 patients placed on mechanical support were prospectively registered. Survival and successful hospital discharge were compared between patients placed on ECMO only, ECMO with early crossover, and ECMO with delayed crossover...
September 23, 2016: Artificial Organs
Xin Li, Iago Sousa-Casasnovas, Carolina Devesa, Miriam Juárez, Francisco Fernández-Avilés, Manuel Martínez-Sellés
BACKGROUND: Cardiogenic shock (CS) has a poor prognosis. The heterogeneity in the mortality through different subgroups suggests that some factors can be useful to perform risk stratification and guide management. We aimed to find predictors of in-hospital mortality in these patients. METHODS: We analyzed all cases of cardiogenic shock due to medical conditions admitted in our intensive acute cardiovascular care unity from November 2010 till November 2015. Clinical, biochemical and hemodynamic variables were registered, as was the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile at 24h of CS diagnosis...
September 12, 2016: International Journal of Cardiology
Luigi Adamo, Yuanyuan Tang, Michael E Nassif, Eric Novak, Philip G Jones, Shane LaRue, John A Spertus, Douglas L Mann
OBJECTIVES: This study sought to assess the performance of the HeartMate Risk Score (HMRS) in a large multicenter cohort, with a focus on its performance as a function of disease severity. BACKGROUND: The HMRS has been proposed as a simple tool for risk stratification of LVAD recipients, but subsequent studies have challenged its validity. METHODS: We performed a retrospective, longitudinal, comparative study using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database...
August 28, 2016: JACC. Heart Failure
Sangjin Lee, Jason N Katz, Ulrich P Jorde, Nader Moazami, Ranjit John, Kartik S Sundareswaran, David J Farrar, O H Frazier
There is insufficient data on patients with small body size to determine if this should be considered a risk factor for continuous-flow left ventricular assist device (CF-LVAD) support. We sought to evaluate survival outcomes, adverse events, and functional status of CF-LVAD patients with body surface area (BSA)<1.5 m in a large national registry. Adults with BSA<1.5 m (n=128) implanted with a HeartMate II (HMII)-LVAD from the INTERMACs registry from April 2008 to December 2012 formed this cohort. Outcomes were compared to HMII Bridge to Transplant (BTT) and Destination Therapy (DT) Post-Approval Studies...
August 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Suzanne V Arnold, Philip G Jones, Larry A Allen, David J Cohen, Timothy J Fendler, Jonathan E Holtz, Sanjeev Aggarwal, John A Spertus
BACKGROUND: A left ventricular assist device (LVAD) improves survival and quality of life for many, but not all, patients with end-stage heart failure who are ineligible for transplantation. We sought to evaluate the frequency of poor outcomes using a novel composite measure that integrates quality of life with mortality. METHODS AND RESULTS: Within the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) national registry, poor outcome was defined as death or an average Kansas City Cardiomyopathy Questionnaire <45 during the year after LVAD (persistently limiting heart failure symptoms and poor quality of life)...
August 2016: Circulation. Heart Failure
P Nadziakiewicz, J Pacholewicz, M Zakliczynski, T Niklewski, J Borkowski, T Hrapkowicz, M Zembala
BACKGROUND: Mechanical circulatory support is increasingly used in patients with heart failure as a bridge to transplant or recovery. Results of use the Polish POLVAD MEV pulsatile circulatory support system and its comparison with novel devices never was done. We compared the course of patients with left ventricular circulatory support (left ventricular assist device [LVAD]) supported by POLVAD MEV or continuous flow devices Heart Mate II (HM II) and Heart Ware (HW) in single-center cohort...
June 2016: Transplantation Proceedings
Ivan Netuka, Tomáš Kvasnička, Jan Kvasnička, Ingrid Hrachovinová, Peter Ivák, František Mareček, Jana Bílková, Ivana Malíková, Michaela Jančová, Jiří Malý, Poornima Sood, Kartik S Sundareswaran, Jean M Connors, Mandeep R Mehra
BACKGROUND: Contemporary continuous-flow left ventricular assist devices (CF-LVADs) are associated with degradation of von Willebrand factor (vWF) high-molecular-weight multimers (HMWMs), a critical factor supporting platelet function. We hypothesized that the HeartMate 3 fully magnetically levitated LVAD, designed to reduce circulatory shear stress, favorably influences these hemostatic parameters. METHODS: Fifteen consecutive HeartMate 3 LVAD patients were compared with 11 consecutive HeartMate II controls...
July 2016: Journal of Heart and Lung Transplantation
Veli K Topkara, A Reshad Garan, Barry Fine, Amandine F Godier-Furnémont, Alexander Breskin, Barbara Cagliostro, Melana Yuzefpolskaya, Koji Takeda, Hiroo Takayama, Donna M Mancini, Yoshifumi Naka, Paolo C Colombo
BACKGROUND: Time course and predictors of myocardial recovery on contemporary left ventricular assist device support are poorly defined because of limited number of recovery patients at any implanting center. This study sought to investigate myocardial recovery using multicenter data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). METHODS AND RESULTS: Thirteen thousand four hundred fifty-four adult patients were studied. Device explant rates for myocardial recovery were 0...
July 2016: Circulation. Heart Failure
Minoru Ono, Yoshiki Sawa, Takeshi Nakatani, Ryuji Tominaga, Yoshiro Matsui, Kenji Yamazaki, Yoshikatsu Saiki, Hiroshi Niinami, Goro Matsumiya, Hirokuni Arai
BACKGROUND: The HeartMate II (HMII) continuous-flow LVAD was approved for Japanese health insurance coverage in April 2013 as a bridge to transplantation (BTT). We report on post-approval Japanese multicenter outcomes, and a comparison between patients with low and high body surface area (BSA). METHODS AND RESULTS: HMII LVAD was implanted in 104 consecutive patients at 15 Japanese centers between April 2013 and July 2014. Perioperative data were submitted to the Japanese Registry for Mechanically Assisted Circulatory Support...
August 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Teruhiko Imamura, Koichiro Kinugawa
Optimal timing of ventricular assist device (VAD) therapy has been discussed mainly among patients with heart failure dependent on inotrope infusion, but little is known about the indication of VAD therapy among less sick ambulatory patients. Considering recent improvement of VAD therapy outcome, now is the best time to discuss the expansion of VAD indication into less sick population. In this review, we will investigate optimal candidates for VAD therapy especially among ambulatory populations on the basis of recent evidence...
June 27, 2016: Annals of Thoracic and Cardiovascular Surgery
Natasha A Loghmanpour, Robert L Kormos, Manreet K Kanwar, Jeffrey J Teuteberg, Srinivas Murali, James F Antaki
OBJECTIVES: This study investigates the use of a Bayesian statistical model to address the limited predictive capacity of existing risk scores derived from multivariate analyses. This is based on the hypothesis that it is necessary to consider the interrelationships and conditional probabilities among independent variables to achieve sufficient statistical accuracy. BACKGROUND: Right ventricular failure (RVF) continues to be a major adverse event following left ventricular assist device (LVAD) implantation...
September 2016: JACC. Heart Failure
Michael F Swartz, Ron Angona, Karen Smith, Franca Kraenzlin, Christine M Stypula, Devang Joshi, Vakhtang Tchantchaleishvili, George L Hicks, H Todd Massey
Bi-ventricular (Bi-V) mechanical circulatory support is commonly used as a bridge to cardiac transplant. However, the optimal strategy is unknown. We examined the outcomes, as well as the costs in the use of Bi-V support as a bridge to cardiac transplant. From 2001 to 2014, three different Bi-V support strategies were utilized: 1) Para-corporeal ventricular assist device (PVAD-2001-2006), 2) Heartmate II left ventricular assist device in conjunction with a temporary CentriMag right ventricular assist device (HMII + CMAG-2006-2012), and the total artificial heart (TAH-2012-2014)...
September 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Josephine Chou, Christian Bermudez, Robert Kormos, Jeffrey Teuteberg
Cardiogenic shock complicating acute myocardial infarctions (CS-AMI) carries high mortality rates. Early use of durable continuous flow left ventricular assist devices (CF-LVAD) in these patients has traditionally been discouraged. Therefore we sought to assess the efficacy and complications of CF-LVAD use in CS-AMI after stabilization with temporary mechanical support. From January 2006 to November 2014, 9 patients underwent CF-LVAD implant after CS-AMI (Heartmate II, six; HVAD, three). All patients required temporary mechanical circulatory support prior to CF-LVAD implant and were INTERMACS profile 1; average time from MI to CF-LVAD implant was 20 days...
June 1, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
David N Rosenthal, Christopher S Almond, Robert D Jaquiss, Christine E Peyton, Scott R Auerbach, David R Morales, Deirdre J Epstein, Ryan S Cantor, Robert L Kormos, David C Naftel, Ryan J Butts, Nancy S Ghanayem, James K Kirklin, Elizabeth D Blume
BACKGROUND: Ventricular assist devices (VADs) have been used in children on an increasing basis in recent years. One-year survival rates are now >80% in multiple reports. In this report we describe adverse events experienced by children with durable ventricular assist devices, using a national-level registry (PediMACS, a component of INTERMACS) METHODS: PediMACS is a national registry that contains clinical data on patients who are <19 years of age at the time of VAD implantation...
May 2016: Journal of Heart and Lung Transplantation
Yu Xia, David Stern, Patricia Friedmann, Daniel Goldstein
BACKGROUND: Atrial fibrillation (AF) is a well-established risk factor for thromboembolic (TE) complications. AF is frequently found in patients with advanced heart failure, including patients undergoing left ventricular assist device (LVAD) implantation. However, reports on whether preoperative AF increases the risk of TE events after LVAD implantation are scarce and limited to single-center or 2-center studies. We sought to evaluate the association of preoperative AF with TE events and patient survival using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
July 2016: Journal of Heart and Lung Transplantation
Keyur B Shah, Kristin L Thanavaro, Daniel G Tang, Mohammed A Quader, Anit K Mankad, Inna Tchoukina, Leroy R Thacker, Melissa C Smallfield, Gundars Katlaps, Michael L Hess, Richard H Cooke, Vigneshwar Kasirajan
BACKGROUND: Insufficient data delineate outcomes for Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 patients with the total artificial heart (TAH). METHODS: We studied sixty-six consecutive patients implanted with the TAH at our institution from 2006-2012, and compared outcome by INTERMACS profile. INTERMACS profiles were adjudicated retrospectively by a reviewer blinded to clinical outcomes. RESULTS: Survival after TAH implantation at 6 and 12 months was 76% and 71%, respectively...
April 27, 2016: Journal of Cardiac Failure
Keith D Aaronson, Scott C Silvestry, Simon Maltais, Hari R Mallidi, O H Frazier, Steven W Boyce, Katrin Leadley, Kevin B Najarian, Mark S Slaughter, Francis D Pagani
Advanced heart failure patients who are classified as bridge to transplant (BTT) often remain on mechanical circulatory support (MCS) for long durations because of the limited supply of donor organs. Here, we present the outcomes of patients who have been supported by the HeartWare ventricular assist device system for more than 2 years. In the HeartWare BTT and continued access protocol trial, 74 of the 382 total patients (19.4%) had more than 2 years of MCS with a mean time of 1,045 days on device. The long-term group was more frequently female, was nonwhite, and had Interagency Registry for Mechanically Assisted Circulatory Support profiles 4-7...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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