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https://www.readbyqxmd.com/read/29049666/bivalirudin-anticoagulation-for-left-ventricular-assist-device-implantation-on-an-extracorporeal-life-support-system-in-patients-with-heparin-induced-thrombocytopenia-antibodies
#1
Edis Ljajikj, Armin Zittermann, Michiel Morshuis, Jochen Börgermann, Maria Ruiz-Cano, Michael Schoenbrodt, Jan Gummert, Andreas Koster
OBJECTIVES: Heparin-induced thrombocytopenia (HIT) requires alternative anticoagulation strategies. We investigated outcomes in patients with HIT antibodies undergoing low-dose bivalirudin anticoagulation during left ventricular assist device implantation on an extracorporeal life support system (ECLS) and compared the results with non-HIT patients treated with heparin and receiving left ventricular assist device implantation with ECLS support. METHODS: The institutional ventricular assist device database was searched for the period from March 2012 to March 2016...
July 28, 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
#2
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/29037445/effect-of-age-and-renal-function-on-survival-after-left-ventricular-assist-device-implantation
#3
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Yunus E Yasar, Kavita Sharma, Nisha A Gilotra, Isabella Kardys, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Olivier C Manintveld, Stuart D Russell
Left ventricular assist devices (LVAD) are increasingly used, especially as destination therapy in in older patients. The aim of this study was to evaluate the effect of age on renal function and mortality in the first year after implantation. A retrospective multicenter cohort study was conducted, evaluating all LVAD patients implanted in the 2 participating centers (age ≥18 years). Patients were stratified according to the age groups <45, 45-54, 55-64, and ≥65 years old. Overall, 241 patients were included (mean age 52...
September 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28975053/extracorporeal-life-support-with-left-ventricular-decompression-improved-survival-in-severe-cardiogenic-shock-results-from-a-retrospective-study
#4
Bastian Schmack, Philipp Seppelt, Alexander Weymann, Christina Alt, Mina Farag, Rawa Arif, Andreas O Doesch, Philip W Raake, Klaus Kallenbach, Ashham Mansur, Aron-Frederik Popov, Matthias Karck, Arjang Ruhparwar
OBJECTIVE: Extracorporeal life support (ECLS) is a life-saving procedure used in the treatment of severe cardiogenic shock. Within this retrospective single centre study, we examined our experience in this critically ill patient cohort to assess outcomes and clinical parameters by comparison of ECLS with or without selective left ventricular decompression. METHODS: Between 2004 and 2014 we evaluated 48 adult patients with INTERMACS level 1 heart failure (age 49...
2017: PeerJ
https://www.readbyqxmd.com/read/28970073/outcomes-of-restrictive-and-hypertrophic-cardiomyopathies-after-lvad-an-intermacs-analysis
#5
Snehal R Patel, Omar Saeed, David Naftel, Susan Myers, James Kirklin, Ulrich P Jorde, Daniel J Goldstein
BACKGROUND: Patients with restrictive (RCM) and hypertrophic (HCM) cardiomyopathies are felt to be a difficult population to treat with LVAD therapy. Scarce data exist on outcomes of continuous flow (CF) LVAD support in these challenging patient cohorts. METHODS: The INTERMACS Registry was queried for all patients with RCM (n=94) and HCM (n=104) who underwent CFLVAD implantation between March 2008 and March 2014. Survival, adverse event (AE) rates, baseline demographics, echo parameters, and competing outcomes were compared to patients with dilated (DCM) cardiomyopathy (n=8749)...
September 29, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28965736/second-annual-pediatric-interagency-registry-for-mechanical-circulatory-support-pedimacs-report-pre-implant-characteristics-and-outcomes
#6
Elizabeth D Blume, Christina VanderPluym, Angela Lorts, J Timothy Baldwin, Joseph W Rossano, David L S Morales, Ryan S Cantor, Marissa A Miller, James D St Louis, Devin Koehl, David L Sutcliffe, Pirooz Eghtesady, James K Kirklin, David N Rosenthal
BACKGROUND: Expanded use of pediatric ventricular assist devices (VADs) has decreased mortality in children awaiting heart transplantation. Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), a National Heart, Lung, and Blood Institute-sponsored North American database, provides a platform to understand this emerging population. METHODS: Between September 2012 and September 2016, patients aged younger than 19 years who underwent VAD implantation were enrolled in Pedimacs...
July 4, 2017: Journal of Heart and Lung Transplantation
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
#7
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/28958345/intermacs-analysis-of-stroke-during-support-with-continuous-flow-left%C3%A2-ventricular-assist-devices-risk-factors-and-outcomes
#8
Deepak Acharya, Renzo Loyaga-Rendon, Charity J Morgan, Kara A Sands, Salpy V Pamboukian, Indranee Rajapreyar, William L Holman, James K Kirklin, José A Tallaj
OBJECTIVES: This study sought to evaluate predictors of stroke during left ventricular assist device (LVAD) support from data available prior to implantation, and quantify stroke-related morbidity and mortality. BACKGROUND: Stroke is a major complication after LVAD. Pre-implant factors that influence stroke are not well understood. METHODS: We evaluated all patients in INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) who were implanted with continuous flow LVADs from May 1, 2012, to March 31, 2015...
October 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28952014/defining-ambulatory-advanced-heart-failure-medamacs-and-beyond
#9
REVIEW
Garrick C Stewart, Amrut V Ambardekar, Michelle M Kittleson
PURPOSE OF REVIEW: Extended survival with LVADs has generated interest in implantation for ambulatory patients with advanced heart failure (HF) prior to dependence on inotropes, though we remain limited in our ability to define and advance indications in this less sick advanced HF population. RECENT FINDINGS: The MedaMACS and ROADMAP studies have informed prognosis and decision-making for ambulatory patients with advanced HF. Sicker INTERMACS profiles are consistently associated with high risk of death or rescue LVAD...
September 26, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28948385/delayed-sternal-closure-does-not-reduce-complications-associated-with-coagulopathy-and-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#10
Roh Yanagida, Navin Rajagopalan, Daniel L Davenport, Thomas A Tribble, Mark A Bradley, Charles W Hoopes
Delayed sternal closure (DSC) is occasionally adopted after implantation of left ventricular assist device (LVAD). Recent studies suggest that DSC be used for high risk group of patients with coagulopathy, hemodynamic instability or right ventricular failure. However, whether DSC is efficacious for bleeding complication or right ventricular failure is not known. This study is single center analysis of 52 patients, who underwent LVAD implantation. Of those 52 patients, 40 consecutive patients underwent DSC routinely...
September 25, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28942783/japanese-registry-for-mechanically-assisted-circulatory-support-first-report
#11
Takeshi Nakatani, Kazuhiro Sase, Hiroaki Oshiyama, Masatoshi Akiyama, Masao Horie, Kan Nawata, Tomohiro Nishinaka, Yoshihisa Tanoue, Koichi Toda, Masao Tozawa, Shunichi Yamazaki, Masanobu Yanase, Hiroshi Ohtsu, Michiko Ishida, Ayaka Hiramatsu, Kensuke Ishii, Soichiro Kitamura
BACKGROUND: In Japan, ventricular assist devices (VADs) have been used for patients with severe heart failure as a bridge to transplantation (BTT) since 1992. However, it was not until 1997, when the Organ Transplant Law was enacted, that medical devices received approval by the national health insurance system for that use. To encourage research and development of innovative medical devices, the Pharmaceuticals and Medical Devices Agency has established a public-private partnership in collaboration with academic societies, hospitals and manufacturers...
October 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28942782/eighth-annual-intermacs-report-special-focus-on-framing-the-impact-of-adverse-events
#12
James K Kirklin, Francis D Pagani, Robert L Kormos, Lynne W Stevenson, Elizabeth D Blume, Susan L Myers, Marissa A Miller, J Timothy Baldwin, James B Young, David C Naftel
BACKGROUND: The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database now includes >20,000 patients from >180 hospitals. METHODS: The eighth annual report of INTERMACS updates the first decade of patient enrollment. RESULTS: In the current era, >95% of implants are continuous flow devices. Overall survival continues to remain >80% at 1 year and 70% at 2 years. Review of major adverse events shows minimal advantage for patients with ambulatory heart failure pre-implant...
October 2017: Journal of Heart and Lung Transplantation
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
#13
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/28888521/impact-of-center-left-ventricular-assist%C3%A2-device-volume-on-outcomes%C3%A2-after%C3%A2-implantation-an-intermacs-analysis
#14
Jennifer A Cowger, John M Stulak, Palak Shah, Todd F Dardas, Francis D Pagani, Shannon M Dunlay, Simon Maltais, Keith D Aaronson, Ramesh Singh, Nahush A Mokadam, James K Kirklin, Christopher T Salerno
OBJECTIVES: This study examined patient outcomes after left ventricular assist device (LVAD) implantation across a range of center surgical volumes. BACKGROUND: In order for a center to qualify for reimbursement, Centers for Medicare and Medicaid Services (CMS) requires it to implant ≥10 LVADs or total artificial hearts over a 3-year period. The impact of center LVAD surgical volumes on patient outcomes has not been thoroughly scrutinized. METHODS: Center volumes were provided for 7,416 patients undergoing LVAD implantation who were enrolled in INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support)...
October 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28841580/durable-biventricular-support-using-right-atrial-placement-of-the-heartware-hvad
#15
Hao A Tran, Travis L Pollema, Jorge Silva Enciso, Barry H Greenberg, Denise D Barnard, Eric D Adler, Victor G Pretorius
Patients with Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1-2 who either have or are at risk for right ventricular failure face significant morbidity and mortality after continuous flow left ventricular assist device (CF-LVAD) implantation. Currently, the options for biventricular support are limited the Total Artificial Heart (TAH; CardioWest, Syncardia, Tuscon, AZ) or biventricular assist device (BiVAD), which uses bulky extracorporeal or implantable displacement pumps...
August 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28781147/durable-mechanical-circulatory-support-in-teenagers-and-adults-with-congenital-heart-disease-a-systematic-review
#16
Jill M Steiner, Eric V Krieger, Karen K Stout, April Stempien-Otero, Claudius Mahr, Nahush A Mokadam, Joshua L Hermsen
BACKGROUND: Heart failure is the leading cause of morbidity and mortality for adults with congenital heart disease (ACHD). Many patients are ineligible for transplantation, and those who are eligible often face long wait times with high wait-list morbidity. Durable mechanical circulatory support (MCS) may be an option for many patients. This systematic review evaluates the published literature on the use of durable MCS in teenagers and adults with congenital heart disease. METHODS: A comprehensive search of MEDLINE (PubMed), EMBASE, and the Cochrane Library was performed electronically in July 2015 and updated in March 2016, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28777392/long-term-follow-up-of-continuous-flow-left-ventricular-assist-devices-complications-and-predisposing-risk-factors
#17
Tolulope A Adesiyun, Rhondalyn C McLean, Ryan J Tedford, Glenn J R Whitman, Chris M Sciortino, John V Conte, Ashish S Shah, Stuart D Russell
PURPOSE: To assess LVAD complications and their overall effect on mortality and determine factors associated with development of early and long-term complications. METHODS: A retrospective cohort study of patients who underwent continuous flow LVAD placement between January 1, 2000 and November 30, 2013 was performed. The incidence of complications (sepsis or bacteremia, driveline infections, gastrointestinal bleeding, pump thrombosis, cerebrovascular accidents and anemia requiring transfusion) was collected and logistic regression and Cox proportional hazards analyses were performed...
August 2, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28757150/temporal-differences-in-outcomes-during-long-term-mechanical-circulatory-support
#18
Simon Maltais, Lucman A Anwer, Nicholas A Haglund, Jennifer Cowger, Palak Shah, Keith D Aaronson, Francis D Pagani, Shannon M Dunlay, Ramesh Singh, Christopher T Salerno, John M Stulak
BACKGROUND: Device indications have changed for placement of continuous-flow left ventricular assist devices (CF-LVADs). We performed a multicenter analysis evaluating temporal variations in outcomes after CF-LVAD implantation. METHODS & RESULTS: We retrospectively defined three time intervals to reflect changes in CF-LVAD technology (Period 1: 2004 to 2009; Period 2: 2010 to 2012; and Period 3: 2012 to 2014). A total of 1,064 patients (HeartMate II (HMII)=835, HeartWare (HVAD)=229) underwent CF-LVAD implantation between May 2004 and October 2014...
July 27, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28754423/gender-differences-and-outcomes-in-left-ventricular-assist-device-support-the-european-registry-for-patients-with-mechanical-circulatory-support
#19
Christina Magnussen, Alexander M Bernhardt, Francisco M Ojeda, Florian M Wagner, Jan Gummert, Theo M M H de By, Thomas Krabatsch, Paul Mohacsi, Meike Rybczynski, Dorit Knappe, Bjoern Sill, Tobias Deuse, Stefan Blankenberg, Renate B Schnabel, Hermann Reichenspurner
BACKGROUND: Despite the increasing use of ventricular assist devices (VADs), gender differences in indications, hemodynamics, and outcome are not well understood. We examined gender differences and gender-specific predictors for perioperative outcome in patients on ventricular support. METHODS: Multicenter data of 966 patients (median age 55 years, 151 women) from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) were analyzed. Median follow-up was 1...
July 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28662987/changes-in-disease-specific-versus-generic-health-status-measures-after-left-ventricular-assist-device-implantation-insights-from-intermacs
#20
Michael E Nassif, John A Spertus, Philip G Jones, Timothy J Fendler, Larry A Allen, Kathleen L Grady, Suzanne V Arnold
BACKGROUND: Quantifying quality of life (QoL) after left ventricular assist device (LVAD) remains challenging. Heart failure (HF)-specific health status measures are ideal for assessing symptoms of HF; however, if patients' QoL is limited by other factors, they may experience improved HF-specific QoL but no concurrent improvement in generic QoL. We sought to examine and predict discrepancies between disease-specific and generic QoL measures after LVAD. METHODS: We examined HF-specific and generic QoL with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol-5D Visual Analog Scale (VAS), respectively, among 1,888 patients with advanced heart failure who underwent LVAD implantation from 2012 to 2014 as part of the INTERMACS registry...
May 20, 2017: Journal of Heart and Lung Transplantation
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