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Lvad , ventricular assist device

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https://www.readbyqxmd.com/read/27922890/tolerability-and-biological-effects-of-long-acting-octreotide-in-patients-with-continuous-flow-left-ventricular-assist-devices
#1
Rajiv Malhotra, Keyur B Shah, Raveen Chawla, Sammy Pedram, Melissa C Smallfield, Anna G Priday, Christine T DeWilde, Donald F Brophy
Patients with implanted continuous, non-pulsatile, left ventricular assist devices (LVADs) have increased occurrence of gastrointestinal bleeding (GIB). While the pathophysiology is multifactorial, there are few treatments beyond supportive care. Octreotide acetate is a somatostatin analog that reduces GIB in various patient populations. However, there are sparse case-series that suggest octreotide acetate may reduce GIB in LVAD patients. This 10 patient, 28-week Phase I study evaluated the safety and tolerability of octreotide acetate long-acting release (LAR) 20 mg depot injection every four weeks until week 16 following LVAD placement...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922889/pump-speed-optimization-in-stable-patients-with-a-left-ventricular-assist-device
#2
Lotte E Couperus, Victoria Delgado, Mand J H Khidir, Marijke P M Vester, Meindert Palmen, Marta Fiocco, Eduard R Holman, Laurens F Tops, Robert J M Klautz, Harriëtte F Verwey, Martin J Schalij, Saskia L M A Beeres
Optimal left ventricular assist device (LVAD) functioning and preservation of right ventricular (RV) function are major survival determinants in destination therapy (DT)-LVAD recipients. Currently, the indication for routine pump speed optimization in stable patients and its effect on RV function at follow-up remain underexplored. Hemodynamically stable patients (N=17, age 61 [interquartile range {IQR} 51-66]years; 13 [77%] male) underwent a routine speed ramp test. Echocardiographic images were obtained at incremental speed settings to determine optimal pump speed...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922882/exercise-hemodynamics-as-a-predictor-of-myocardial-recovery-in-lvad-patients
#3
Louise Segan, Shane Nanayakkara, Angeline Leet, Donna Vizi, David M Kaye
Mechanical circulatory support using left ventricular assist devices (LVADs) has been demonstrated to improve survival in patients with advanced heart failure. LVAD therapy also promotes reverse ventricular remodeling, which in some cases has led to sufficient myocardial recovery to allow LVAD removal. Identification of suitable patients for LVAD removal however remains challenging. We investigated the hypothesis that invasive assessment of exercise hemodynamics may provide additional information in relation to the assessment of contractile reserve in potential candidates for LVAD explant...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27909839/biventricular-support-using-a-centrifugal-pump-in-a-6%C3%A2-year-old-with-fulminant-myocarditis
#4
Hiromu Kehara, Tamaki Takano, Takamitsu Terasaki, Kenji Okada
We experienced a case of ventricular assist with both a pulsatile-flow and a continuous-flow pump in a pediatric patient, and herein report the clinical course and characteristics of the pumps. A 6-year-old female was diagnosed with fulminant myocarditis and transferred to our hospital for mechanical support. After 12 days of extracorporeal membrane oxygenation, we implanted a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) using centrifugal Gyro pumps with a membrane oxygenator in a paracorporeal fashion...
December 1, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27908653/molecular-changes-in-children-with-heart-failure-undergoing-left-ventricular-assist-device-therapy
#5
Elizabeth Medina, Carmen C Sucharov, Penny Nelson, Shelley D Miyamoto, Brian L Stauffer
OBJECTIVE: To determine whether left ventricular assist device (LVAD) treatment in children with heart failure would result in the modification of molecular pathways involved in heart failure pathophysiology. STUDY DESIGN: Forty-seven explanted hearts from children were studied (16 nonfailing control, 20 failing, and 11 failing post-LVAD implantation [F-LVAD]). Protein expression and phosphorylation states were determined by receptor binding assays and Western blots...
November 29, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27905008/feasibility-and-accuracy-of-gated-blood-pool-spect-equilibrium-radionuclide-ventriculography-for-the-assessment-of-left-and-right-ventricular-volumes-and-function-in-patients-with-left-ventricular-assist-devices
#6
Olivier Lairez, Clément Delmas, Pauline Fournier, Emmanuelle Cassol, Simon Méjean, Pierre Pascal, Antoine Petermann, Camille Dambrin, Vincent Minville, Didier Carrié, Hervé Rousseau, Michel Galinier, Jérôme Roncalli, Bertrand Marcheix, Isabelle Berry
BACKGROUND: Left ventricular assist devices (LVADs) require serial assessment of right and left ventricular (RV & LV) volumes and function. Because the RV is not assisted, its function is a critical determinant of the hemodynamic and contributes significantly to postoperative morbidity and mortality. We evaluated the feasibility and the accuracy of tomographic-equilibrium radionuclide ventriculography (t-ERV) for the assessment of patients with LVADs. METHODS: Twenty-four patients with LVAD underwent t-ERV...
November 30, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27903010/heartmate-ii-left-ventricular-assist-device-pump-exchange-a-single-institution-experience
#7
Asad F Shaikh, Susan M Joseph, Brian Lima, Shelley A Hall, Rajasekhar Malyala, Aldo E Rafael, Gonzalo V Gonzalez-Stawinski, Themistokles Chamogeorgakis
Background Left ventricular assist devices (LVADs) have revolutionized the treatment of patients with end-stage heart failure. These devices are replaced when pump complications arise if heart transplant is not possible. We present our experience with HeartMate II (HMII (Thoratec, Plesanton, California, United States)) LVAD pump exchange. Materials and Methods We retrospectively reviewed all cases that required pump exchange due to LVAD complication from November 2011 until June 2016 at a single high-volume institution...
November 30, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27899134/a-modified-park-s-stitch-to-correct-aortic-insufficiency-for-bioprosthetic-valve-at-time-of-left-ventricular-assist-device-implant-a-case-report
#8
Toshinobu Kazui, Nicole Sydow, Mark Friedman, Samuel Kim, Scott Lick, Zain Khalpey
BACKGROUND: Aortic valve insufficiency (AI) at the time of left ventricular assist device (LVAD) insertion needs to be corrected, however there is little known about how to manage bioprosthetic valvular AI. CASE PRESENTATION: A 55-year-old female with dilated cardiomyopathy who previously had a bioprosthetic aortic valve replacement needed a LVAD as a bridge to transplant. Her left ventricular ejection fraction was 10% and had mild to moderate transvalvular AI. She underwent a HeartWare HVAD insertion along with aortic valvular coaptation stitch repair (Park's stitch) to the bioprosthetic valve...
November 30, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27885993/arterial-pulsatility-under-phasic-left-ventricular-assist-device-support
#9
Selim Bozkurt, Sjoerd van Tuijl, Frans N van de Vosse, Marcel C M Rutten
The aim of this study is to understand whether the phasic Continuous Flow Left Ventricular Assist Device (CF-LVAD) support would increase the arterial pulsatility. A Micromed DeBakey CF-LVAD was used to apply phasic support in an ex-vivo experimental platform. CF-LVAD was operated over a cardiac cycle by phase-shifting the pulsatile pump control with respect to the heart cycle, in 0.05 s increments in each experiment. The pump flow rate was selected as the control variable and a reference model was used to operate the CF-LVAD at a pulsatile speed...
November 25, 2016: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/27884156/targeted-myocardial-gene-expression-in-failing-hearts-by-rna-sequencing
#10
Kajari Dhar, Alexandra M Moulton, Eric Rome, Fang Qiu, Jeff Kittrell, Eugenia Raichlin, Ronald Zolty, John Y Um, Michael J Moulton, Hesham Basma, Daniel R Anderson, James D Eudy, Brian D Lowes
BACKGROUND: Myocardial recovery with left ventricular assist device (LVAD) therapy is highly variable and difficult to predict. Next generation ribonucleic acid (RNA) sequencing is an innovative, rapid, and quantitative approach to gene expression profiling in small amounts of tissue. Our primary goal was to identify baseline transcriptional profiles in non-ischemic cardiomyopathies that predict myocardial recovery in response to LVAD therapy. We also sought to verify transcriptional differences between failing and non-failing human hearts...
November 25, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27882424/influence-of-transplant-center-procedural-volume-on-survival-outcomes-of-heart-transplantation-for-children-bridged-with-mechanical-circulatory-support
#11
Alex Hsieh, Dmitry Tumin, Patrick I McConnell, Mark Galantowicz, Joseph D Tobias, Don Hayes
Transplant center expertise improves survival after heart transplant (HTx) but it is unknown whether center expertise ameliorates risk associated with mechanical circulatory support (MCS) bridge to transplantation. This study investigated whether center HTx volume reduced survival disparities among pediatric HTx patients bridged with extracorporeal membrane oxygenation (ECMO), left ventricular assist device (LVAD), or no MCS. Patients ≤18 years of age receiving first-time HTx between 2005 and 2015 were identified in the United Network of Organ Sharing registry...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27875369/echocardiography-for-less-invasive-implantation-of-left-ventricular-assist-devices
#12
Harry Magunia, Christian Schlensak, David Schibilsky, Jan N Hilberath, Peter Rosenberger, Martina Nowak-Machen
New surgical techniques aim for less-invasive implantation of left ventricular assist devices (LVAD) via small surgical incision sites. Echocardiography plays an important role during patient selection and guidance of the procedure. The surgical incision site can be identified preoperatively by transthoracic echocardiography. Intraoperative identification of left ventricular apex, de-airing and monitoring heart function is performed by transesophageal echocardiography. This article highlights special echocardiographic considerations during less-invasive LVAD implantation surgeries...
November 21, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27873344/impact-of-residual-mitral-regurgitation-on-right-ventricular-systolic-function-after-left-ventricular-assist-device-implantation
#13
Serkan Ertugay, Hatice S Kemal, Umit Kahraman, Catagay Engin, Sanem Nalbantgil, Tahir Yagdi, Mustafa Ozbaran
Significant mitral regurgitation (MR) is thought to decrease after left ventricular assist device (LVAD) implantation, and therefore repair of mitral valve is not indicated in current practice. However, residual moderate and severe MR leads to pulmonary artery pressure increase, thereby resulting in right ventricular (RV) dysfunction during follow-up. We examined the impact of residual MR on systolic function of the right ventricle by echocardiography after LVAD implantation. This study included 90 patients (mean age: 51...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27871197/left-ventricular-assist-device-induced-reverse-remodeling-it-s-not-just-about-myocardial-recovery
#14
Karolina K Marinescu, Nir Uriel, Douglas L Mann, Daniel Burkhoff
The abnormal structure, function and molecular makeup of dilated cardiomyopathic hearts can be partially normalized in patients supported by a left ventricular assist device (LVAD), a process called reverse remodeling. This leads to recovery of function in many patients, though the rate of full recovery is low and in many cases is temporary, leading to the concept of heart failure remission, rather than recovery. Areas covered: We summarize data indicative of ventricular reverse remodeling, recovery and remission during LVAD support...
November 22, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27863356/left-ventricular-assist-devices-and-gastrointestinal-evaluation-results-of-a-consecutive-case-series
#15
Sultan Alotaibi, Raimund Erbel, Till Neumann
AIMS: To evaluate the benefit of preoperative gastrointestinal endoscopic evaluation in patients undergoing continuous flow left ventricular assist devices (CF-LVADs) implantation. METHODS AND RESULTS: A retrospective review of all fifty-three patients undergoing CF-LVADs at West-German Heart and Vascular Center, University of Duisburg-Essen was performed. A routine preoperative esophagogastroduodenoscopy was performed in seven patients to assess gastrointestinal (GI) bleeding...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27862317/impact-of-insurance-status-on-heart-transplant-waitlist-mortality-for-patients-with-left-ventricular-assist-devices
#16
Sitaramesh Emani, Dmitry Tumin, Randi E Foraker, Don Hayes, Sakima A Smith
OBJECTIVES: To test the hypotheses that receipt of Medicaid or Medicare (versus private insurance or self-pay) and low socioeconomic status (SES) leads to increased mortality and lower chances of transplantation among heart transplant (HTx) candidates with Bridge to Transplant Left Ventricular Assist Devices (BTT LVAD). BACKGROUND: Survival while awaiting HTx has improved with the use of BTT LVADs. However, it is unknown if benefits extend uniformly across patient groups based on insurance status...
November 16, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27862075/minimally-invasive-implantation-of-heartware-assist-device-and-simultaneous-tricuspid-valve-reconstruction-through-partial-upper-sternotomy
#17
Julia Hillebrand, Andreas Hoffmeier, Tonny Djie Tiong Tjan, Juergen R Sindermann, Christoph Schmidt, Sven Martens, Mirela Scherer
Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27861429/clinical-implications-of-physiological-flow-adjustment-in-continuous-flow-left-ventricular-assist-devices
#18
Vakhtang Tchantchaleishvili, Jessica G Y Luc, Caitlin M Cohan, Kevin Phan, Laila Hübbert, Steven W Day, H Todd Massey
There is increasing evidence for successful management of end-stage heart failure with continuous-flow left ventricular assist device (CF-LVAD) technology. However, passive flow adjustment at fixed CF-LVAD speed is susceptible to flow balancing issues as well as adverse hemodynamic effects relating to the diminished arterial pulse pressure and flow. With current therapy, flow cannot be adjusted with changes in venous return, which can vary significantly with volume status. This limits the performance and safety of CF-LVAD...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27861427/quality-of-life-and-mid-term-survival-of-patients-bridged-with-extracorporeal-membrane-oxygenation-to-left-ventricular-assist-device
#19
Shinya Unai, Kentaro Yamane, Daizo Tanaka, Gary Cook, Hitoshi Hirose, Nicholas C Cavarocchi, John W C Entwistle
Insertion of a left ventricular assist device (LVAD) improves survival and quality of life (QOL) in patients with class IV heart failure failing medical management. However, QOL and survival of patients bridged to LVAD with extracorporeal membrane oxygenation (ECMO) is unknown. Between July 2008 and June 2014, 213 patients underwent insertion of HeartMate II LVAD at 2 VAD centers without a bridge with a temporary VAD. ECMO was used as a bridge prior to LVAD insertion in 22 INTERMACS 1 patients (ECMO-VAD group)...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27858326/left-ventricular-assist-devices-impact-hospital-resource-utilization-without-affecting-patient-mortality-in-gastrointestinal-bleeding
#20
Feng Li, Alice Hinton, Alan Chen, Nishaki K Mehta, Samer Eldika, Cheng Zhang, Hisham Hussan, Darwin L Conwell, Somashekar G Krishna
BACKGROUND: Left ventricular assist devices (LVADs) are being utilized for management of end-stage heart failure and require systemic anticoagulation. Gastrointestinal bleeding (GIB) is one of the most common adverse events following LVAD implantation. AIM: To investigate the impact of continuous-flow (CF) LVAD implants on outcomes of patients admitted with GIB. METHODS: This is a cross-sectional study utilizing the Nationwide Inpatient Sample in the CF-LVAD era from 2010 to 2012...
November 17, 2016: Digestive Diseases and Sciences
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