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Circulatory Support

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https://www.readbyqxmd.com/read/27932340/is-walk-score-associated-with-hospital-admissions-from-chronic-diseases-evidence-from-a-cross-sectional-study-in-a-high-socioeconomic-status-australian-city-state
#1
Soumya Mazumdar, Vincent Learnihan, Thomas Cochrane, Hai Phung, Bridget O'Connor, Rachel Davey
OBJECTIVES: To explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs. DESIGN: A cross-sectional analysis of public hospital episode data (2007-2013). SETTING: Hospitalisations from the ACT, Australia at very small geographic areas. PARTICIPANTS: Secondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27931654/the-response-of-the-microcirculation-to-mechanical-support-of-the-heart-in-critical-illness
#2
REVIEW
Sakir Akin, Atila Kara, Corstiaan A den Uil, Can Ince
Critical illness associated with cardiac pump failure results in reduced tissue perfusion in all organs and occurs in various conditions such as sepsis, cardiogenic shock, and heart failure. Mechanical circulatory support (MCS) devices can be used to maintain organ perfusion in patients with cardiogenic shock and decompensated chronic heart failure. However, correction of global hemodynamic parameters by MCS does not always cause a parallel improvement in microcirculatory perfusion and oxygenation of the organ systems, a condition referred to as a loss of hemodynamic coherence between macro- and microcirculation (MC)...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931587/do-prior-driveline-infections-increase-the-risk-of-infection-in-heart-transplant-patients-treated-with-rabbit-antithymocyte-globulin-induction-therapy
#3
D Arman, D Kuraitis, J Moriguchi, M Hamilton, F Liou, S Siddiqui, M Luu, P Zakowski, F Arabia, J Kobashigawa
BACKGROUND: The use of mechanical circulatory support devices (MCSDs) has been increasing over the past several years. Driveline infections (DLIs) are one of the most common complications seen in these patients; reportedly, up to 50% of patients with MCSDs can develop this complication. It is believed that the removal of the driveline results in treatment of the localized infection area. MCSD patients are also known to develop circulating antibodies. These circulating antibodies have been associated with poor outcomes after heart transplantation...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27928595/-left-ventricular-unloading-in-cardiogenic-shock
#4
A Schäfer, J Bauersachs
Cardiogenic shock is an acute life-threatening condition, which results in impaired end-organ perfusion and oxygenation. Invasive ventilation and medicinal treatment with inotropes or vasopressors are necessary in most cases; however, they are also associated with reduced long-term prognosis. Frequently, medical treatment is not even sufficient to stabilize the patient; therefore, dedicated mechanical circulatory support devices that actively reduce the load on the left ventricle were developed to allow myocardial recovery or to gain time until definitive treatment...
December 7, 2016: Herz
https://www.readbyqxmd.com/read/27927755/characteristics-and-outcomes-of-patients-with-myocarditis-listed-for-heart-transplantation
#5
Chantal A ElAmm, Sadeer G Al-Kindi, Guilherme H Oliveira
BACKGROUND: Myocarditis can cause dilated cardiomyopathy resulting in end-stage heart failure requiring advanced therapies. There is little contemporary information on the clinical progression, need for mechanical circulatory support, and outcomes of orthotopic heart transplantation of these patients. METHODS AND RESULTS: We queried the UNOS database (United Network for Organ Sharing) for all adults listed for orthotopic heart transplantation (2000-2015) with a listed diagnosis of myocarditis...
December 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27922888/experience-with-extracorporeal-life-support-for-cardiogenic-shock-in-the-older-population-over-70-years-of-age
#6
Margaux Pontailler, Pierre Demondion, Guillaume Lebreton, Jean-Louis Golmard, Pascal Leprince
The both aims of this single-centre, retrospective study were to analyse the outcomes and to identify the independent predictors of 30-day and long-term mortality in case of cardiopulmonary resuscitation requiring extracorporeal life support (ECLS) in the elderly.From October 2004 to May 2014, 163 patients with a mean age of 75.5 years [range 70-91] required veno-arterial ECLS. The main indication was post-cardiotomy cardiogenic shock (79.6%). ECLS duration averaged 5.6 ± 4.3 days. Thirty-day mortality was 72% (n=117) and follow-up survival rate was 14...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922885/ventricular-assist-device-implantation-configurations-impact-overall-mechanical-circulatory-support-system-thrombogenic-potential
#7
Wei-Che Chiu, Yared Alemu, Allison J McLarty, Shmuel Einav, Marvin J Slepian, Danny Bluestein
Ventricular assist devices (VAD) became in recent years the standard of care therapy for advanced heart failure with hemodynamic compromise. With the steadily growing population of device recipients, various post-implant complications have been reported, mostly associated with the hyper-shear generated by VADs that enhance their thrombogenicity by activating platelets. While VAD design optimization can significantly improve its thromboresistance, the implanted VAD need to be evaluated as part of a system. Several clinical studies indicated that variability in implantation configurations may contribute to the overall system thrombogenicity...
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
#8
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/27919719/impact-of-left-heart-bypass-on-arterial-oxygenation-during-one-lung-ventilation-for-thoracic-aortic-surgery
#9
Kikuko Suga, Yoshiro Kobayashi, Ryoichi Ochiai
OBJECTIVE: The aim of this study was to reveal the mechanism of improved arterial oxygenation by measuring the changes in oxygenation before and after initiation of left heart bypass (LHB) during one-lung ventilation (OLV) for thoracic aortic surgery. DESIGN: Prospective, observational study. SETTING: Single-institution, private hospital. PARTICIPANTS: The study comprised 50 patients who underwent aortic surgery via a left thoracotomy approach with LHB circulatory support...
September 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27919337/radiation-and-circulatory-disease
#10
Mark P Little
Exposure to therapeutic doses of ionizing radiation is associated with damage to the heart and coronary arteries. However, only recently have studies with high-quality individual dosimetry data allowed this risk to be quantified while also adjusting for concomitant chemotherapy, and medical and lifestyle risk factors. At lower levels of exposure the evidence is less clear. In this article I review radiation-associated risks of circulatory disease in groups treated with radiotherapy for malignant and non-malignant disease, and in occupationally- or environmentally-exposed groups receiving rather lower levels of radiation dose, also for medical diagnostic purposes...
October 2016: Mutation Research
https://www.readbyqxmd.com/read/27916778/predictive-value-of-qrs-duration-at-admission-for-in-hospital-clinical-outcome-of-takotsubo-cardiomyopathy
#11
Tetsuo Yamaguchi, Tsutomu Yoshikawa, Toshiaki Isogai, Takamichi Miyamoto, Yuichiro Maekawa, Tetsuro Ueda, Konomi Sakata, Tsutomu Murakami, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
BACKGROUND: Prolonged QRS duration (pQRSd) on electrocardiogram (ECG) is a strong predictor of poor outcome in heart failure, myocardial infarction, and myocarditis, but it is unclear whether pQRSd also predicts poor outcomes of takotsubo cardiomyopathy (TC).Methods and Results:Between 1 January 2010 and 31 December 2012, we retrospectively enrolled 299 patients with TC (mean age, 73.5±11.7 years; 21.4% male) from the Tokyo CCU Network database, which consists of 71 cardiovascular centers in the metropolitan area...
December 2, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27916741/design-and-principle-of-operation-of-the-heartmate-phptm-percutaneous-heart-pump
#12
N M Van Mieghem, Joost Daemen, Corstiaan den Uil, Onur Dur, Linda Joziasse, AnneMarie Maugenest, Keif Fitzgerald, Chris Parker, Paul Muller, Robert-Jan van Geuns
The HeartMate PHP (Percutaneous Heart Pump) is a second-generation transcatheter axial flow circulatory support system. The collapsible catheter pump is inserted through a 14F sheath, deployed across the aortic valve expanding to 24F and able to deliver up to 5L/min blood flow at minimum hemolytic risk. As such this device may be a valuable adjunct to percutaneous coronary intervention (PCI) of challenging lesions in high-risk patients or treatment of cardiogenic shock. This technical report discusses: (i) the HeartMate PHP concept, (ii) the implantation technique, (iii) the hemodynamic performance in an in vitro cardiovascular flow testing setup and (iv) preliminary clinical experience...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#13
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27909480/a-case-of-wide-complex-tachycardia-in-a-patient-with-a-biventricular-assist-device
#14
Abrams Mark P, Whang William, Iyer Vivek, Garan Hasan, Biviano Angelo
This case report highlights the variety of wide complex tachycardias, and the need for their prompt management, in the growing population of patients with circulatory support devices. We present a case that demonstrates how a wide complex supraventricular tachycardia in a patient with a biventricular assist device can be safely and effectively targeted for treatment using percutaneous radiofrequency catheter ablation, allowing for clinical improvement, weaning of RVAD treatment, and discharge home with LVAD alone...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27906830/heterotopic-abdominal-rat-heart-transplantation-as-a-model-to-investigate-volume-dependency-of-myocardial-remodeling
#15
Kálmán Benke, Alex Ali Sayour, Csaba Mátyás, Bence Ágg, Balázs Tamás Németh, Attila Oláh, Mihály Ruppert, István Hartyánszky, Zoltán Szabolcs, Tamás Radovits, Béla Merkely, Gábor Szabó
Heterotopic abdominal rat heart transplantation has been extensively used to investigate ischemic/reperfusion injury, immunological consequences during heart transplantations and also to study remodeling of the myocardium due to volume unloading. We provide a unique review on the latter and present a summary of the experimental studies on rat heart transplantation to illustrate changes that occur to the myocardium due to volume unloading. We divided the literature based on whether normal or failing rat heart models were used...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#16
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27895411/reoperation-in-an-adult-female-with-right-sided-hirschsprung-s-disease-complicated-by-refractory-hypertension-and-cough
#17
Zhi-Jian Wei, Lei Huang, A-Man Xu
Hirschsprung's disease (HD) is an intestinal malformation caused by the innate absence of ganglion cells in the neural plexus of the colorectal wall, and is most common in male infants. It is rare in adult, and is usually left-sided. Herein we reported based on the CARE guidelines a case of a 47-year-old adult female suffering from "right-sided" HD complicated by refractory hypertension and cough. The patient with a history of cesarean section and with digestive unfitness (abdominal pain, distention, and constipation) only since 20 years old had recurrence of HD after initial surgery due to the incomplete removal of the HD-affected bowel based on a diagnosis of "chronic ileus", leading to the relapse of the digestive symptoms and the emergence of some intractable circulatory and respiratory complications which could be hardly controlled by conservative treatment...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27892719/is-a-pulse-absolutely-necessary-during-cardiopulmonary-bypass
#18
Gengo Sunagawa, Marijan Koprivanac, Jamshid H Karimov, Nader Moazami, Kiyotaka Fukamachi
The benefits and disadvantages of pulsatility in mechanical circulatory support devices have been argued since before the first use of cardiopulmonary bypass (CPB) with a nonpulsatile pump. The debate over the superiority of either pulsatile or nonpulsatile perfusion during CPB persists, but recently, the evidence in favor of pulsatile perfusion during CPB is increasing. Complications associated with chronic nonpulsatile flow in patients implanted with left ventricular assist devices have renewed interest in generating pulsatility with these devices...
November 28, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27889846/gastrointestinal-bleeding-during-index-hospitalization-for-mechanical-circulatory-support-devices-implantation-is-the-squeeze-worth-the-ooze
#19
EDITORIAL
Darius A Jahann, Vanessa M Shami
No abstract text is available yet for this article.
November 26, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27888865/advances-in-gastrointestinal-bleeding
#20
Ángel Lanas
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin...
September 2016: Gastroenterología y Hepatología
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