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Lvad , ventricular assist device

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https://www.readbyqxmd.com/read/28806755/acquired-von-willebrand-syndrome-in-cardiogenic-shock-patients-on-mechanical-circulatory-microaxial-pump-support
#1
Ulrike Flierl, Jörn Tongers, Dominik Berliner, Jan-Thorben Sieweke, Florian Zauner, Christoph Wingert, Christian Riehle, Johann Bauersachs, Andreas Schäfer
Early use of mechanical circulatory support, e.g. veno-arterial extracorporeal membrane oxygenation (ECMO) or left ventricular unloading by microaxial pump in refractory cardiogenic shock is recommended in current guidelines. Development of acquired von Willebrand Syndrome (AVWS) in patients with left ventricular assist devices (LVADs) and ECMO has been reported. There is an increasing number of patients treated with the Impella® CP microaxial pump for left ventricular unloading. However, the prevalence of AVWS in these high risk patients is unknown and needs to be determined...
2017: PloS One
https://www.readbyqxmd.com/read/28804754/use-of-the-full-thickness-resection-device-ftrd-to-prevent-bleeding-after-colonic-polypectomy-in-a-patient-with-a-left-ventricular-assist-device
#2
Richard F Knoop, Hans-Juergen Richer-Schrag, Robert Thimme, Andreas Fischer
Background and study aims  Treatment of colorectal polyps in patients undergoing permanent anticoagulation is associated with a significantly increased risk of peri-interventional bleeding. This specifically applies to polyps > 1 cm where endoscopic full-thickness resection (EFTR) with the full-thickness-resection device (FTRD) can be taken into consideration as an alternative approach to classical snare polypectomy. For these indications, EFTR appears to be superior to conventional techniques especially in terms of sufficient hemostasis due to the mechanical tissue compression achieved by the FTRD's integrated Over-The-Scope Clip (OTSC)...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28802656/rethinking-papillary-muscle-resection-for-refractory-ventricular-tachycardia-in-the-lvad-era-a-case-report
#3
Zachary J Il'Giovine, Adam D DeVore, Chetan B Patel, Jason Koontz, Jacob Schroder
We report the case of a 57-year-old man with a history of ischemic cardiomyopathy who presented to the hospital with recurrent episodes of ventricular tachycardia refractory to antiarrhythmic medications. Mapping identified a deep premature ventricular contraction focus in the anterolateral papillary muscle, an area that has been previously identified as difficult to treat with radiofrequency catheter ablation. The hospital course was complicated by cardiogenic shock and VT-storm, and the patient ultimately underwent surgical resection of the anterolateral papillary muscle with left ventricular assist device placement as a successful bridge to cardiac transplantation...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28799950/orthostatic-hypotension-in-patients-with-left-ventricular-assist-devices-acquired-autonomic-dysfunction
#4
Marat Fudim, Joseph G Rogers, Camille Frazier-Mills, Chetan B Patel
Contemporary left ventricular assist device (LVAD) technology uses nonphysiologic continuous flow to deliver blood into the circulation. This results in a reduction of pulsatility, which is implicated in some of the commonly associated side effects with LVAD therapy, including hypertension and gastrointestinal arterial-venous malformation with related bleeding. A less frequently observed side effect is orthostatic hypotension (OH) in patients supported with LVAD therapy. We present three cases of OH in patients with LVAD, followed by a discussion on how LVAD therapy may induce autonomic dysfunction...
August 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28790277/-management-of-right-heart-failure-after-cardiac-surgery
#5
Takeo Fujino, Akira Shiose
Perioperative right heart failure(RHF) is an important problem, especially in the field of heart failure surgery. Right ventricular performance is determined by the combination of preload, contractility, heart rate, rhythm and afterload. Many factors influence on these parameters in the perioperative period, and the deterioration of one of them can cause RHF. Recently, we often encounter perioperative RHF after left ventricular assist device (LVAD) implantation, and prompt LVAD pump speed optimization and treatment for RHF is required to avoid complications and hemodynamic deterioration...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28781011/pre-operative-proteinuria-in-left-ventricular-assist-devices-and-clinical-outcome
#6
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Kavita Sharma, Nisha A Gilotra, Jasper J Brugts, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Olivier C Manintveld, Stuart D Russell
BACKGROUND: This study evaluated the association of pre-operative proteinuria before continuous flow left ventricular assist device (CF-LVAD) implantation in relation to mortality and the need for renal replacement therapy (RRT) during the first year of follow-up. METHODS: This retrospective, multicenter cohort study evaluated all patients (n = 241) who underwent CF-LVAD implantation in the 2 participating tertiary referral centers. Patients were included if a urine dipstick was performed within 7 days before CF-LVAD implantation...
July 15, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28777392/long-term-follow-up-of-continuous-flow-left-ventricular-assist-devices-complications-and-predisposing-risk-factors
#7
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/28777390/thrombosis-in-left-ventricular-assistance-device-with-centrifugal-technology-is-early-thrombolysis-a-better-solution
#8
Paolo Centofanti, Andrea Baronetto, Matteo Attisani, Davide Ricci, Erika Simonato, Michele W La Torre, Massimo Boffini, Mauro Rinaldi
BACKGROUND: Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. METHODS: We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016...
July 27, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28777136/incidence-and-impact-of-on-cardiopulmonary-bypass-vasoplegia-during-heart-transplantation
#9
Lauren K Truby, Koji Takeda, Maryjane Farr, James Beck, Melana Yuzefpolskaya, Paolo C Colombo, Veli Tokpara, Donna Mancini, Yoshifumi Naka, Hiroo Takayama
Despite significant advances in the medical management of heart transplant (HT) recipients, perioperative complications, including vasoplegia, remain a significant contributor to morbidity and mortality. This is a retrospective review of patients who received HT at our institution between 2012 and 2015. Mean systemic vascular resistance (SVR) was calculated during the bypass run. Vasoplegia was defined as a mean SVR <800 dynes s/cm despite a high pressor requirement (>1,500 μg neosynephrine bolused)...
August 2, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28774573/quality-of-life-of-family-caregivers-of-patients-with-a-left-ventricular-assist-device-in-japan
#10
Naoko P Kato, Ikuko Okada, Yukie Kagami, Miyoko Endo, Masaru Hatano, Minoru Ono, Tiny Jaarsma, Koichiro Kinugawa
BACKGROUND: The role of caregivers is important for the successful support of left ventricular assist device (LVAD) patients. We aimed to (1) evaluate quality of life (QoL) of caregivers pre-and post-LVAD implant and (2) identify factors associated with caregivers' QoL. METHODS: The caregivers' QoL was assessed with the Short Form-8 before implant, at 3 and 6 months after LVAD implantation. The physical and mental component summary (PCS and MCS) scores were calculated...
July 31, 2017: Journal of Cardiology
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
#11
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/28770031/systematic-left-ventricular-assist-device-implant-eligibility-with-non-invasive-assessment-the-siena-protocol
#12
REVIEW
Matteo Cameli, Ferdinando Loiacono, Stefania Sparla, Marco Solari, Elisabetta Iardino, Giulia Elena Mandoli, Sonia Bernazzali, Massimo Maccherini, Sergio Mondillo
In patients with end-stage left ventricular (LV) heart failure who receive LV assist device (LVAD) implantation, right ventricular (RV) failure represents a possible critical complication that heavily affects morbidity and mortality. Several clinical, laboratory, hemodynamic, and echocardiographic variables have been found to be associated with RV failure occurrence after surgery. Different models and risk scores have been proposed, with poor results. No accordance has ever been reached about RV pre-operative evaluation, and time has come to introduce a standardized systematic protocol for LVAD suitability assessment according to RV function...
June 2017: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28760474/impact-of-postoperative-liver-dysfunction-on-survival-after-left-ventricular-assist-device-implantation
#13
Kaustav Majumder, John R Spratt, Christopher T Holley, Samit S Roy, Rebecca J Cogswell, Kenneth Liao, Ranjit John
BACKGROUND: Liver dysfunction in left ventricular assist device (LVAD) recipients is common both before and after implantation. Postoperative liver dysfunction (PLD) develops in some LVAD recipients without preoperative liver dysfunction. The aim of this study was to assess clinical outcomes in such patients. METHODS: Records of all patients undergoing implantation of a HeartMate II (HM II, St. Jude Medical, Inc, Minneapolis, MN) LVAD at a single center at the University of Minnesota from January 2005 through June 2014 were analyzed...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760470/improved-approach-with-subcostal-exchange-of-the-heartmate-ii-left-ventricular-assist-device-difference-in-on-and-off-pump
#14
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Emily Phillips, Joyce Wald, Matthew L Williams, David W Low, Michael A Acker, Pavan Atluri
BACKGROUND: The HeartMate II (St. Jude Medical, Inc, St. Paul, MN [previously Thoratec]) left ventricular assist device (LVAD) exchange has traditionally involved a redo sternotomy. Alternate minimally invasive subcostal approaches have the advantage of avoiding sternal reentry, excessive bleeding, and prolonged recovery. METHODS: This retrospective review included patients who underwent an exchange from May 2009 to March 2016. The patients were divided into three cohorts: (1) redo sternotomy, (2) subcostal approach involving cardiopulmonary bypass (CPB) (ON-CPB SC), and (3) subcostal approach off the CPB pump (OFF-CPB SC)...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760462/histone-modification-is-correlated-with-reverse-lv-remodeling-in-nonischemic-dilated-cardiomyopathy
#15
Emiko Ito, Shigeru Miyagawa, Satsuki Fukushima, Yasushi Yoshikawa, Shunsuke Saito, Tetsuya Saito, Akima Harada, Maki Takeda, Noriyuki Kashiyama, Yuki Nakamura, Motoko Shiozaki, Koichi Toda, Yoshiki Sawa
BACKGROUND: Although implantation of a left ventricular assist device (LVAD) induces reverse remodeling of the left ventricle in end-stage nonischemic dilated cardiomyopathy (DCM), the underlying mechanism is not fully understood. It has been shown that epigenetic modification, such as methylation or acetylation of the histone, is one of the most important upstream signals in cardiac failure. This study hypothesized that histone profiles may be modified by LVAD implantation for end-stage nonischemic DCM, in association with reverse left ventricular remodeling...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28759816/phospholamban-immunostaining-is-a-highly-sensitive-and-specific-method-for-diagnosing-phospholamban-p-arg14del-cardiomyopathy
#16
Wouter P Te Rijdt, Z Joy van der Klooster, Edgar T Hoorntje, Jan D H Jongbloed, Paul A van der Zwaag, Folkert W Asselbergs, Dennis Dooijes, Rudolf A de Boer, J Peter van Tintelen, Maarten P van den Berg, Aryan Vink, Albert J H Suurmeijer
Phospholamban (PLN) p.Arg14del cardiomyopathy is associated with an increased risk of malignant ventricular arrhythmias and severe heart failure and a poor prognosis from late adolescence. It can be diagnosed in whole heart specimens, but rarely in right ventricular biopsy specimens, by PLN immunohistochemistry showing PLN-containing aggregates concentrated in cardiomyocytes in dense perinuclear aggresomes. The purpose of this study was to determine whether PLN immunohistochemistry can be used to diagnose PLN p...
May 30, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28757150/temporal-differences-in-outcomes-during-long-term-mechanical-circulatory-support
#17
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/28756099/predictors-of-ventricular-arrhythmia-after-left-ventricular-assist-device-implantation-a-large-single-center-observational-study
#18
Elena Efimova, Julia Fischer, Livio Bertagnolli, Borislav Dinov, Simon Kircher, Sascha Rolf, Philipp Sommer, Andreas Bollmann, Sergio Richter, Anna Meyer, Jens Garbade, Gerhard Hindricks, Arash Arya
BACKGROUND: Ventricular arrhythmias (VAs) are common in patients after left ventricular assist device (LVAD) implantation. OBJECTIVE: The purpose of this study was to determine the predictors of VAs and their impact on mortality in LVAD patients. METHODS: A total of 98 consecutive patients with an implantable cardioverter-defibrillator (ICD) (86 [88%] male, mean age 57 ± 10 years), 57 [58%] with nonischemic dilated cardiomyopathy) who had received an LVAD between May 2011 and December 2013 at our institution were included in the study...
July 27, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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/28752193/readmissions-after-continuous-flow-left-ventricular-assist-device-implantation
#20
Mitsutoshi Kimura, Kan Nawata, Osamu Kinoshita, Haruo Yamauchi, Yasuhiro Hoshino, Masaru Hatano, Eisuke Amiya, Koichi Kashiwa, Miyoko Endo, Yukie Kagami, Mariko Nemoto, Minoru Ono
Continuous flow left ventricular assist device (CF-LVAD) therapy has improved the survival of patients with advanced heart failure. However, the readmission rate of CF-LVAD patients is still relatively high. A total of 90 patients who received CF-LVADs between April 2011 and March 2016 at our institute and were discharged home were analyzed retrospectively. They were followed up through March 2017. Clinical data, including frequency, length and etiology of readmission, were obtained from medical records. The mean observation period after initial discharge was 713 ± 322 days...
July 27, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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