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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
#1
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...
November 24, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#2
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...
February 15, 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
#3
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...
February 10, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#11
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
January 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28087105/left-ventricular-assist-device-outcomes-based-on-flow-configuration-and-pre-operative-left-ventricular-dimension-an-interagency-registry-for-mechanically-assisted-circulatory-support-analysis
#12
Palak Shah, Sarah Birk, Simon Maltais, John Stulak, Angelo Elmi, Francis D Pagani, Jennifer A Cowger
BACKGROUND: Axial configuration (AC) and centrifugal configuration (CC) left ventricular assist devices (LVAD) have different flow characteristics, and whether the interaction between device flow configuration and the pre-operative left ventricular internal diastolic diameter (LVIDD) mediates adverse events after LVAD implantation is unknown. METHODS: We queried 9,424 continuous-flow LVAD recipients who received LVADs from April 2008 to June of 2015 in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
December 16, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28076895/implantation-of-left-ventricular-assist-device-in-a-patient-with-left-ventricular-non-compaction
#13
Keki R Balsara, Andrew Bierhals, Justin Vader, Michael K Pasque, Aki Itoh
Left ventricular noncompaction (LVNC) may result in systolic left ventricular (LV) failure resulting in the need for heart transplantation. LV assist devices (LVAD) have been used to bridge these patients to transplantation; however, the extensive trabeculations found in these patients predispose them to thromboembolic events and pump thrombosis. We describe a patient with LVNC in whom an aggressive surgical approach was used to debride the LV cavity of trabeculations to successfully implant an LVAD.
January 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#14
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28058856/effective-treatment-with-a-new-protocol-using-tissue-type-plasminogen-activator-thrombolysis-for-pump-thrombosis-with-the-hvad-device
#15
Benedikt Schrage, Hanno Grahn, Florian M Wagner, Alexander Bernhardt, Meike Rybczynski, Stefan Blankenberg, Hermann Reichenspurner, Markus J Barten
BACKGROUND: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis. METHODS: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28054898/pump-thrombosis-following-heartmate-ii-left-ventricular-assist-device-implantation-in-a-patient-with-aspirin-and-plavix-resistance
#16
Ali Ghodsizad, A Badiye, M Zeriouh, W Pae, M M Koerner, M Loebe
Despite advances in pump technology, thromboembolic events and pump thrombosis are potentially life-threatening complications in patients with continuous flow ventricular assist devices. Here we describe a patient with pump thrombosis following LVAD HeartMate II implantation presenting with Aspirin and Plavix resistance and signs of acute hemolysis as manifested by high LDH, changing pump power, pulse index and reduced pump flows.
14, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28033200/lvad-outflow-graft-angle-and-thrombosis-risk
#17
Alberto Aliseda, Venkat Keshav Chivukula, Patrick Mcgah, Anthony R Prisco, Jennifer A Beckman, Guilherme J M Garcia, Nahush A Mokadam, Claudius Mahr
This study quantifies thrombogenic potential (TP) of a wide range of left ventricular assist device (LVAD) outflow graft anastomosis angles through state-of-the-art techniques: 3D imaged-based patient-specific models created via virtual surgery and unsteady computational fluid dynamics with Lagrangian particle tracking. This study aims at clarifying the influence of a single parameter (outflow graft angle) on the thrombogenesis associated with flow patterns in the aortic root after LVAD implantation. This is an important and poorly-understood aspect of LVAD therapy, because several studies have shown strong inter and intrapatient thrombogenic variability and current LVAD implantation strategies do not incorporate outflow graft angle optimization...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28009715/impact-of-lvad-implantation-site-on-ventricular-blood-stagnation
#18
Anthony R Prisco, Alberto Aliseda, Jennifer A Beckman, Nahush A Mokadam, Claudius Mahr, Guilherme J M Garcia
Treatment of end-stage heart failure includes cardiac transplantation or ventricular assist device (VAD) therapy. While increasingly prevalent, current VAD therapy has inherent complications, including thrombosis. Studies have demonstrated that VAD implantation alters intra-cardiac blood flow, creating areas of stagnation that predispose to thrombus formation. Two potential surgical configurations exist for VAD implantation: through the apical or diaphragmatic surfaces of the heart. We hypothesized that diaphragmatic implantation causes more stagnation than apical implantation...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28009712/rehospitalization-patterns-in-pediatric-outpatients-with-continuous-flow-vads
#19
Seth A Hollander, Sharon Chen, Jenna M Murray, Aileen Lin, Elizabeth McBrearty, Christopher S Almond, David N Rosenthal
As continuous flow ventricular assist devices (CF-VADs) are used increasingly in children and adolescents, more pediatric patients will be supported as outpatients. Herein we report the patterns of rehospitalization after CF-VAD implantation at a single center. We retrospectively reviewed the medical records of 19 consecutive patients who received CF-VADS between 6/12/2010 and 5/11/2016 and were discharged on device therapy. The frequency, duration, and indications for all hospitalizations between the time of implant hospitalization discharge and 8/01/2016 were analyzed...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28009711/surgical-technique-for-ventricular-device-exchange-from-heartmate-ii-to-hvad
#20
Michele Gallo, Jaimin R Trivedi, Michael A Sobieski, Todd H Massey, Allen Cheng, Mark S Slaughter
Implantable continuous-flow left ventricular assist devices (VAD) have improved the survival of end-stage heart failure patients. Recent studies have shown an increased occurrence of device replacement in the axial-flow pumps particularly for thrombosis. In some patients, to try and avoid recurrent pump thrombosis, it might be advantageous to switch from the axial flow LVAD to a newer generation centrifugal flow LVAD. Technically, this requires some adaption of the LVAD inflow and outflow connections. We describe our technique and outcomes in patients that underwent the conversion from an axial flow LVAD to a centrifugal flow LVAD...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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