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Refractory heart failure

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https://www.readbyqxmd.com/read/28819361/unilateral-headache-status-after-intra-aortic-balloon-pump-placement
#1
Garret M Weber, Alan L Gass, Shalvi B Parikh
INTRODUCTION: Intra-aortic balloon pump (IABP) counterpulsation is a catheter-based treatment for coronary artery disease and decompensated heart failure to increase coronary blood flow and improve cardiac output. IABP is generally well tolerated, and complications are usually related to peripheral vasculature or red blood cell and platelet consumption. The usual insertion site via femoral artery renders the patient bedbound. Recently, axillary artery has been used in patients with atherosclerotic peripheral vascular disease and documented small arteries or in those awaiting transplant to ensure ambulation and prevent deconditioning...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28816096/management-of-severe-pulmonary-hemorrhage-in-a-neonate-on-veno-arterial-ecmo-by-the-temporary-clamping-of-the-endotracheal-tube-a-case-report
#2
Vaclav Vobruba, Tomas Grus, Frantisek Mlejnsky, Jan Belohlavek, Jan Hridel, Lukas Lambert
Severe pulmonary hemorrhage in the newborn is an infrequent, but life-threatening, event. A newborn with persistent pulmonary hypertension and a large persistent ductus arteriosus and open foramen ovale presented with hypoxemia and progressive right heart failure shortly after birth, requiring veno-arterial extracorporeal membrane oxygenation (ECMO) support. Twenty minutes after the initiation of ECMO, the patient developed severe pulmonary hemorrhage refractory to conventional treatment. As a last resort, the endotracheal tube was clamped...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28805198/severe-reversible-hypocalcemic-cardiomyopathy-diagnosed-36-years-after-subtotal-thyroidectomy-a-case-report
#3
Waldemar Elikowski, Małgorzata Małek-Elikowska, Patrycja Lachowska-Kotowska
Chronic hypocalcemia, irrespectively of its etiology, can lead to severe impairment of the left ventricular (LV) contractility manifesting as dilated cardiomyopathy, usually defined as hypocalcemic cardiomyopathy (hypocaCM). This rarely diagnosed type of heart failure (HF), can be completely reversible, when treated properly with calcium and vitamin D supplementation or, in some subjects, with human recombinant parathormone. A CASE REPORT: The authors present a case of a 60-year-old male admitted with advanced pulmonary congestion, recurrent pulmonary edema and pleural effusion...
July 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28782466/current-status-of-renal-artery-angioplasty-and-stenting-for-resistant-hypertension-a-case-series-and-review-of-the-literature
#4
Antonis S Manolis, Antonis A Manolis, Helen Melita
BACKGROUND: Renal artery stenosis (RAS) has a high prevalence in older patients, especially in the context of general atherosclerosis. It is frequently associated with resistant hypertension and impaired renal function and their attendant consequences. The issue whether revascularization via percutaneous renal angioplasty and stenting (PRA/S) can benefit these patients remains unsettled. OBJECTIVE: To present a case series of patients with refractory hypertension and RAS undergoing PRA/S and also to provide an extensive review of the literature on the current status of PRA/S for resistant hypertension...
August 4, 2017: Current Hypertension Reviews
https://www.readbyqxmd.com/read/28772042/giant-cell-myocarditis-masquerading-as-orbital-myositis-with-a-rapid-fulminant-course-necessitating-mechanical-support-and-heart-transplantation
#5
Vinisha Garg, Weiyi Tan, Reza Ardehali, Janki Shah, Tracy Huynh, Olcay Aksoy
Giant cell myocarditis (GCM), a rapidly progressive inflammation of the myocardium, is associated with fulminant heart failure, refractory ventricular arrhythmias, and conduction system abnormalities. Few case reports have noted orbital myositis as the initial clinical presentation. Our case demonstrates a unique presentation of GCM with only ocular symptoms, which unlike prior studies, rapidly progressed to heart failure, tachyarrhythmias, and conduction disease. Our case necessitated quick recognition and treatment with mechanical support making this the first known case of GCM with successful placement of biventricular assist devices and ultimately with heart transplantation...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28772036/implantation-of-a-left-ventricular-assist-device-to-provide-long-term-support-for-end-stage-duchenne-muscular-dystrophy-associated-cardiomyopathy
#6
Douglas Stoller, Faris Araj, Alpesh Amin, Catherine Fitzsimmons, Robert Morlend, Jennifer T Thibodeau, Claudio Ramaciotti, Mark H Drazner, Dan M Meyer, Pradeep P A Mammen
A young man with Duchenne muscular dystrophy presented to the UT Southwestern Neuromuscular Cardiomyopathy Clinic with advanced heart failure. Despite maximal medical therapy, his cardiac function continued to decline requiring initiation of inotrope therapy. Given the patient's clinical deterioration, a left ventricular assist device (LVAD) was implanted as destination therapy after undergoing a multidisciplinary assessment. The patient tolerated the surgical implantation of the LVAD without any significant complications, and he has had a relatively unremarkable course 38 months post-LVAD implantation...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28767884/case-3-2017-a-47-year-old-female-with-refractory-heart-failure-and-embolic-acute-myocardial-infarction
#7
João Gabriel Batista Lage, Paulo Sampaio Gutierrez
No abstract text is available yet for this article.
July 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28760437/hyponatremia-in-refractory-congestive-heart-failure-patients-treated-with-icodextrin-based-peritoneal-dialysis-a-case-series
#8
Margarita Kunin, Liat Ganon, Eli J Holtzman, Dganit Dinour
Severe congestive heart failure (CHF) patients are prone to hyponatremia. Peritoneal dialysis (PD) is increasingly used for long-term management of refractory CHF patients. The glucose polymer icodextrin was proposed to be a good option for fluid removal in such patients. A small, although statistically significant reduction in serum sodium (∼2mmol/l) consistently observed in multiple trials, is considered as not clinically relevant. Here we reported five refractory CHF patients who demonstrated sodium drop by median of 8meq/l (range 5...
July 28, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28729965/fluid-overload-as-a-major-target-in-management-of-cardiorenal-syndrome-implications-for-the-practice-of-peritoneal-dialysis
#9
REVIEW
Amir Kazory
Congestion is an integral component of cardiorenal syndrome and portends an adverse impact on the outcomes. Recent studies suggest that congestion has the ability of modulating the interactions between the kidney and the heart in this setting. Peritoneal dialysis (PD) is a home-based therapeutic modality that is not only offered to patients with end-stage renal disease to provide solute clearance and ultrafiltration, but it has also been used in patients with refractory heart failure and fluid overload to help optimize volume status...
July 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28707396/role-of-abnormal-repolarization-in-the-mechanism-of-cardiac-arrhythmia
#10
O E Osadchii
In cardiac patients, life-threatening tachyarrhythmia is often precipitated by abnormal changes in ventricular repolarization and refractoriness. Repolarization abnormalities typically evolve as a consequence of impaired function of outward K(+) currents in cardiac myocytes, which may be caused by genetic defects or result from various acquired pathophysiological conditions, including electrical remodelling in cardiac disease, ion channel modulation by clinically used pharmacological agents, and systemic electrolyte disorders seen in heart failure, such as hypokalaemia...
July 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28689765/unanswered-questions-in-contemporary-heart-failure
#11
Lauren G Gilstrap, David Snipelisky, Omar AbouEzzeddine, Justin Vader, Lauren Cooper, Jacob Kelley, Antonio Perez, Kenneth Varian, Anuradha Lala, Monica Shah, Lynne W Stevenson
Background The epidemiology of heart failure (HF) is changing. This study aims to describe questions that arise during the routine care of heart failure (HF) patients that are unanswered by the current literature and describe how the type and focus of these questions has changed over time. Methods Investigators from the NHLBI-sponsored Heart Failure Apprentice Network collected and categorized questions from 5 academic hospitals over 12 months. A total of 174 unanswered questions were collected and analyzed...
July 6, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28688177/renal-vein-dilation-predicts-the-poor-outcome-in-patients-with-refractory-cirrhotic-ascites
#12
Naoki Matsumoto, Masahiro Ogawa, Mariko Kumagawa, Yukinobu Watanabe, Midori Hirayama, Takao Miura, Hiroshi Nakagawara, Shunichi Matsuoka, Mitsuhiko Moriyama, Hirotoshi Fujikawa
BACKGROUND & AIMS: Renal venous hypertension is known to be associated with worsening of renal function in patients with decompensated heart failure. Intra-abdominal hypertension including cirrhotic ascites also leads to renal venous hypertension. We aimed to clarify the effect of renal venous hypertension on cirrhotic ascites. METHODS: Two hepatologists measured the left renal vein diameter in 142 consecutive patients with refractory cirrhotic ascites using non-contrast computed tomography...
July 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28687248/device-therapy-for-rate-control-pacing-resynchronisation-and-av-node-ablation
#13
REVIEW
Dennis H Lau, Anand Thiyagarajah, Stephan Willems, Thomas Rostock, Dominik Linz, Martin K Stiles, David Kaye, Jonathan M Kalman, Prashanthan Sanders
Atrioventricular node ablation (AVNA) is generally reserved for patients whose atrial fibrillation (AF) is refractory all other therapeutic options, since the recipients will often become pacemaker dependent. In such patients, this approach may prove particularly useful, especially if a tachycardia-induced cardiomyopathy is suspected. Historically, an "ablate and pace" approach has involved AVNA and right ventricular pacing, with or without an atrial lead. There is also an evolving role for atrioventricular node ablation in patients with AF who require cardiac resynchronization therapy for treatment of systolic heart failure...
May 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28682031/-the-peritoneal-ultrafiltration-in-patients-with-cardio-renal-disease
#14
Roberto Corciulo, Simone Corciulo
In Italy, the congestive heart failure is the leading cause of hospitalization and despite advances in therapy, the long-term prognosis is poor. Congestive heart failure is associated with advanced varying degrees of chronic renal disease that identify the cardio-renal syndrome type 2. High-dose diuretic therapy often fail to solve the water overload that is frequently the cause of death. The resistance to diuretics aggravates the state of the patient's edema and consequently morbidity and mortality. In the acute stage, the extracorporeal ultrafiltration unable to repair over hydration but needs frequent access weekly or midweek at the dialysis center...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28678701/a-planning-and-guidance-platform-for-cardiac-resynchronization-therapy
#15
Peter Mountney, Jonathan M Behar, Daniel Toth, Maria Panayiotou, Sabrina Reiml, Marie-Pierre Jolly, Rashed Karim, Li Zhang, Alexander Brost, Christopher A Rinaldi, Kawal Rhode
Patients with drug-refractory heart failure can greatly benefit from cardiac resynchronization therapy (CRT). A CRT device can resynchronize the contractions of the left ventricle (LV) leading to reduced mortality. Unfortunately 30- 50% of patients do not respond to treatment when assessed by objective criteria such as cardiac remodeling. A significant contributing factor is suboptimal placement of the LV lead. It has been shown that placing this lead away from scar and at the point of latest mechanical activation can improve response rates...
June 27, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28674854/icodextrin-and-peritoneal-dialysis-advantages-and-new-applications
#16
REVIEW
Periklis Dousdampanis, Carlos Guido Musso, Konstantina Trigka
The impact of icodextrin (ico) on peritoneal dialysis (PD) extension and patient survival is well established. Predominantly, ico-based solutions were prescribed in high-transporter PD patients. Advantages of the ico-based solutions include increased biocompatibility, avoidance of glucotoxicity, enhanced ultrafiltration failure (UF), sodium removal rates, better metabolic and blood pressure control. Bimodal solutions and twice daily exchanges of ico-based solutions are two newly introduced strategies to avoid glucose exposure and/or enhance UF in PD patients with UF failure...
July 3, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28673782/percutaneous-closure-of-periprosthetic-paravalvular-leaks-a-viable-alternative-to-surgery
#17
Ana Isabel Azevedo, Pedro Braga, Alberto Rodrigues, Lino Santos, Bruno Melica, José Ribeiro, Francisco Sampaio, Ricardo Fontes-Carvalho, Marlene Fonseca, Adelaide Dias, Vasco Gama Ribeiro
INTRODUCTION AND OBJECTIVES: Paravalvular leak (PVL) is a possible complication after prosthetic valve implantation. PVL can cause significant symptoms of congestive heart failure and/or hemolysis. Medical therapy is palliative and reoperation has a high mortality rate. Percutaneous transcatheter closure is a promising alternative for symptomatic patients at high surgical risk. We aim to review the efficacy and safety of percutaneous PVL closure in a consecutive series of patients referred to our center...
July 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28666618/troubleshooting-cardiac-resynchronization-therapy-in-nonresponders
#18
Sumandeep Dhesi, Evan Lockwood, Roopinder K Sandhu
Heart failure (HF) is a critical health issue. Despite the advancements in pharmacotherapy, HF-related morbidity and mortality remains high. Cardiac resynchronization therapy (CRT) has been revolutionary in medically refractory, symptomatic HF patients with reduced ejection fraction and a prolonged, abnormal QRS complex. Although CRT affects electromechanical dys-synchrony resulting in favourable ventricular remodelling, improved functional capacity and clinical outcomes with fewer HF hospitalizations and better survival, the response to CRT is not uniform...
April 23, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28664446/postnatal-outcomes-of-fetal-supraventricular-tachycardia-a-multicenter-study
#19
Kevin A Hinkle, Shabnam Peyvandi, Corey Stiver, Stacy A S Killen, Hsin Yi Weng, Susan P Etheridge, Michael D Puchalski
Supraventricular tachycardia (SVT), the most common fetal tachycardia, can be difficult to manage in utero. We sought to better understand predictors of the postnatal clinical course in neonates who experienced fetal SVT. We hypothesized that fetuses with hydrops or those with refractory SVT (failure of first-line SVT therapy) are more likely to experience postnatal SVT. This was a retrospective multicenter cohort study of subjects diagnosed with fetal SVT between 2006 and 2014. Fetuses with structural heart disease were excluded...
June 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28663764/transvenous-versus-open-chest-lead-placement-for-resynchronization-therapy-in-patients-with-heart-failure-comparison-of-ventricular-electromechanical-synchronicity
#20
Hai-Bo Zhang, Xu Meng, Jie Han, Yan Li, Ye Zhang, Teng-Yong Jiang, Ying-Xin Zhao, Yu-Jie Zhou
BACKGROUND: Transvenous lead placement is the standard approach for left ventricular (LV) pacing in cardiac resynchronization therapy (CRT), while the open chest access epicardial lead placement is currently the most frequently used second choice. Our study aimed to compare the ventricular electromechanical synchronicity in patients with heart failure after CRT with these two different LV pacing techniques. METHODS: We enrolled 33 consecutive patients with refractory heart failure secondly to dilated cardiomyopathy who were eligible for CRT in this study...
April 2017: Journal of Geriatric Cardiology: JGC
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