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Lvad , ventricular assist device

Napatt Kanjanahattakij, Benjamin Horn, Basma Abdulhadi, Nicha Wongjarupong, Kenechukwu Mezue, Pattara Rattanawong
Cerebrovascular accident (CVA) is one of the major complications and a leading cause of death in patients with a left ventricular assist device (LVAD). Multiple studies of have shown that patients with blood stream infection (BSI) are more likely to develop CVA compared to patients without BSI. However, there is no meta-analysis to confirm this association. Studies were systematically acquired from MEDLINE and EMBASE electronic databases. Included studies assessed patients with heart failure requiring LVAD and reported the number of patients who had BSI post LVAD, incidence of ischemic CVA, hemorrhagic CVA, or any CVA...
March 16, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Sven Persoon, Michael Paulus, Stephan Hirt, Carsten Jungbauer, Alexander Dietl, Andreas Luchner, Christof Schmid, Lars S Maier, Christoph Birner
Implantation of left ventricular assist devices (LVADs) as bridge to transplant in end-stage heart failure allows for analyzing reverse remodeling processes of the supported heart. Whether this therapy influences the cGMP-PKG signaling pathway, which is currently under thorough investigation for developing new heart failure therapeutics, is unknown. In fourteen end-stage heart failure patients (8 with dilated cardiomyopathy, DCM; 6 with ischemic cardiomyopathy, ICM) tissue specimens of left ventricles were collected at LVAD implantation and afterwards at receiver heart explantation, respectively...
March 15, 2018: Heart and Vessels
D Marshall Brinkley, David DeNofrio, Robin Ruthazer, Amanda R Vest, Navin K Kapur, Gregory S Couper, Michael S Kiernan
BACKGROUND: Since Food and Drug Administration's approval of the HeartMate II left ventricular assist device (LVAD) as destination therapy, the number of hospitals offering LVAD therapy has grown rapidly. A rising number are performed at centers without internal transplant programs. We sought to determine whether outcomes after destination therapy LVAD implantation are similar at transplant and nontransplant centers. METHODS AND RESULTS: Adult recipients of a primary, continuous-flow LVAD as destination therapy between January 2012 and March 2014 from the Interagency Registry for Mechanically Assisted Circulatory Support were included...
March 2018: Circulation. Heart Failure
Heidi J Reich, Lawrence S C Czer, Danny Ramzy, Francisco Arabia, Jaime Moriguchi, Deborah D Ascheim, Timothy D Henry
The use of stem cell therapy in combination with a left ventricular assist device (LVAD) for patients with advanced heart failure (HF) is an attractive concept with the potential to alter the natural history of HF. Cell therapy trials for HF have demonstrated excellent safety and encouraging results, but current rates of myocardial recovery after LVAD implantation are limited. Early trials combining these 2 therapies to increase the likelihood of recovery and to potentially obviate the need for subsequent transplantation appear promising...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Pavol Sajgalik, Vaclav Kremen, Vratislav Fabian, Simon Maltais, John M Stulak, Sudhir S Kushwaha, Lyle D Joyce, John A Schirger, Bruce D Johnson
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare)...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jessica Schultz, Ranjit John, Cindy Martin, Forum Kamdar, Thenappan Thenappan, Rebecca Cogswell
Myocardial fibrosis identified by apical core pathology at the time of left ventricular assist device (LVAD) implantation may add information regarding myocardial recovery potential. In this analysis, we report the prevalence of myocardial fibrosis by cardiomyopathy type and its association with other known markers of left ventricular recovery. Left ventricular assist device core pathology was reviewed on 332 patients who underwent LVAD implantation at a single institution between 2005 and 2016. Baseline clinical and echocardiographic characteristics were compared among patients with and without myocardial fibrosis by cardiomyopathy type...
March 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Kay Lash, Rachelle Oppel, Jeanette Hasse
Technology advances have made it possible to prolong life for patients with heart failure who are not transplant candidates or while awaiting transplant. Many different cardiac devices are available that can be used as a bridge to transplant (temporary support) or as a destination therapy (permanent support). Placement of these devices can cause complications that, if not addressed, could negatively impact the nutrition status of patients. Placement of nasointestinal feeding tubes using an electromagnetic sensor-guided enteral access system (EMS-EAS) has been difficult in patients with implantable devices because of the potential for interference with the EMS-EAS and the left ventricular assist device (LVAD)...
March 12, 2018: Nutrition in Clinical Practice
Christina Feldmann, Anamika Chatterjee, Axel Haverich, Jan D Schmitto
Cardiovascular diseases are the leading cause of mortality rates throughout the world. Next to an insufficient number of healthy donors, this has led to increasing numbers of patients on heart transplant waiting lists with prolonged waiting times. Innovative technological advancements have led to the production of ventricular assist devices that play an increasingly important role in end stage heart failure therapy. This review is intended to provide an overview of current implantable left ventricular assist devices, different design concepts and implantation techniques...
March 13, 2018: Advances in Experimental Medicine and Biology
Shawn M Shah, Nicholas R Teman, Eileen Dearth, Leora T Yarboro, John A Kern
Utilization of a left ventricular assist device (LVAD) as a bridge to myocardial recovery is an established therapy for acute systolic heart failure. However, device removal can present a technical challenge with no clear consensus on preferred method. In this case report, we describe a complex patient who underwent successful explantation of an LVAD using an intraoperatively constructed apical plug. This method utilizes inexpensive and easily accessible materials, minimizes ventricular distortion during device removal, and preserves the ventricular sewing ring for future reimplantation...
March 9, 2018: Annals of Thoracic Surgery
Jasmin S Hanke, Günes Dogan, Amelie Zoch, Marcel Ricklefs, Leonhard Wert, Christina Feldmann, Christoph Bara, Malakh Shrestha, Jochen Tillmanns, Tibor Kempf, Johann Bauersachs, Axel Haverich, Jan D Schmitto
BACKGROUND: The HeartMate 3 (HM3; Abbott Laboratories, Lake Forest, Ill) left ventricular assist device (LVAD) received its Conformité Européenne mark for Europe in October 2015 and is currently under investigation of the Food and Drug Administration to gain approval in the United States. Within this study, we present the first real-world experiences, 1-year outcomes, and adverse events of a single-center cohort treated with the HM3. METHODS: We prospectively studied midterm results of 27 consecutive patients receiving the HM3 at a single institution...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
Alexandros Briasoulis, Chakradhari Inampudi, Emmanuel Akintoye, Oluwole Adegbala, Paulino Alvarez, Jay Bhama
The utilization of contemporary continuous-flow left ventricular assist device (CF-LVADs) has increased, accounting for >90% of implants from 2009 to 2014. The present study aimed to identify the annual national estimates in utilization, in-hospital mortality, and major complications with CF-LVAD using data from the National Inpatient Sample, the largest all-payer inpatient data set in the United States, and the US Census Bureau, for the years 2009 to 2014. Participants included all adult patients who received CF-LVADs from 2009 to 2014...
February 12, 2018: American Journal of Cardiology
Sahil Agrawal, Lohit Garg, Mahek Shah, Manyoo Agarwal, Brijesh Patel, Amitoj Singh, Aakash Garg, Ulrich P Jorde, Navin K Kapur
BACKGROUND: Early readmissions contribute significantly to heart failure-related morbidity and negatively affect quality of life. Data on left ventricular assist device (LVAD)-related 30-day readmissions are scarce and limited to small studies. METHODS AND RESULTS: Patients undergoing LVAD implantation between January 2013 and November 2014 who survived the index hospitalization were identified in the Nationwide Readmissions Database. We analyzed the incidence, predictors, causes, and costs of 30-day readmissions...
March 2018: Circulation. Heart Failure
Per Sundbom, Michael Roth, Hans Granfeldt, Daniel M Karlsson, Henrik Ahn, Fredrik Gustafsson, Laila Hubbert
INTRODUCTION: The use of left ventricular assist device (LVAD) has grown rapidly. Adverse events do continue to occur. In recent years, analysis of LVAD sound recordings emerged as a means to monitor pump function and detect pump thrombosis. The aim of this study was to characterize the sounds from HeartMate II and to evaluate the use of handheld iOS devices for sound recordings. METHOD: Signal analysis of LVAD sound recordings, with dedicated recording equipment and iOS devices, was performed...
March 1, 2018: International Journal of Artificial Organs
George S Chrysant, Anita A Phancao, Douglas A Horstmanshof, Susie Jones, James W Long
Evaluation of left ventricular devices is becoming increasingly important as the implantation of these devices increases. Cardiac computed tomography angiography (CCTA) has many potential advantages compared with plain radiographs and echocardiography to troubleshoot these devices and potentially help guide therapy. Heart failure (HF) remains a deadly, progressive disease with substantive and increasing morbidity, mortality, cost, and prevalence. Use of left ventricular assist devices (LVAD) as treatment for refractory HF has been steadily rising during the last decade...
March 5, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Indranee Rajapreyar, Deepak Acharya, José Tallaj, Lauren Hornbuckle, Jessica Sharpton, Joanna Joly, Salpy Pamboukian
Ventricular arrhythmias occurs in 20-50% of patients supported with left ventricular assist devices (LVAD). Ventricular arrhythmias are well tolerated with LVAD support but long-term consequences include worsening right ventricular function. Management of ventricular arrhythmias in LVAD patients includes use of antiarrhythmic agents or ablation. Amiodarone has been used a first-line agent to treat ventricular arrhythmias post-LVAD implantation. Chronic treatment with amiodarone for arrhythmias can result in hyperthyroidism and hypothyroidism in 5-10% of patients...
March 5, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Edo Y Birati, Thomas C Hanff, Dawn Maldonado, E Wilson Grandin, Peter J Kennel, Jeremy A Mazurek, Esther Vorovich, Matthew Seigerman, Jessica L L Howard, Michael A Acker, Yoshifumi Naka, Joyce Wald, Lee R Goldberg, Mariell Jessup, Pavan Atluri, Kenneth B Margulies, P Christian Schulze, J Eduardo Rame
BACKGROUND: Predicting which patients are unlikely to benefit from continuous flow left ventricular assist device (LVAD) treatment is crucial for the identification of appropriate patients. Previously developed scoring systems are limited to past eras of device or restricted to specific devices. Our objective was to create a risk model for patients treated with continuous flow LVAD based on the preimplant variables. METHODS AND RESULTS: We performed a retrospective analysis of all patients implanted with a continuous flow LVAD between 2006 and 2014 at the University of Pennsylvania and included a total of 210 patients (male 78%; mean age, 56±15; mean follow-up, 465±486 days)...
March 7, 2018: Journal of the American Heart Association
Julie T Bidwell, Karen S Lyons, James O Mudd, Kathleen L Grady, Jill M Gelow, Shirin O Hiatt, Christopher V Chien, Christopher S Lee
BACKGROUND: Although current guidelines emphasize the importance of social support to the success of left ventricular assist device (LVAD) therapy, few studies examine the influence of the caregiver on patient outcomes or quantify the impact of LVAD caregiving on caregiver outcomes. The purpose of this analysis was to identify patient and caregiver determinants of patient quality of life (QOL) and caregiver strain in response to LVAD therapy. METHODS AND RESULTS: Data on patients receiving LVAD therapy and their caregivers (n=50 dyads) were prospectively collected pre-implantation and 1, 3, and 6 months post-implantation...
March 7, 2018: Journal of the American Heart Association
Rizwan A Tahir, Lauren E Rotman, Matthew C Davis, Esther B Dupépé, Maximillian K Kole, Mahnaz Rehman, Celeste T Williams, Salpy V Pamboukian, Michael Bazydlo, Beverly C Walters
BACKGROUND: There is a dearth of literature regarding the management and outcomes of patients who develop intracranial hemorrhage (ICH) with a left ventricular assist device (LVAD) for advanced heart failure. Therefore, we conducted a multi-centered case series highlighting patient outcomes and prognostic factors to help clinicians better understand and care for these high-risk patients. METHODS: A case series from 2 large-volume institutions (defined as large by the Nationwide Inpatient Sample [NIS] hospital size, i...
March 3, 2018: World Neurosurgery
Brandon K Martinez, Brenda Yik, Raymond Tran, Sabrina Ilham, Craig I Coleman, Douglas L Jennings, William L Baker
Continuous-flow left ventricular assist devices (CF-LVADs) prolong survival in advanced heart failure patients. Anticoagulation control is critical in CF-LVAD patients due to increased thromboembolic and bleeding risk. We assessed the quality of INR control in CF-LVAD patients measured by time in therapeutic range (TTR). We performed a systematic literature search of MEDLINE and SCOPUS through July 2017 to identify studies evaluating TTR in anticoagulated adult CF-LVAD patients. Data on key characteristics and the TTR end point were then extracted from each study by two investigators using a standardized tool...
March 6, 2018: Artificial Organs
Mitsugu Ogawa, Muhammad F Masood, Gregory A Ewald, Justin M Vader, Shane J LaRue, Allen Cheng, Keki R Balsara, Akinobu Itoh
Although the incidence of driveline failure has been significantly reduced with the major modification to the driveline connection to the HeartMate II left ventricular assist device (LVAD), internal and external driveline damage continues to be a major reason for pump exchange or driveline repair. We report three cases of internal driveline damage under the costal margin and in the adjacent abdominal wall. All three cases developed occasional electrical disruptions 2-5 years after the original LVAD implant through the median sternotomy...
March 3, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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