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https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#1
Remigiusz Antończyk, Ewa Trejnowska, Jerzy Pacholewicz, Tomasz Wolny, Paweł Nadziakiewicz, Karolina Antończyk, Izabela Copik, Magdalena Piontek, Małgorzata Jasińska, Krzysztof Filipiak, Maciej Głowacki, Maciej Gawlikowski, Marcin Borowicz, Roman Kustosz, Jacek Waszak, Piotr Przybyłowski, Marian Zembala, Michał Zakliczyński, Michał Oskar Zembala
Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28508806/telemonitoring-and-medical-care-of-heart-failure-patients-supported-by-left-ventricular-assist-devices-the-medolution-project
#2
Nils Reiss, Thomas Schmidt, Frerk Müller-von Aschwege, Wolfgang Thronicke, Jan-Dirk Hoffmann, Jenny Inge Röbesaat, Ezin Deniz, Andreas Hein, Heiko Krumm, Franz-Josef Stewing, Detlev Willemsen, Jan Dieter Schmitto, Christina Feldmann
Long-term survival after left ventricular assist device (LVAD) implantation in heart failure patients is mainly determined by a sophisticated after-care. Ambulatory visits only take place every 12 weeks. In case of life-threatening complications (pump thrombosis, driveline infection) this might lead to delayed diagnosis and delayed intervention. It is the intention of the international project Medolution (Medical care evolution) to develop new approaches in order to create best structures for telemonitoring of LVAD patients...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28430913/prediction-of-adverse-events-after-catheter-based-procedures-in-adolescents-and-adults-with-congenital-heart-disease-in-the-impact-registry
#3
Ada C Stefanescu Schmidt, Aimee Armstrong, Kevin F Kennedy, David Nykanen, Jamil Aboulhosn, Ami B Bhatt
Aims: We sought to identify factors associated with major adverse events (MAE) after cardiac catheterization in adolescents and adults with congenital heart disease (CHD), and create the first model to individualize risk discussions in this growing population. Methods and results: Improving Pediatric and Adult Congenital Treatment (IMPACT), a National Cardiovascular Data Registry, contains congenital catheterization data from over 87 hospitals in the United States...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28396088/erythrocyte-aging-as-a-mechanism-of-anemia-and-a-biomarker-of-device-thrombosis-in-continuous-flow-left-ventricular-assist-devices
#4
Ziad Taimeh, Ryan J Koene, Julie Furne, Ashish Singal, Peter M Eckman, Michael D Levitt, Marc R Pritzker
BACKGROUND: Blood trauma caused by continuous-flow left ventricular assist devices (CF-LVADs) has been associated with device thrombosis and anemia. Accurate in vivo quantification of erythrocyte turnover and its contribution to CF-LVAD complications have yet to be elucidated. METHODS: We investigated the age (lifespan) of circulating erythrocytes in subjects with CF-LVAD. Erythrocyte lifespan is a quantitative indicator of in vivo erythrocyte turnover that can be accurately derived from measurement of the exhaled carbon monoxide (CO) level...
February 9, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28376837/heartmate-3-fully-magnetically-levitated-left-ventricular-assist-device-for-the-treatment-of-advanced-heart-failure-1%C3%A2-year-results-from-the-ce-mark-trial
#5
Thomas Krabatsch, Ivan Netuka, Jan D Schmitto, Daniel Zimpfer, Jens Garbade, Vivek Rao, Michiel Morshuis, Friedhelm Beyersdorf, Silvana Marasco, Laura Damme, Yuriy Pya
BACKGROUND: The HeartMate 3 Left Ventricular Assist System (LVAS) (St. Jude Medical Inc., St Paul, MN) with full magnetic levitation allows for wide and consistent blood flow paths and an artificial pulse designed for enhanced hemocompatibility. The HeartMate 3 received market approval in the European Union in 2015 following completion of a multicenter study. After reaching the 6-month study endpoint, patients continue to be followed for 2 years with the 1-year results presented herein...
April 4, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28357450/an-alternative-strategy-for-bridge-to-transplant-recovery-in-small-children-with-dilated-cardiomyopathy
#6
REVIEW
Gilles Mets, Joseph Panzer, Daniël De Wolf, Thierry Bové
Dilated cardiomyopathy in children still has a poor prognosis with high rates of mortality and cardiac transplantation (resp. around 20 and 25%). Awaiting transplantation or possible recovery, these pediatric patients are mechanically supported with extracorporeal membrane oxygenation or a paracorporeal ventricular assist device, both resulting in higher survival rates but also entailing considerable risks of infection, thrombosis, or bleeding. A new indication for an old technique, i.e., pulmonary artery banding, presents itself as an interesting alternative to mechanical circulatory support in selected infants and small children with dilated LV cardiomyopathy and preserved RV function...
March 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28329060/first-series-of-left-ventricular-assist-device-exchanges-to-heartmate-3
#7
Jasmin S Hanke, Sebastian V Rojas, Günes Dogan, Christina Feldmann, Erik Beckmann, Ezin Deniz, Bettina Wiegmann, Jana-Elena Michaelis, L Christian Napp, Dominik Berliner, Malakh Shrestha, Johann Bauersachs, Axel Haverich, Jan D Schmitto
OBJECTIVES: Left ventricular assist device (LVAD) exchange is becoming a standard surgical procedure. The exchange procedure is an opportunity to upgrade patients to a new generation pump that offers advanced reduction of adverse events or longer battery hours. METHODS: We performed an analysis of 6 consecutive patients who underwent LVAD exchange to HeartMate 3 either from a HeartWare or HeartMate (HM) II device. Minimally invasive operations were performed through a lateral thoracotomy...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28268010/first-experiences-with-heartmate-3-follow-up-and-adverse-events
#8
Jasmin S Hanke, Günes Dogan, Sebastian V Rojas, Amelie Zoch, Christina Feldmann, Ezin Deniz, Murat Avsar, Gregor Warnecke, Axel Haverich, Jan D Schmitto
BACKGROUND: The novel HeartMate 3 (HM3) left ventricular assist device (LVAD) received its CE mark in October 2015. It is a new compact LVAD featuring fully magnetically levitated pump, artificial pulse, large pump gaps, and a modular driveline. Here, we present outcomes and adverse events of a single-center cohort 6 months after HM3 implantation. METHODS: We retrospectively studied a patient cohort of 27 patients who were supported with the HM3 at a single institution...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28266662/clinical-correlates-of-b-type-natriuretic-peptide-monitoring-in-outpatients-with-left-ventricular-assist-device
#9
Marketa Hegarova, Milos Kubanek, Ivan Netuka, Jiri Maly, Zora Dorazilova, Tomas Gazdic, Janka Franekova, Vera Lanska, Vojtech Melenovsky, Josef Kautzner, Ivan Malek
BACKGROUND: B-type natriuretic peptide (BNP) is a strong predictor of prognosis in chronic heart failure. We aimed to evaluate the clinical correlates and interpretation of BNP monitoring in LVAD out-patient recipients. METHODS: We performed a prospective study in 136 individuals after HeartMate II LVAD implantation. During follow-up they were divided into group A (severe adverse events requiring hospitalisation), group B (mild to moderate adverse events) and group C (an uneventful course)...
February 27, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28265218/minimally-invasive-lvad-deactivation-in-a-65-year-old-man-with-recurrent-pump-thrombosis-and-left-ventricular-recovery
#10
Akshay Pendyal, Christopher V Chien, James O Mudd, Jill M Gelow
Pump thrombosis is a dire sequela after left ventricular assist device (LVAD) implantation. Treatment comprises antiplatelet agents, anticoagulants, thrombolytic agents, and pump exchange. Although pump exchange is the definitive therapy, it is also the most invasive, often exposing patients to the risks of repeat sternotomy and cardiopulmonary bypass. In some cases, patients experience left ventricular recovery after LVAD implantation. The optimal strategy surrounding the management of LVADs in patients who have experienced ventricular recovery is unknown; techniques range from total system explantation to partial pump resection...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28216204/left-ventricular-assist-device-thrombosis-is-associated-with-an-increase-in-the-systolic-to-diastolic-velocity-ratio-measured-at-the-inflow-and-outflow-cannulae
#11
Ankit Jain, Ben Rohrer, Brian Gebhardt, Janis L Breeze, Joshua D Quick, Gregory Couper, Michael S Kiernan, Matthew Lawrence, Frederick C Cobey
OBJECTIVE: To determine whether the ratio of peak systolic-to-nadir diastolic velocity (S/D ratio) measured using Doppler at the left ventricular assist device (LVAD) inflow and outflow cannulae is associated with pump thrombosis and to determine whether there is an absolute decrease in the diastolic cannula velocities in LVAD thrombosis. DESIGN: Retrospective chart review. SETTING: University hospital. PARTICIPANTS: Patients who underwent LVAD exchange...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#12
Rohan J Kalathiya, Jonathan Grinstein, Nir Uriel, Atman P Shah
Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28184979/association-between-hematologic-and-inflammatory-markers-and-31-thrombotic-and-hemorrhagic-events-in-berlin-heart-excor-patients
#13
Amit Iyengar, Matthew L Hung, Kian Asanad, Oh Jin Kwon, Nicholas J Jackson, Brian L Reemtsen, Myke D Federman, Reshma M Biniwale
Bleeding and thrombotic events remain a significant cause of morbidity in pediatric patients supported with ventricular assist devices (VADs). The objective of this study is to identify the association between markers of anticoagulation and bleeding and thrombosis events during Berlin Heart ExCor support. A retrospective, single-center analysis of 9 patients supported with the Berlin Heart ExCor was performed. Inflammatory and anticoagulation parameters including C-reactive protein, fibrinogen, partial thromboplastin time (PTT), and platelet count were measured at 48 and 24 h before and after bleeding or thrombosis events...
April 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28163887/central-venous-access-related-adverse-events-after-trabectedin-infusions-in-soft-tissue-sarcoma-patients-experience-and-management-in-a-nationwide-multi-center-study
#14
Michiel C Verboom, Jan Ouwerkerk, Neeltje Steeghs, Jacob Lutjeboer, J Martijn Kerst, Winette T A van der Graaf, Anna K L Reyners, Stefan Sleijfer, Hans Gelderblom
BACKGROUND: Trabectedin has shown efficacy against soft tissue sarcomas (STS) and has manageable toxicity. Trabectedin is administered through central venous access devices (VAD), such as subcutaneous ports with tunneled catheters, Hickman catheters and PICC lines. Venous access related adverse events are common, but have not yet been reported in detail. METHODS: A retrospective analysis of patient files of STS patients receiving trabectedin monotherapy between 1999 and 2014 was performed in all five STS referral centers in the Netherlands...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28138529/epidermal-mechano-acoustic-sensing-electronics-for-cardiovascular-diagnostics-and-human-machine-interfaces
#15
Yuhao Liu, James J S Norton, Raza Qazi, Zhanan Zou, Kaitlyn R Ammann, Hank Liu, Lingqing Yan, Phat L Tran, Kyung-In Jang, Jung Woo Lee, Douglas Zhang, Kristopher A Kilian, Sung Hee Jung, Timothy Bretl, Jianliang Xiao, Marvin J Slepian, Yonggang Huang, Jae-Woong Jeong, John A Rogers
Physiological mechano-acoustic signals, often with frequencies and intensities that are beyond those associated with the audible range, provide information of great clinical utility. Stethoscopes and digital accelerometers in conventional packages can capture some relevant data, but neither is suitable for use in a continuous, wearable mode, and both have shortcomings associated with mechanical transduction of signals through the skin. We report a soft, conformal class of device configured specifically for mechano-acoustic recording from the skin, capable of being used on nearly any part of the body, in forms that maximize detectable signals and allow for multimodal operation, such as electrophysiological recording...
November 2016: Science Advances
https://www.readbyqxmd.com/read/28134659/assessment-of-bleeding-and-thrombosis-based-on-aspirin-responsiveness-after-continuous-flow-left-ventricular-assist-device-placement
#16
Catherine K Floroff, Krista L Rieger, Tara M Veasey, Sara E Strout, Walter F DeNino, Holly B Meadows, Martha R Stroud, John M Toole, Dawn P Heyward, Meredith A Brisco, Jennifer L Cook, John Lazarchick, Walter E Uber
Pump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding following LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial non-responders who were then titrated upward to achieve therapeutic response.Patients ≥ 18 years of age with initial placement of HeartMate II® (HMII) LVAD at our institution and at least one VerifyNow® Aspirin test performed during initial hospitalization were included...
January 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28118265/intermittent-aortic-valve-opening-and-risk-of-thrombosis-in-vad-patients
#17
Claudius Mahr, Venkat Keshav Chivukula, Patrick McGah, Anthony R Prisco, Jennifer A Beckman, Nahush A Mokadam, Alberto Aliseda
This study evaluates quantitatively the impact that intermittent Aortic Valve opening has on the thrombogenicity in the aortic arch region for patients under Left Ventricular Assist Device therapy. The influence of flow through the Aortic Valve, opening once every five cardiac cycles, on the flow patterns in the ascending aortic is measured in a patient-derived CT-image-based model, after LVAD implantation. The mechanical environment of flowing platelets is investigated, by statistical treatment of outliers in Lagrangian particle tracking, and thrombogenesis metrics (platelet residence times and activation state characterized by shear stress accumulation) are compared for the cases of no Aortic Valve opening and intermittent Aortic Valve opening...
January 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28118262/permanent-atrial-fibrillation-and-2-year-clinical-outcomes-in-patients-with-a-left-ventricular-assist-device-implant
#18
Cenk Oezpeker, Armin Zittermann, Thomas Pühler, Stephan Ensminger, Jan F Gummert, Michiel Morshuis
Atrial fibrillation (AF) may increase the risk of thromboembolic complications in patients with left ventricular assist devices (LVADs). In a single-center study we investigated 205 patients with sinus rhythm (SR group) and 117 patients with AF (AF group). Our main read outs were 2-year overall survival (primary endpoint), perioperative right heart failure and 2-year freedom from stroke, pump thrombosis, and gastrointestinal bleeding (secondary endpoints). Oral anticoagulation was performed with phenprocomoun (INR target range: 2...
January 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28110971/risk-factors-mortality-and-timing-of-ischemic-and-hemorrhagic-stroke-with-left-ventricular-assist-devices
#19
Jennifer A Frontera, Randall Starling, Sung-Min Cho, Amy S Nowacki, Ken Uchino, M Shazam Hussain, Maria Mountis, Nader Moazami
BACKGROUND: Stroke is a major cause of mortality after left ventricular assist device (LVAD) placement. METHODS: Prospectively collected data of patients with HeartMate II (n = 332) and HeartWare (n = 70) LVADs from October 21, 2004, to May 19, 2015, were reviewed. Predictors of early (during index hospitalization) and late (post-discharge) ischemic and hemorrhagic stroke and association of stroke subtypes with mortality were assessed. RESULTS: Of 402 patients, 83 strokes occurred in 69 patients (17%; 0...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28106960/a-novel-technique-to-exclude-the-left-ventricle-with-an-assist-device
#20
Stefan Klotz, Roza MeyerSaraei, Alex Frydrychowicz, Michael Scharfschwerdt, Andreas Koertge, Leon Putman, Hans Sievers
Left ventricular assist device implantation disrupts the natural intracavitary blood flow path through the heart, introducing flow patterns potentially associated with thrombosis, especially around the inflow cannula. We describe a novel technique for completely excluding the left ventricle with an assist device by using a cone shaped ring-reinforced prosthesis.
December 9, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
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