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https://www.readbyqxmd.com/read/29907499/incidence-of-temporary-mechanical-circulatory-support-before-heart-transplantation-and-impact-on-post-transplant-outcomes
#1
David Ouyang, Gunsagar Gulati, Richard Ha, Dipanjan Banerjee
BACKGROUND: Proposed changes to the United Network for Organ Sharing heart transplant allocation protocol will prioritize patients receiving temporary mechanical circulatory support (tMCS), including extracorporeal membrane oxygenation (ECMO), percutaneous ventricular assist devices (PVADs), and intra-aortic balloon pumps (IABPs). We sought to evaluate contemporary trends in the incidence and outcomes of patients who required tMCS during the hospitalization before heart transplantation...
April 26, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29902098/acute-right-ventricular-myocardial-infarction
#2
Arif Albulushi, Andreas Giannopoulos, Nikolaos Kafkas, Stylianos Dragasis, Gregory Pavlides, Yiannis S Chatzizisis
Acute right ventricle myocardial infarction (RVMI) is observed in 30-50% of patients presenting with inferior wall myocardial infarction and, occasionally, with anterior wall myocardial infarction. The clinical consequences vary from no hemodynamic compromise to severe hypotension and cardiogenic shock depending on the extent of RV ischemia. Areas covered: The pathophysiological mechanisms, diagnostic steps and novel therapeutic approaches of acute RVMI are described. Expert commentary: Diagnosis of acute RVMI is based on physical examination, cardiac biomarkers, electrocardiography and coronary angiography, whereas non-invasive imaging modalities (echocardiography, cardiac magnetic resonance imaging) play a complementary role...
June 14, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29901460/mechanical-circulatory-devices-in-acute-heart-failure
#3
Marc Pineton de Chambrun, Nicolas Bréchot, Alain Combes
PURPOSE OF REVIEW: Temporary circulatory support (TCS) with short-term mechanical circulatory support (MCS) devices is increasingly used as a salvage therapy for patients with refractory cardiogenic shock. This article provides an overview of current devices, their indications and management, and discusses results of recent case series and trials. RECENT FINDINGS: Percutaneous active MCS devices (Impella, TandemHeart…) and venoarterial extracorporeal membrane oxygenation (VA-ECMO) are utilized as a bridge to 'decision' that includes weaning after cardiac function recovery, transplantation, long-term MCS and withdrawal in case of futility...
June 8, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29893357/one-year-outcomes-in-patients-with-st-segment-elevation-myocardial-infarction-caused-by-unprotected-left-main-coronary-artery-occlusion-treated-by-primary-percutaneous-coronary-intervention
#4
Hai-Wei Liu, Ya-Ling Han, Quan-Min Jin, Xiao-Zeng Wang, Ying-Yan Ma, Geng Wang, Bin Wang, Kai Xu, Yi Li, Shao-Liang Chen
Background: Very few data have been reported for ST-segment elevation myocardial infarction (STEMI) caused by unprotected left main coronary artery (ULMCA) occlusion, and very little is known about the results of this subgroup of patients who underwent primary percutaneous coronary intervention (PCI). The aim of this study was to determine the clinical features and outcomes of patients with STEMI who underwent primary PCI for acute ULMCA occlusion. Methods: From January 2000 to February 2014, 372 patients with STEMI caused by ULMCA acute occlusion (ULMCA-STEMI) who underwent primary PCI at one of two centers were enrolled...
June 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29892476/ambulatory-intra-aortic-balloon-pump-in-advanced-heart-failure
#5
REVIEW
Syed Yaseen Naqvi, Ibrahim G Salama, Ayhan Yoruk, Leway Chen
Cardiac transplantation is the gold standard treatment for patients with advanced congestive heart failure that is refractory to maximal medical therapy. However, donor heart availability remains the major limiting factor, resulting in a large number of patients waiting long periods of time before transplantation. As a result, mechanical circulatory support devices have been increasingly used as a 'bridge' in order to sustain organ function and stabilise haemodynamics while patients remain on the transplant waiting list or undergo left ventricular assist device surgery...
May 2018: Cardiac Failure Review
https://www.readbyqxmd.com/read/29889168/electrocardiographic-changes-in-patients-with-acute-myocardial-infarction-caused-by-left-main-trunk-occlusion
#6
Cinzia D'Angelo, Silvia Zagnoni, Pamela Gallo, Gianfranco Tortorici, Gianni Casella, Giuseppe Di Pasquale
BACKGROUND: Left main trunk (LMT) occlusion is a rare angiographic finding. The primary purpose was to investigate the ECG pattern of patients with angiographic confirmation of LMT as culprit lesion. METHODS: Forty-eight patients (32 men; mean age 73 years) with angiographic total (21 patients; 44%) or subtotal (27 patients; 56%) occlusion of the LMT were analyzed. Twenty patients (42%) were found to have concomitant coronary lesions. Eighteen patients (38%) required intra-aortic balloon pump support...
June 7, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29877888/salutary-effects-of-the-pulvad-a-novel-implantable-counterpulsation-assist-device-on-cardiac-mechanoenergetics
#7
Christos Kontogiannis, Dionysios Aravantinos, Ioannis Nanas, Chris J Kapelios, Sotirios Marinakis, Styliani Vakrou, Smaragdi Sarchosi, Despina N Perrea, Jay W Mason, John N Nanas, Konstantinos Malliaras
The pressure unloading left ventricular assist device (PULVAD) is a novel implantable counterpulsation LVAD, designed to provide ventricular unloading with augmentation of LV performance and retention of pulsatility. We assessed the effects of the PULVAD on hemodynamics and LV mechanoenergetics in seven farm pigs with acute ischemic heart failure. The PULVAD was implanted in the thorax and was connected to the ascending aorta. The PULVAD was pneumatically driven by a standard intra-aortic balloon pump console and was electrocardiogram-synchronized to provide LV pressure unloading along with diastolic aortic pressure augmentation...
June 5, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29850272/unique-ecg-findings-in-acute-pulmonary-embolism-ste-with-reciprocal-changes-and-pathologic-q-wave
#8
Amanda Grant-Orser, Brennan Ballantyne, Wael Haddara
A 68-year-old male presented to the emergency department with retrosternal chest pain, presyncope, and then a pulseless electrical activity cardiac arrest. An ECG prior to his arrest revealed ST elevations in leads V1-V3, Q waves in lead V2, and reciprocal ST depressions in the lateral and inferior leads. He received thrombolytic therapy for a presumptive diagnosis of ST elevation myocardial infarction. Return of spontaneous circulation was achieved and he underwent a coronary angiogram. No critical disease was found and his left ventriculogram showed normal contraction...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29850116/contemporary-applications-of-intra-aortic-balloon-counterpulsation-for-cardiogenic-shock-a-real-world-experience
#9
Federico Pappalardo, Silvia Ajello, Massimiliano Greco, Małgorzata Celińska-Spodar, Michele De Bonis, Alberto Zangrillo, Andrea Montisci
Background: Intra-aortic balloon pump (IABP) had a pivotal role in the therapy of cardiogenic shock (CS), but recent studies have questioned its effects on patients' outcome. Aim of this study is the description of a "real world" series of patients in which IABP was used as a primary mechanical circulatory support (MCS). Methods: All patients who received IABP in our institution during 1 year were prospectively enrolled in our study. The outcomes were: ICU mortality, length of ICU stay, factors associated with mortality and complications of IABP...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29807676/modified-shock-index-a-bedside-clinical-index-for-risk-assessment-of-st-segment-elevation-myocardial-infarction-at-presentation
#10
Glória Abreu, Pedro Azevedo, Carlos Galvão Braga, Catarina Vieira, Miguel Álvares Pereira, Juliana Martins, Carina Arantes, Catarina Rodrigues, Alberto Salgado, Jorge Marques
INTRODUCTION: Prompt identification of higher-risk patients presenting with ST-segment elevation myocardial infarction (STEMI) is crucial to pursue a more aggressive approach. OBJECTIVE: We aimed to assess whether the modified shock index (MSI), the ratio of heart rate to mean arterial pressure, could predict six-month mortality among patients admitted with STEMI. METHODS: A retrospective observational cohort study was performed in a single center including 1158 patients diagnosed with STEMI, without cardiogenic shock on admission, between July 2009 and December 2014...
May 25, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29806528/recovery-from-anthracycline-induced-cardiomyopathy-with-biventricular-assist-and-valve-repairs-a-case-report-and-literature-review
#11
Yoshiyuki Takami, Naoki Hoshino, Yasuchika Kato, Yusuke Sakurai, Kentaro Amano, Yoshiro Higuchi, Masato Tochii, Michiko Ishida, Hiroshi Ishikawa, Yasushi Takagi, Yukio Ozaki
INTRODUCTION: Ventricular assist device is used in the patients with severe heart failure due to cardiotoxicity of anthracyclines, which are widely used chemotherapeutic agents for a wide range of malignant tumors. However, recovery of cardiac function is rare. METHODS: We present the clinical course of a 43-year-old woman in remission from diffuse large B-cell lymphoma after the chemotherapy including anthracyclines, who presented in cardiogenic shock 8 months after the end of chemotherapy...
May 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29792510/in-reply-to-intra-aortic-balloon-pump-protects-against-hydrostatic-pulmonary-oedema-during-peripheral-venoarterial-extracorporeal-membrane-oxygenation
#12
Jamie R Privratsky, Sebastian Diaz, Alina Nicoara, Mani A Daneshmand
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an increasingly utilized life-saving measure. However, left-ventricular distention from inadequate left-ventricular off-loading can lead to unwanted pulmonary and cardiac complications. We are writing to indicate our agreement with a recent article by Brechot et al. published in the June 2017 issue where the authors demonstrated that intra-aortic balloon pump provides mechanical support to off-load the left ventricle during VA-ECMO, which prevents pulmonary edema...
May 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29778750/our-modified-technique-of-combined-antegrade-vein-graft-cardioplegia-infusion-versus-conventional-antegrade-method-in-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#13
Mehrzad Sharifi, Seyed Reza Mousavi, Mohammad Rafiei
BACKGROUND: To determine the efficacy of antegrade cardioplegia supplemented with venous graft perfusion in patients scheduled for coronary artery bypass grafting (CABG). METHODS: 223 consecutive patients scheduled for isolated CABG were randomized to receive either continuous crystalloid cardioplegia via vein grafts on completion of each distal anastomosis plus intermittent blood cardioplegia through aortic root (group 1, n = 110) or antegrade blood cardioplegia alone (group 2, n = 113)...
May 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29777285/insufficient-left-ventricular-unloading-after-extracorporeal-membrane-oxygenation-a-case-series-observational-study
#14
W Hu, J Zhou, L Chen, J Huang, W Hu, Y Zhu, T Yuan
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a method widely used to support circulation in patients with fulminant myocarditis (FM). However, a common complication associated with ECMO is left ventricular (LV) overload. METHODS: This case series observed the effects of intra-aortic balloon pump (IABP) and beta-blockers for the treatment of LV overload after ECMO. The cases of eight patients with FM who underwent ECMO from September 2009 to July 2016 were reviewed...
May 18, 2018: Herz
https://www.readbyqxmd.com/read/29762859/meta-analyses-on-intra-aortic-balloon-pump-in-cardiogenic-shock-complicating-acute-myocardial-infarction-may-provide-biased-results
#15
M C Acconcia, Q Caretta, F Romeo, M Borzi, M A Perrone, D Sergi, F Chiarotti, C M Calabrese, A Sili Scavalli, C Gaudio
OBJECTIVE: Intra-aortic balloon pump (IABP) is the device most commonly investigated in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI). Recently meta-analyses on this topic showed opposite results: some complied with the actual guideline recommendations, while others did not, due to the presence of bias. We investigated the reasons for the discrepancy among meta-analyses and strategies employed to avoid the potential source of bias. MATERIALS AND METHODS: Scientific databases were searched for meta-analyses of IABP support in AMI complicated by CS...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29755073/-beating-mitral-valve-replacement-for-functional-mitral-regurgitation-after-cardiac-resynchronization-therapy-report-of-a-case
#16
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi
A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29754660/predictors-of-intra-aortic-balloon-pump-hemodynamic-failure-in-non-acute-myocardial-infarction-cardiogenic-shock
#17
Steven Hsu, Swetha Kambhampati, Christopher M Sciortino, Stuart D Russell, Steven P Schulman
OBJECTIVES: To characterize patient profile and hemodynamic profile of those undergoing intra-aortic balloon pump (IABP) for cardiogenic shock and define predictors of hemodynamic failure of IABP support. BACKGROUND: Clinical characteristics of IABP support in cardiogenic shock not related to acute myocardial infarction (AMI) remain poorly characterized. METHODS: We retrospectively studied a cohort of 74 patients from 2010 to 2015 who underwent IABP insertion for cardiogenic shock complicating acute decompensated heart failure not due to AMI...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29748076/comparison-of-levosimendan-and-milrinone-for-ecls-weaning-in-patients-after-cardiac-surgery-a-retrospective-before-and-after-study
#18
Annina Jacky, Alain Rudiger, Bernard Krüger, Markus J Wilhelm, Sebastian Paal, Burkhardt Seifert, Donat R Spahn, Dominique Bettex
OBJECTIVES: Pharmacodynamics suggests that levosimendan might be a valuable inotrope for weaning from extracorporeal life support (ECLS). As there is a paucity of evidence regarding the effectiveness and safety of such an approach, the aim was to report the authors' experiences in ECLS weaning before and after the implementation of levosimendan in clinical practice. DESIGN: Retrospective before-and-after study. SETTING: Cardiac intensive care unit of a university hospital...
April 6, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29727370/effect-of-a-perioperative-intra-aortic-balloon-pump-in-high-risk-cardiac-surgery-patients-a-randomized-clinical-trial
#19
Graziela Santos Rocha Ferreira, Juliano Pinheiro de Almeida, Giovanni Landoni, Jean Louis Vincent, Evgeny Fominskiy, Filomena Regina Barbosa Gomes Galas, Fabio A Gaiotto, Luís Oliveira Dallan, Rafael Alves Franco, Luiz Augusto Lisboa, Luis Roberto Palma Dallan, Julia Tizue Fukushima, Stephanie Itala Rizk, Clarice Lee Park, Tânia Mara Strabelli, Silvia Helena Gelas Lage, Ligia Camara, Suely Zeferino, Jaquelline Jardim, Elisandra Cristina Trevisan Calvo Arita, Juliana Caldas Ribeiro, Silvia Moreira Ayub-Ferreira, Jose Otavio Costa Auler, Roberto Kalil Filho, Fabio Biscegli Jatene, Ludhmila Abrahao Hajjar
OBJECTIVES: The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN: A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING: Heart Institute of São Paulo University. PATIENTS: High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION: Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use...
April 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29721682/-infarct-related-cardiogenic-shock-prognosis-and-treatment
#20
REVIEW
R Prondzinsky, H Lemm, A Geppert, M Buerke, M Russ, K Werdan
Patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) experience cardiogenic shock in about 6-10% of cases during the hospital treatment. In recent years, the incidence seems to be decreasing due to invasive diagnostics and therapy after myocardial infarction. Early diagnosis is important to initiate immediate revascularization using percutaneous coronary intervention (PCI) with stent implantation as part of cardiogenic shock treatment. Thus, a significant improvement in survival can be achieved...
May 2, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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