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Lvad , ventricular assist device

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https://www.readbyqxmd.com/read/28731484/cpr-ecls-bvad-and-successful-heart-transplantation-within-2-months-a-single-centre-case-series-in-two-young-high-urgency-listed-patients
#1
Anna K Schmidt, Diyar Saeed, Arash Mehdiani, Bozena Sowinski, Ralf Westenfeld, Payam Akhyari, Artur Lichtenberg, Udo Boeken
INTRODUCTION: In times of organ shortage, death while on the heart waiting-list still represents a major problem. As a consequence, bridging to transplant as well as the decision when to escalate therapy play a very important role. METHODS AND RESULTS: We report on two young patients with dilated cardiomyopathy and acute decompensation who were successfully bridged to heart transplantation with both left and temporary right ventricular assist devices in just 2 months...
July 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28730986/long-term-use-of-left-ventricular-assist-devices-a-report-on-clinical-outcomes
#2
Sneha Raju, Jane MacIver, Farid Foroutan, Carolina Alba, Filio Billia, Vivek Rao
BACKGROUND: The literature examining clinical outcomes and readmissions during extended (> 1 yr) left ventricular assist device (LVAD) support is scarce, particularly in the era of continuous-flow LVADs. METHODS: We completed a retrospective cohort study on consecutive LVAD patients from June 2006 to March 2015, focusing on those who received more than 1 year of total LVAD support time. Demographic characteristics, clinical outcomes and readmissions were analyzed using standard statistical methods...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730501/the-pseudo-sah-sign-an-imaging-pitfall-in-postmortem-computed-tomography
#3
Go Shirota, Wataru Gonoi, Masako Ikemura, Masanori Ishida, Yukako Shintani, Hiroyuki Abe, Masashi Fukayama, Tomohiko Higashida, Hidemi Okuma, Osamu Abe
Postmortem computed tomography (PMCT) of the brain has an important role in detection of subarachnoid hemorrhage (SAH), which has a high mortality rate. However, a phenomenon known as "pseudo-SAH," or high-attenuation areas along the cisterns mimicking SAH, may be seen on CT. The aim of this study was to evaluate the diagnostic accuracy of brain PMCT for SAH and to identify the characteristics of pseudo-SAH. Findings on PMCT (sulcal effacement, asymmetry, maximum thickness of SAH signs, presence of acute/subacute intraventricular/intraparenchymal hemorrhage) and clinical history (left ventricular assist device [LVAD] implantation, anticoagulation therapy/coagulation disorder, global ischemia) were compared between subjects with true SAH and those with pseudo-SAH...
July 20, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28729354/continuous-flow-lvad-support-causes-a-distinct-form-of-intestinal-angiodysplasia
#4
Jooeun Kang, Samson Hennessy-Strahs, Pawel Kwiatkowski, Christian Bermudez, Michael A Acker, Pavan Atluri, Patrick McConnell, Carlo R Bartoli
Rationale: The objective of this autopsy study was to determine whether abnormal gastrointestinal vascularity develops during continuous-flow LVAD support. Objective: Left ventricular assist device (LVAD) support causes pathologic degradation of von Willebrand factor (vWF) and bleeding from gastrointestinal angiodysplasia at an alarming rate. It has been speculated that LVAD support, itself may cause angiodysplasia. The relationship to abnormal vWF metabolism is unknown. We tested the hypothesis that abnormal gastrointestinal vascularity develops during continuous-flow LVAD support...
July 20, 2017: Circulation Research
https://www.readbyqxmd.com/read/28727672/cardiac-rehabilitation-in-patients-with-left-ventricular-assist-device-a-systematic-review-and-meta-analysis
#5
Toufik Mahfood Haddad, Alok Saurav, Aiman Smer, Muhammad S Azzouz, Abhilash Akinapelli, Mark A Williams, Venkata M Alla
PURPOSE: Exercise-based cardiac rehabilitation (EBCR) has been demonstrated to improve functional capacity in heart failure (HF). However, there are limited data on the effect of EBCR in patients with advanced HF and left ventricular assist devices (LVADs). This meta-analysis sought to evaluate the effects of EBCR on functional capacity in patients with LVAD. METHODS: PubMed, Web of Science, CINAHL, and Cochrane Library databases were searched for randomized studies assessing the impact of EBCR in patients following LVAD implantation compared with standard therapy (ST)...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28711755/palliative-care-clinicians-caring-for-patients-before-and-after-continuous-flow-left-ventricular-assist-device
#6
Sara E Wordingham, Colleen K McIlvennan, Timothy J Fendler, Amy L Behnken, Shannon M Dunlay, James N Kirkpatrick, Keith M Swetz
Left ventricular assist devices (LVADs) are an available treatment option for carefully-selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. While survival and quality of life improve with LVADs compared to medical therapy, complications persist including bleeding, infection, and stroke...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711647/surgical-training-improves-performance-in-minimally-invasive-left-ventricular-assist-device-implantation-without-cardiopulmonary-bypass
#7
Lu-Feng Zhang, Hai-Bo Feng, Zhi-Guo Yu, Shi Jing, Feng Wan
OBJECTIVE: We introduced a live animal model for training of minimally invasive implantation of a continuous-flow left ventricular assist device (CF-LVAD) without cardiopulmonary bypass for operator's performance improvement. DESIGN: After watching a videotape of LVAD implantation on the beating heart through the cardiac apex, the surgical team performed implantation of LVADs into 5 pigs during 3 training sessions in a time series. The procedure success rate, operating time, and technical and global performances by self-evaluation and senior evaluation were compared among the sessions...
July 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28711453/a-roadmap-for-evaluating-the-use-and-value-of-durable-ventricular-assist-device-therapy
#8
EDITORIAL
Sarah T Ward, Qixing Liang, Francis D Pagani, Min Zhang, Robert L Kormos, Keith D Aaronson, Andrew D Althouse, Brahmajee K Nallamothu, Donald S Likosky
Heart failure is a disease characterized by profound human suffering with limitations in survival despite treatment with guideline-directed medical therapies. Patients with heart failure frequently progress to advanced stages and often require cardiac transplantation or implantation of left ventricular assist devices (LVADs) to extend survival and improve quality of life. As the number of suitable heart donors, number of experienced medical centers and patient comorbidities place restrictions on the feasibility of cardiac transplantation, implantation of LVADs has emerged as a more frequently applied treatment as either a bridge to transplantation or as permanent therapy...
June 23, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28709930/particle-image-velocimetry-study-of-the-celiac-trunk-hemodynamic-induced-by-continuous-flow-left-ventricular-assist-device
#9
Francesco Scardulla, Diego Bellavia, Leonardo D'Acquisto, Giuseppe M Raffa, Salvatore Pasta
Whereas left ventricular assist device (LVAD) is the gold-standard therapy for patients with heart failure, gastrointestinal bleeding is one of the most common complications. LVAD implantation may remarkably impact aortic hemodynamics so that experimental and computational flow analyses can be used to study the disease mechanisms. Here we present an experimentally-calibrated computational model of the celiac trunk hemodynamic of a LVAD-supported patient who experienced bleeding after device implantation. Specifically, both particle image velocimetry (PIV) and echocardiography were used to measure and compare flow distributions in each branch of a phantom model of the patient abdominal aorta...
July 12, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28708213/novel-use-of-low-dose-thalidomide-in-refractory-gastrointestinal-bleeding-in-left-ventricular-assist-device-patients
#10
Benjamin J J Seng, Louis L Y Teo, Laura L Chan, David K L Sim, Ka L Kerk, Jia L Soon, Teing E Tan, Cumaraswamy Sivathasan, Choon P Lim
BACKGROUND: Gastrointestinal bleeding (GIB) is a complication reported in patients post left ventricular assist device (LVAD) implantation that is associated with high mortality rates. Thalidomide is an anti-angiogenic compound that may offer a potential option for management of refractory LVAD-related GIB. METHODS: A single-center, retrospective review was conducted from January 2009 to October 2016 at a tertiary cardiology center. It included LVAD patients initiated on thalidomide for refractory GIB...
July 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28707188/hemodynamic-benefits-of-counterpulsation-implantable-percutaneous-and-intraaortic-rotary-blood-pumps-an-in-silico-and-in-vitro-study
#11
Yu Wang, Steven C Koenig, Michael A Sobieski, Mark S Slaughter, Guruprasad A Giridharan
Mechanical circulatory support (MCS) devices have become a standard therapy for heart failure (HF) patients. MCS device designs may differ by level of support, inflow and/or outflow cannulation sites, and mechanism(s) of cardiac unloading and blood flow delivery. Investigation and direct comparison of hemodynamic parameters that help characterize performance of MCS devices has been limited. We quantified cardiac and vascular hemodynamic responses for different types of MCS devices. Continuous flow (CF) left ventricular (LV) assist devices (LVAD) with LV or left atrial (LA) inlet, counterpulsation devices, percutaneous CF LVAD, and intra-aortic rotary blood pumps (IARBP) were quantified using established computer simulation and mock flow loop models...
July 13, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28705316/cell-specific-pathways-supporting-persistent-fibrosis-in-heart-failure
#12
Stephen D Farris, Creighton Don, Deri Helterline, Christopher Costa, Tabitha Plummer, Susanne Steffes, Claudius Mahr, Nahush A Mokadam, April Stempien-Otero
BACKGROUND: Only limited data exist describing the histologic and noncardiomyocyte function of human myocardium in end-stage heart failure (HF). OBJECTIVES: The authors sought to determine changes in noncardiomyocyte cellular activity in patients with end-stage HF after left ventricular assist device (LVAD)-induced remodeling to identify mechanisms impeding recovery. METHODS: Myocardium was obtained from subjects undergoing LVAD placement and/or heart transplantation...
July 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28692527/sildenafil-in-left-ventricular-assist-device-is-safe-and-well-tolerated
#13
Ashwin K Ravichandran, Shane J LaRue, Eric Novak, Susan A Joseph, Joel D Schilling
Right heart failure is a potentially devastating complication of mechanical circulatory support, occurring at a rate of 0.49 events per 100 patient-months. Pulmonary vasodilators such as phosphodiesterase-5 inhibitors (PDE5i) have been frequently used to unload the right ventricle in left ventricular assist device (LVAD) patients, but there is scant evidence to support this practice. The purpose of this analysis is to provide additional data regarding the safety and efficacy of the PDE5i sildenafil in a real world population of patients supported with LVADs at Washington University in St...
July 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28692526/preoperative-nutritional-assessment-with-the-prognostic-nutrition-index-in-patients-undergoing-left-ventricular-assist-device-implantation
#14
Gardner Yost, Antone Tatooles, Geetha Bhat
The prognostic nutritional index (PNI) is a simple metric that uses serum albumin and total lymphocyte count to provide a basic indicator for nutritional status. It has recently garnered attention as a prognosticator of outcomes in many types of cancer. We investigated the utility of the PNI as a marker for poor outcomes following left ventricular assist device (LVAD) implantation. Two hundred eighty-eight consecutive patients implanted with continuous-flow LVADs were included. Prognostic nutritional index was calculated for all patients (PNI = [10 × serum albumin {g/dl}] + [0...
July 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28682993/quantification-of-von-willebrand-factor-cleavage-by-adamts-13-in-patients-supported-by-left-ventricular-assist-devices
#15
Yong Zhou, Shizhen Qin, Tristan Hilton, Li Tang, Miguel Cruz, Ruben Hernandez, Joel L Moake, Qiang Tian, O H Frazier, Jing-Fei Dong, Angelo Nascimbene
Patients supported by left ventricular assist devices (LVADs) often present with the loss of large von Willebrand factor (VWF) multimers. This VWF deficiency is believed to contribute to the bleeding diathesis of patients on LVAD support and is caused by excessive VWF cleavage by the metalloprotease ADAMTS-13 under high shear stress. However, only a small percentage of patients who have suffered the loss of large VWF multimers bleed. The actual rates of VWF cleavage in these patients have not been reported, primarily because of the lack of reliable detection methods...
July 1, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28674109/left-ventricular-assist-device-malfunctions-it-s-more-than-just-the-pump
#16
Robert L Kormos, Michael McCall, Andrew D Althouse, Lagazzi Luigi, Richard D Schaub, Michael A Kormos, Jared A Zaldonis, Christopher M Sciortino, Kathleen L Lockard, Nicole M Kuntz, Elizabeth M Dunn, Jeffrey J Teuteberg
Background -Reports of left ventricular assist device (LVAD) malfunction have focused on pump thrombosis. However, the device consists of the pump, driveline and peripherals, all of which are potentially subject to failure. Methods -Prospectively collected data were reviewed for all LVAD device malfunctions (DM) occurring in rotary LVADs implanted at a single center between April 2004 and May 2016. Durable LVADs included 108 Heartmate II (HMII) and 105 HeartWare ventricular assist devices (HVAD). DM data were categorized according to device type and into categories related to the component that failed: a) controller, b) peripheral components and c) the implantable blood pump or its integral electrical driveline...
July 3, 2017: Circulation
https://www.readbyqxmd.com/read/28665827/cessation-of-continuous-flow-left-ventricular-assist-device-related-gastrointestinal-bleeding-after-heart-transplantation
#17
Snehal R Patel, Kyung Taek Oh, Tolulope Ogriki, Daniel Sims, J Julia Shin, Shivank Madan, Omar Saeed, Daniel J Goldstein, Ulrich P Jorde
Gastrointestinal bleeding (GIB) is a major complication of continuous flow left ventricular assist device (CF LVAD) therapy. The precise pathophysiology of CF LVAD-related bleeding remains poorly understood, and the effect of pump removal at the time of transplantation on actual bleeding frequency has not previously been studied. A single-center retrospective review was conducted on patients who received CF LVAD and subsequently developed GIB. Baseline demographics and markers of pulsatility (aortic valve opening and the HeartMate II [HM2] pulse index) were compared between those with and without GIB...
June 28, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28665826/unrecognized-left-heart-failure-in-lvad-recipients-the-role-of-routine-invasive-hemodynamic-testing
#18
Palak Shah, Nina Badoe, Sheila Phillips, Kamil Abdullah, Christopher W May, Jose L Nabut, Ramesh Singh, Christopher deFilippi, Shashank S Desai
The role of routine right heart catheterizations (RHCs) in left ventricular assist device (LVAD) patients is undefined. We analyzed 105 continuous-flow LVAD recipients who underwent an RHC approximately 3 months after implant. In 38 patients, LVAD speed was ramped with the goal of optimizing hemodynamics. Our cohort consisted of 71 (68%) HeartMate II (HMII) and 34 (32%) HeartWare (HVAD) patients. Thirty patients (29%) had either a reduced cardiac index (CI ≤ 2.2 L/min/m), elevated pulmonary capillary wedge pressure (PCWP > 18 mm Hg), or both...
June 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28662987/changes-in-disease-specific-versus-generic-health-status-measures-after-left-ventricular-assist-device-implantation-insights-from-intermacs
#19
Michael E Nassif, John A Spertus, Philip G Jones, Timothy J Fendler, Larry A Allen, Kathleen L Grady, Suzanne V Arnold
BACKGROUND: Quantifying quality of life (QoL) after left ventricular assist device (LVAD) remains challenging. Heart failure (HF)-specific health status measures are ideal for assessing symptoms of HF; however, if patients' QoL is limited by other factors, they may experience improved HF-specific QoL but no concurrent improvement in generic QoL. We sought to examine and predict discrepancies between disease-specific and generic QoL measures after LVAD. METHODS: We examined HF-specific and generic QoL with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol-5D Visual Analog Scale (VAS), respectively, among 1,888 patients with advanced heart failure who underwent LVAD implantation from 2012 to 2014 as part of the INTERMACS registry...
May 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28661912/favorable-effects-on-pulmonary-vascular-hemodynamics-with-continuous-flow-left-ventricular-assist-devices-are-sustained-5-years-after-heart-transplantation
#20
Abdulfattah Saidi, Craig H Selzman, Abdulmohsin Ahmadjee, Mohammad Al-Sarie, Gregory L Snow, Omar Wever-Pinzon, Rami A Alharethi, Bruce Reid, Josef Stehlik, Abdallah G Kfoury, Feras Bader
It is unclear whether pulmonary hemodynamics improvement with left ventricle unloading with left ventricular assist devices (LVADs) is sustained long term after heart transplant (HT). We sought to assess the effects on pulmonary vascular hemodynamics during continuous-flow (CF-LVAD) and pulsatile flow (PF-LVAD) support up to 5 years after HT. Invasive hemodynamics were evaluated before LVAD, before HT, and at 3 months, 1, and 3-5 years posttransplant. Thirty-eight patients were included in the study and divided into two groups according to the type of LVAD support...
June 15, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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