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https://www.readbyqxmd.com/read/28938306/different-clinical-course-and-complications-in-interagency-registry-for-mechanically-assisted-circulatory-support-1-patients-managed-with-or-without-extracorporeal-membrane-oxygenation
#1
Jason J Han, Jennifer Chung, Carol W Chen, Ann C Gaffey, Alex Sotolongo, Christyna Justice, Alyse E Ameer, J Eduardo Rame, Christian Bermudez, Michael A Acker, Pavan Atluri
Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28930797/optimizing-the-safety-profile-of-everolimus-by-delayed-initiation-in-de-novo-heart-transplant-recipients-results-of-the-prospective-randomized-study-everheart
#2
Luciano Potena, Carlo Pellegrini, Francesco Grigioni, Cristiano Amarelli, Ugolino Livi, Massimo Maccherini, Gabriella Masciocco, Giuseppe Faggian, Paola Lilla Della Monica, Gino Gerosa, Nicola Marraudino, Marco Corda, Massimo Boffini
BACKGROUND: Although everolimus potentially improves long-term heart transplantation (HTx) outcomes, its early postoperative safety profile had raised concerns and needs optimization. METHODS: This 6-month, open-label, multicenter randomized trial was designed to compare the cumulative incidence of a primary composite safety endpoint comprising wound healing delays, pericardial effusion (PCEs), pleural effusion (PLEs) needing drainage, and renal insufficiency events (estimated glomerular filtration rate [eGFR] ≤30/mL/min/1...
September 19, 2017: Transplantation
https://www.readbyqxmd.com/read/28929512/systematic-design-of-a-magnetically-levitated-brushless-dc-motor-for-a-reversible-rotary-intra-aortic-blood-pump
#3
Yaxin Wang, Thomas G Logan, P Alex Smith, Po-Lin Hsu, William E Cohn, Liping Xu, Richard A McMahon
The IntraVAD is a miniature intra-aortic ventricular assist device (VAD) designed to work in series with the compromised left ventricle. A reverse-rotation control (RRc) mode has been developed to increase myocardial perfusion and reduce ventricular volume. The RRc mode includes forward rotation in systole and reverse rotation in diastole, which requires the IntraVAD to periodically reverse its rotational direction in synchrony with the cardiac cycle. This periodic reversal leads to changes in pressure force over the impeller, which makes the entire system less stable...
September 20, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28928552/comparative-efficacy-of-minimal-concentration-of-racemic-bupivacaine-0-0625-with-fentanyl-and-ropivacaine-0-1-with-fentanyl-for-epidural-labor-analgesia
#4
T N Chethanananda, M R Shashank, N Madhu, J Achyutha, Karna Venkata Siva Kumar
BACKGROUND AND AIMS: This study aims to compare the minimum effective concentration of local anesthetic (LA) bupivacaine and ropivacaine with highly lipid soluble opioids fentanyl for providing optimal labor epidural analgesia. SETTINGS AND DESIGN: The objective of this study was to evaluate the efficacy of racemic bupivacaine 0.0625% and 0.1% of ropivacaine both mixed with 2 μg/ml of fentanyl for epidural labor analgesia in parturients with spontaneous labor and normal fetal heart rate tracing...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#5
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28916901/pulmonic-valve-disease-review-of-pathology-and-current-treatment-options
#6
REVIEW
Mouhammad Fathallah, Richard A Krasuski
PURPOSE OF REVIEW: Our review is intended to provide readers with an overview of disease processes involving the pulmonic valve, highlighting recent outcome studies and guideline-based recommendations; with focus on the two most common interventions for treating pulmonic valve disease, balloon pulmonary valvuloplasty and pulmonic valve replacement. RECENT FINDINGS: The main long-term sequelae of balloon pulmonary valvuloplasty, the gold standard treatment for pulmonic stenosis, remain pulmonic regurgitation and valvular restenosis...
September 16, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28913838/simultaneous-acquisition-of-perfusion-image-and-dynamic-mr-angiography-using-time-encoded-pseudo-continuous-asl
#7
Yuriko Suzuki, Michael Helle, Peter Koken, Marc Van Cauteren, Matthias J P van Osch
PURPOSE: Both dynamic magnetic resonance angiography (4D-MRA) and perfusion imaging can be acquired by using arterial spin labeling (ASL). While 4D-MRA highlights large vessel pathology, such as stenosis or collateral blood flow patterns, perfusion imaging provides information on the microvascular status. Therefore, a complete picture of the cerebral hemodynamic condition could be obtained by combining the two techniques. Here, we propose a novel technique for simultaneous acquisition of 4D-MRA and perfusion imaging using time-encoded pseudo-continuous arterial spin labeling...
September 14, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28902381/-organ-interactions-heart-and-lung-management-of-the-acute-right-heart-failure
#8
Guido Michels, Roman Pfister
The pathophysiology and the management of patients with acute right heart failure are very complex. The bed-side focused echocardiography is the basis of differential diagnosis and acute diagnosis. Individual therapy monitoring is complex due to the strong preload dependence of the right ventricle and the limitation of non-invasive estimation of pulmonary-vascular hemodynamics, so that the indication for a pulmonary artery catheter should be liberal in acute right heart failure. The treatment goals of acute right heart failure are the treatment of the underlying disease or triggering factors in combination with individualized optimization of hemodynamic tailored to current right-ventricular function...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28901848/pulmonary-hypertension-secondary-to-left-heart-disease
#9
Ghazal Kabbach, Debabrata Mukherjee
Pulmonary hypertension (PH) related to left heart disease (LHD) is the most common form of PH, accounting for more than two third of all PH cases. The hemodynamic abnormalities seen in PH-LHD are complex, and there are currently minimal evidence-based recommendations for the management of PH-LHD. While it is accepted that PH in the context of left heart disease is a marker of worse prognosis, it remains unclear whether its primary treatment is beneficial or harmful. In this article, we discuss the prevalence and significance of PH in patients with heart failure (HF) with reduced ejection fraction (HFrEF) as well as HF with preserved ejection fraction (HFpEF), and those with valvular heart disease and provide insights into the complex pathophysiology of cardiopulmonary interrelationship in individuals with PH due to left heart disease...
September 12, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28901515/vulnerability-study-of-myelinated-and-unmyelinated-nerve-fibers-in-acute-ocular-hypertension-in-rabbit
#10
Jiying Shen, Qiang Yang, Daoyi Yu, Jihong Wu, Yuanfang Zhu, Wenyi Guo
In the current study, it was aimed to evaluate the changes in myelinated and unmyelinated nerve fibers in retinal ischemia‑reperfusion injuries caused by acute ocular hypertension and to determine the sequence of these changes. Adult healthy New Zealand white rabbits were randomized to the hemodynamic group [n=12; used to determine the optimal intraocular pressure (IOP) for the subsequent experiments] and the hypertension group (n=6; 70‑mmHg hypertension induced in one eye). IOP was adjusted using a cannula and saline...
September 12, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28900864/ventricular-tachycardia-with-icd-shocks-when-to-medicate-and-when-to-ablate
#11
REVIEW
Amir AbdelWahab, John Sapp
PURPOSE OF REVIEW: Ventricular tachycardia occurrence in implantable cardioverter defibrillator (ICD) patients may result in shock delivery and is associated with increased morbidity and mortality. In addition, shocks may have deleterious mechanical and psychological effects. Prevention of ventricular tachycardia (VT) recurrence with the use of antiarrhythmic drugs or catheter ablation may be warranted. Antiarrhythmic drugs are limited by incomplete efficacy and an unfavorable adverse effect profile...
September 13, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28889364/open-complete-anterior-dislocation-of-the-sacro-iliac-joint-in-a-4-year-old-boy-a-case-report-of-a-rare-injury-with-5-year-follow-up
#12
Walid A Elnahal, Mahmoud Fahmy, Mehool Acharya
Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh...
September 9, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#13
RANDOMIZED CONTROLLED TRIAL
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28863039/extracorporeal-membrane-oxygenation-for-end-stage-interstitial-lung-disease-with-secondary-pulmonary-hypertension-at-rest-and-exercise-insights-from-simulation-modeling
#14
Scott Chicotka, Daniel Burkhoff, Marc L Dickstein, Matthew Bacchetta
Interstitial lung disease (ILD) represents a collection of lung disorders with a lethal trajectory with few therapeutic options with the exception of lung transplantation. Various extracorporeal membrane oxygenation (ECMO) configurations have been used for bridge to transplant (BTT), yet no optimal configuration has been clearly demonstrated. Using a cardiopulmonary simulation, we assessed different ECMO configurations for patients with end-stage ILD to assess the physiologic deficits and help guide the development of new long-term pulmonary support devices...
August 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28862375/analysis-of-in-pact-deep-trial-on-the-association-between-changes-in-perfusion-from-pre-to-postrevascularization-and-clinical-outcomes-in-critical-limb-ischemia
#15
Tarek A Hammad, Thomas Zeller, Iris Baumgartner, Dierk Scheinert, Krishna J Rocha-Singh, Mehdi H Shishehbor
OBJECTIVES: To quantify changes in ankle and toe pressure from pre- to post-endovascular revascularization for critical limb ischemia (CLI) and examine their association with major adverse limb events (MALE). BACKGROUND: Despite societal guidelines recommendation of routine hemodynamic surveillance following revascularization, little is known about hemodynamic assessment in CLI. METHODS: Among the 358 patients with CLI from the international multicenter IN...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28858972/influence-of-ankle-active-dorsiflexion-movement-guided-by-inspiration-on-the-venous-return-from-the-lower-limbs-a-prospective-study
#16
Hongying Pi, Hong'an Ku, Ting Zhao, Jie Wang, Yicheng Fu
BACKGROUND: Active ankle movement is recommended intervention for preventing deep vein thrombosis effectively and easily by promoting venous return from the lower limbs. The active ankle dorsiflexion and plantar flexion movement guided by deep breathing is considered the most effective method, although outstanding problems remain, including low patient compliance and difficult motion essentials. PURPOSE: The aims of this study were to compare the influence of different ankle active movements on venous return from the lower limbs and to suggest the optimal movement for preventing deep venous thrombosis in the lower limbs...
August 31, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28856523/hemodynamic-support-devices-for-shock-and-high-risk-pci-when-and-which-one
#17
REVIEW
George W Vetrovec
PURPOSE OF REVIEW: This article addresses evolving devices and uses of hemodynamic support in the management of high-risk PCI and AMI with cardiogenic shock. RECENT FINDINGS: Recent publications question the benefit of Intra-aortic Balloon Pump support for AMI Shock. Furthermore, in high-risk PCI, the Impella support system provides better late outcomes than does the intra-aortic balloon pump. We have entered a new era in which larger, higher flow devices that increase cardiac output while unloading the left ventricle provide better outcome...
August 31, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28853220/hemodynamic-evaluation-of-a-biological-and-mechanical-aortic-valve-prosthesis-using-patient-specific-mri-based-cfd
#18
Florian Hellmeier, Sarah Nordmeyer, Pavlo Yevtushenko, Jan Bruening, Felix Berger, Titus Kuehne, Leonid Goubergrits, Marcus Kelm
Modeling different treatment options before a procedure is performed is a promising approach for surgical decision making and patient care in heart valve disease. This study investigated the hemodynamic impact of different prostheses through patient-specific MRI-based CFD simulations. Ten time-resolved MRI data sets with and without velocity encoding were obtained to reconstruct the aorta and set hemodynamic boundary conditions for simulations. Aortic hemodynamics after virtual valve replacement with a biological and mechanical valve prosthesis were investigated...
August 29, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28852976/experimental-study-of-right-ventricular-hemodynamics-after-tricuspid-valve-replacement-therapies-to-treat-tricuspid-regurgitation
#19
Yen Ngoc Nguyen, Munirah Ismail, Foad Kabinejadian, Chi Wei Ong, Edgar Lik Wui Tay, Hwa Liang Leo
The increased understanding of right heart diseases has led to more aggressive interventions to manage functional tricuspid regurgitation (FTR). In some cases of FTR, prosthetic valve replacement is typically considered when concomitant organic components or significant geometrical distortions are involved in the pathology of the tricuspid valve. However, little is known of the performance of current devices in the right heart circulation. In this study, a novel in vitro mock circulatory system that incorporated a realistic tricuspid valve apparatus in a patient-specific silicon right ventricle (RV) was designed and fabricated...
August 29, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28847146/on-x-versus-st-jude-medical-mechanical-prosthesis-in-mitral-position-are-we-moving-forward-in-design-technology
#20
Ezzeldin A Mostafa, Ashraf A El Midany, Ahmed S Taha, Saeed R El Aasy, Ayman A Doghish, Ahmed Helmy, Sherif A Mansour, Ramy Khorshid, Hosam E Ashor, Yaser Elnahas, Mohammed Saffan
BACKGROUND: Continuous effort is still provided in designing optimal artificial heart valves with better hemodynamic function and reduced thromboembolic potential. The question is do we have moved forward toward this goal or not. METHODS: A prospective, randomized comparative study was done on 360 patients scheduled for elective mitral valve replacement. Patients were grouped into On-X group (n=180) who received On-X mechanical valve and SJM (n=180) who received St Jude mechanical valve...
July 28, 2017: Journal of Cardiovascular Surgery
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