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Refractory heart failure

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https://www.readbyqxmd.com/read/29327638/hybrid-and-surgical-procedures-for-the-treatment-of-persistent-and-longstanding-persistent-atrial-fibrillation
#1
Jose M Sanchez, Ghannam Al-Dosari, Sherman Chu, Ramin Beygui, Tobias Deuse, Nitish Badhwar, Randall J Lee
Atrial fibrillation (AF) is the most common cardiac arrhythmia. The incidence of AF increases with age and is associated with increased stroke, heart failure and mortality. Persistent and long standing persistent AF is difficult to treat and often refractory to medical therapy and catheter ablation. Areas covered: This article reviews the historical development of the surgical Cox-MAZE procedure and current hybrid and minimally invasive surgical approaches for the treatment of persistent and long standing persistent AF...
January 12, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29303795/nonejecting-hearts-on-femoral-veno-arterial-extracorporeal-membrane-oxygenation-aortic-root-blood-stasis-and-thrombus-formation-a-case-series-and-review-of-the-literature
#2
Hanane Hireche-Chikaoui, Martin R Grübler, Andreas Bloch, Stephan Windecker, Stefan Bloechlinger, Lukas Hunziker
OBJECTIVES: Cardiogenic shock constitutes the final common pathway of cardiac dysfunction associated with tissue hypoperfusion and organ failure. Besides treatment of the underlying cause, temporary mechanical circulatory support serves as a supportive measure. Extracorporeal membrane oxygenation can effectively prevent hypoxemia and end-organ dysfunction, but knowledge about patient selection, risks, and complications remains sparse. DATA SOURCES: Clinical observation...
January 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29281011/extracorporeal-membrane-oxygenation-for-cardiogenic-shock-due-to-alcoholic-cardiomyopathy-a-long-term-follow-up-of-4-cases
#3
Dorothee Valance, Bruno Bouchet, Caroline Brulliard, Benjamin Delmas, Berenice Puech, Eric Braunberger, Nicolas Allou, Jerome Allyn
Even though alcoholism is a major health concern, alcoholic cardiomyopathy is a little-known pathology. The exact prevalence remains elusive (20-40% of dilated cardiomyopathy). However, it can lead to dilated cardiomyopathy, heart failure and refractory cardiogenic shock. The literature on cardiogenic shock in alcoholic cardiomyopathy is limited. We report 4 cases of patients with refractory cardiogenic shock due to heavy alcohol consumption, who were treated with venoarterial extracorporeal membrane oxygenation...
December 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29275886/the-extent-of-left-atrial-low-voltage-areas-included-in-pulmonary-vein-isolation-is-associated-with-freedom-from-recurrent-atrial-arrhythmia
#4
Dong Huang, Jing-Bo Li, Tarek Zghaib, Esra Gucuk Ipek, Muhammad Balouch, David D Spragg, Hiroshi Ashikaga, Harikrishna Tandri, Sunil K Sinha, Joseph E Marine, Ronald D Berger, Hugh Calkins, Saman Nazarian
BACKGROUND: The extent of left atrial (LA) baseline low-voltage areas (LVA-B), which may be a surrogate for fibrosis, is associated with recurrent atrial fibrillation (AF) after ablation. This study aimed to assess the relationship between the extent of LVA-B isolated by ablation (LVA-I) and AF recurrence. METHODS: The study cohort included 159 consecutive patients with drug-refractory AF who underwent an initial AF ablation with LA voltage mapping during sinus rhythm...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29274911/selective-implantation-of-durable-left-ventricular-assist-devices-as-primary-therapy-for-refractory-cardiogenic-shock
#5
Amit Pawale, Yosef Schwartz, Shinobu Itagaki, Sean Pinney, David H Adams, Anelechi C Anyanwu
OBJECTIVE: Surgical therapy for refractory primary cardiogenic shock is largely based on emergent placement of extracorporeal membrane oxygenation or short-term ventricular assist devices. We have adopted a strategy of routine implantation of durable left ventricular assist devices (LVAD) as initial therapy for refractory cardiogenic shock, in patients who are potential candidates for heart transplantation, and report our experience. METHODS: Retrospective review of 43 consecutive patients with refractory shock caused by acute myocardial infarction (n = 21) or acute decompensated heart failure (n = 22) who were treated with primary implantation of a durable LVAD in a single institution...
November 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29258620/refractory-ventricular-fibrillations-after-surgical-repair-of-atrial-septal-defects-in-a-patient-with-cacna1c-gene-mutation-case-report
#6
Ai Kojima, Fumiaki Shikata, Toru Okamura, Takashi Higaki, Seiko Ohno, Minoru Horie, Shunji Uchita, Yujiro Kawanishi, Kenji Namiguchi, Takumi Yasugi, Hironori Izutani
BACKGROUND: Congenital long QT syndrome (LQTS) can cause ventricular arrhythmic events with syncope and sudden death resulting from malignant torsades de pointes (TdP) followed by ventricular fibrillations (VFs). However, the syndrome is often overlooked prior to the development of arrhythmic events in patients with congenital heart diseases demonstrating right bundle branch block on electrocardiogram (ECG). We present a case of an adult patient with congenital heart disease who developed VFs postoperatively, potentially due to his mutation in a LQTS related gene, which was not identified on preoperative assessment due to incomplete evaluation of his family history...
December 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29233028/therapeutic-effects-of-oral-liothyronine-on-aluminum-phosphide-poisoning-as-an-adjuvant-therapy-a-clinical-trial
#7
M H Goharbari, F Taghaddosinejad, M Arefi, M Sharifzadeh, M Mojtahedzadeh, S Nikfar, M Baeeri, M Rahimifard, M Abdollahi
BACKGROUND: In aluminum phosphide (AlP) poisoning, death is mainly due to cardiovascular failure and refractory acute heart failure. There is a lot of evidence showing thyroid hormones have cardioprotective effects. OBJECTIVE: The purpose of this study was to evaluate the effect of oral liothyronine in the treatment of AlP poisoning. METHODS: Twenty-four patients from intensive care unit of Baharloo Hospital, Tehran, Iran, were included based on the inclusion and exclusion criteria...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/29189425/remodeling-failing-human-myocardium-with-hybrid-cell-matrix-and-transmyocardial-revascularization
#8
Ryan J Avery, Soojie K Yu, Gopi Cherukuri, Ray B Runyan, John Konhilas, Zain I Khalpey
Given the limited treatment options for advanced heart failure, the intrinsic regenerative properties of stem cells have been evaluated for myocardial remodeling. Previous stem cells techniques for myocardiocyte remodeling have been limited by the low cellular retention. Presented is a hybrid approach for remodeling infarcted myocardium through implantation of allogeneic human amniotic fluid-derived mesenchymal stem cells within micronized human allograft-derived liquid matrix during the performance of transmyocardial revascularization (TMR)...
November 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29174125/refractory-heart-failure-after-failed-subcutaneous-implantable-cardioverter-defibrillator-d-testing-the-potential-value-of-early-mechanical-circulatory-support
#9
Connor McNamara, Emile G Daoud, Leonid Gorelik, Angela Sipes, Jaret D Tyler, Michael Essandoh
No abstract text is available yet for this article.
May 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29168622/mitral-valve-pressure-gradient-after-percutaneous-mitral-valve-repair-every-beat-counts
#10
Daniel Lavall, Bruno Scheller, Christian Werner, Axel Buob, Felix Mahfoud
A patient presented with symptoms of decompensated heart failure 2 months after percutaneous mitral valve (MV) repair. Echocardiography demonstrated impaired left ventricular function with elevated MV pressure gradients and pulmonary pressures during rapid atrial fibrillation. Heart rate control was achieved by implantation of a biventricular pacemaker with subsequent His-bundle ablation because atrial fibrillation was refractory to medical treatment. During biventricular pacing at different rates (50-110 b...
November 23, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29162781/successful-withdrawal-from-dobutamine-by-canagliflozin-in-a-diabetic-patient-with-stage-d-heart-failure
#11
Masaki Nakagaito, Shuji Joho, Ryuichi Ushijima, Makiko Nakamura, Tadakazu Hirai, Koichiro Kinugawa
Patients with stage D heart failure (HF) frequently become dependent on high doses of diuretics and inotropic agents. Recently, a sodium-glucose cotransporter 2 inhibitor (SGLT2i), an oral antidiabetic agent, has been demonstrated to have favorable effects in preventing HF. However, it remains unknown whether SGLT2i is reliable for patients with decompensated HF. We experienced a case of a patient with stage D HF for whom attempting intravenous dobutamine withdrawal was difficult even after the administration of all conventional pharmacological treatment...
November 22, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29151508/cardiac-sarcoidosis-presenting-as-acute-progressive-heart-failure-with-abdominal-lymphadenopathy
#12
Satoshi Oka, Ken Umetani, Tomoko Harama, Takuya Shimizu, Aritaka Makino, Keita Sano, Masahiko Nakamura
A 77-year-old Japanese woman presented with asymptomatic abdominal lymphadenopathy. Soluble interleukin-2 receptor (sIL2R) and angiotensin-converting enzyme (ACE) levels were elevated, and a pathological examination of lymph-node biopsies revealed non-caseating granulomas, which was consistent with sarcoidosis. Fluorodeoxyglucose-positron emission tomography did not show a clear accumulation in the mediastinal lymph-nodes or heart. Five months later, she presented with acute progressive heart failure that was refractory to conventional treatment...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29141964/acute-decompensated-pulmonary-hypertension
#13
Laurent Savale, Jason Weatherald, Xavier Jaïs, Constance Vuillard, Athénaïs Boucly, Mitja Jevnikar, David Montani, Olaf Mercier, Gerald Simonneau, Elie Fadel, Olivier Sitbon, Marc Humbert
Acute right heart failure in chronic precapillary pulmonary hypertension is characterised by a rapidly progressive syndrome with systemic congestion resulting from impaired right ventricular filling and/or reduced right ventricular flow output. This clinical picture results from an imbalance between the afterload imposed on the right ventricle and its adaptation capacity. Acute decompensated pulmonary hypertension is associated with a very poor prognosis in the short term. Despite its major impact on survival, its optimal management remains very challenging for specialised centres, without specific recommendations...
December 31, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/29124028/inter-facility-transport-on-extracorporeal-life-support-clinical-outcomes-and-comparative-analysis-with-in-house-patients
#14
Tae Hee Hong, Heemoon Lee, Jae Jun Jung, Yang Hyun Cho, Kiick Sung, Ji-Hyuk Yang, Young-Tak Lee, Su Hyun Cho
Background: Extracorporeal life support (ECLS) is widely used in refractory heart or lung failure, and the demand for inter-facility transportation on ECLS is expanding. However, little is known about post-transportation outcomes, the clinical safety of such transportation, or the characteristics of the transported patients. Methods: This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transport, as well as a comparative analysis of clinical outcomes with those of in-house patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29113751/cardiomyopathy-induced-by-incessant-ventricular-tachycardia-originating-in-the-vicinity-of-the-his-bundle
#15
Sana Ouali, Manel Ben Halima, Selim Boudiche, Anissa Gharbi, Khedher Nadim, Kaouthar Hakim, Fatma Ouarda, Mohamed Sami Mourali
A 04-year-old boy was referred to our institution with severe, progressive heart failure of 4-months duration associated with a persistent wide QRS tachycardia with left bundle branch block and severe left ventricular dysfunction. Because of incessant wide QRS tachycardia refractory to antiarrhythmic drugs, he was referred for electrophysiological study. The ECG was suggestive of VT arising from the right ventricle near the His area. Electrophysiological study revealed that origin of tachycardia was septum of the right ventricle, near His bundle, however the procedure was not successful and an inadvertent complete atrioventricular conduction block occurred...
November 4, 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#16
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29111210/interaction-of-adverse-disease-related-pathways-in-hypertrophic-cardiomyopathy
#17
Ethan J Rowin, Martin S Maron, Raymond H Chan, Anais Hausvater, Wendy Wang, Hassan Rastegar, Barry J Maron
Hypertrophic cardiomyopathy (HC) has been characterized as a generally progressive genetic heart disease, creating an ominous perspective for patients and managing cardiologists. We explored the HC disease burden and interaction of adverse clinical pathways to clarify patient expectations over long time periods in the contemporary therapeutic era. We studied 1,000 consecutive HC patients (52 ± 17 years) at Tufts Medical Center, followed 9.3 ± 8 years from diagnosis, employing a novel disease pathway model: 46% experienced a benign course free of adverse pathways, but 42% of patients progressed along 1 major pathway, most commonly refractory heart failure to New York Heart Association class III or IV requiring surgical myectomy (or alcohol ablation) or heart transplant; repetitive or permanent atrial fibrillation; and least commonly arrhythmic sudden death events...
September 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29103620/an-unusual-cause-of-heart-failure-in-a-young-man
#18
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Arun Gopalakrishnan, Sreevilasam Pushpangadhan Abhilash, Ajitkumar Valaparambil
A 21year old gentleman was admitted with shortness of breath and heart failure. He was noted to have incessant supraventricular tachycardia which was refractory to pharmacological and electrical cardioversion. Electrophysiology study revealed focal atrial tachycardia from an unusual location which was successfully ablated.
October 5, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29103567/-difficulty-in-diagnosis-of-a-cardiogenic-shock-with-thrombotic-and-sub-occluded-lad-a-train-can-hide-another-one
#19
R Cheaito, A Tritar, H Benamer, M Saighi Bouaouina, A Masri, M A Bouzid, M Younes, H Mansour, P Jessen
The pheochromocytome is a localized tumor at the level of the medullosurrenale in 85% of the cases. The clinical presentation is very variable. Severe Heart failure presentation can be the mode of revelation in 2% of the cases. We present the case of a patient admitted for refractory cardiogenic shock correlated to pheochromocytome tumor. The difficulty of this rare clinical presentation was to confirm rapidly and in emergency this diagnosis in the same time when the patient presents a persistante and severe cardiogenic chock after finding a sub-occluded and thrombotic LAD coronary artery and which was treated by thrombectomy and coronary revascularization...
November 2, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29098712/flap-coverage-for-the-treatment-of-exposed-left-ventricular-assist-device-lvad-hardware-and-intractable-lvad-infections
#20
Adam Jacoby, John T Stranix, Oriana Cohen, Eddie Louie, Leora B Balsam, Jamie P Levine
BACKGROUND: Left ventricular assist devices (LVADs) have become useful adjuncts in the treatment of patients with end-stage heart failure. LVAD implantation is associated with a unique set of problems; one such problem is device infection. We report our experience with flap salvage of infected and/or exposed LVAD hardware. METHODS: Between 2011 and 2016, 49 patients underwent LVAD implantation at our institution. Patients were then categorized by infectious status: systemic infection not directly involving the LVAD device, hardware infection responsive to antibiotics, and exposure of LVAD hardware or device infection refractory to antibiotics requiring debridement and flap coverage...
November 3, 2017: Journal of Cardiac Surgery
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