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Circulatory Support

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https://www.readbyqxmd.com/read/28730986/long-term-use-of-left-ventricular-assist-devices-a-report-on-clinical-outcomes
#1
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/28730545/platelet-first-responders-in-wound-response-cancer-and-metastasis
#2
REVIEW
David G Menter, Scott Kopetz, Ernest Hawk, Anil K Sood, Jonathan M Loree, Paolo Gresele, Kenneth V Honn
Platelets serve as "first responders" during normal wounding and homeostasis. Arising from bone marrow stem cell lineage megakaryocytes, anucleate platelets can influence inflammation and immune regulation. Biophysically, platelets are optimized due to size and discoid morphology to distribute near vessel walls, monitor vascular integrity, and initiate quick responses to vascular lesions. Adhesion receptors linked to a highly reactive filopodia-generating cytoskeleton maximizes their vascular surface contact allowing rapid response capabilities...
July 20, 2017: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/28728723/surgical-treatment-of-heart-failure
#3
REVIEW
Robert S D Higgins, Ahmet Kilic, Daniel G Tang
More than 5 million Americans suffer from heart failure and more than 250,000 die annually. Cardiac surgery, as applied to advanced heart failure, has evolved significantly in the past 50 years. Current therapeutic interventions are focused on the appropriate assessment of myocardial dysfunction as a means to select the right patient for the appropriate procedure using state-of-the-art myocardial viability testing and metabolic testing to determine candidacy for conventional interventions, mechanical devices, or transplant...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28723830/early-versus-delayed-coronary-artery-bypass-graft-surgery-for-patients-with-non-st-elevation-myocardial-infarction
#4
Le Dung Ha, Gbolahan Ogunbayo, Ayman Elbadawi, Odunayo Olorunfemi, Adrian Messerli
BACKGROUND: Although coronary artery bypass graft surgery (CABG) has been proven to have mortality and morbidity benefits in patients with non-ST elevation myocardial infarction and multivessel disease, the appropriate timing of this procedure remains unclear. Therefore, we proposed a propensity score-matched analysis comparing the clinical outcomes between patients who underwent CABG within the first 48 h of admission (early CABG) and patients who underwent CABG after 48 h of admission (delayed CABG)...
July 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28720202/a-novel-surgical-approach-to-mechanical-circulatory-support-in-univentricular-infants
#5
Avihu Z Gazit, Orlando Petrucci, Peter Manning, Mark Shepard, Sirine Baltagi, Kathleen Simpson, Chesney Castleberry, Charles Canter, Pirooz Eghtesady
BACKGROUND: Historically, the options for mechanical circulatory support in infants, particularly those with single-ventricle physiology, have been limited and outcomes have generally been poor. We report a new approach implemented for long-term support in a series of such patients. METHODS: This study is a single-center case series of 7 patients with single-ventricle physiology after stage 1 palliation supported with mechanical circulatory support using a novel technique, between May 2014 and September 2015...
July 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28716832/mechanical-circulatory-support-devices-for-acute-right-ventricular-failure
#6
REVIEW
Navin K Kapur, Michele L Esposito, Yousef Bader, Kevin J Morine, Michael S Kiernan, Duc Thinh Pham, Daniel Burkhoff
Right ventricular (RV) failure remains a major cause of global morbidity and mortality for patients with advanced heart failure, pulmonary hypertension, or acute myocardial infarction and after major cardiac surgery. Over the past 2 decades, percutaneously delivered acute mechanical circulatory support pumps specifically designed to support RV failure have been introduced into clinical practice. RV acute mechanical circulatory support now represents an important step in the management of RV failure and provides an opportunity to rapidly stabilize patients with cardiogenic shock involving the RV...
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28716615/development-of-a-protocol-for-successful-palliative-care-consultation-in-population-of-patients-receiving-mechanical-circulatory-support
#7
Shilpee Sinha, Carey Belcher, Alexia Torke, Joycelyn Howard, Marco Caccamo, James A Slaven, Irmina Gradus-Pizlo
BACKGROUND: In 2014, Joint Commission recommended palliative care (PC) engagement in ventricular assist device (VAD) implantation as destination therapy. Limited information is available on established PC protocols in the mechanical circulatory support (MCS) population. MEASURES: The goals of our PC consultation were to document advance care planning (ACP) discussions and designate a surrogate decision maker (SDM) prior to MCS implantation. A retrospective analysis compared the frequency of PC consults, ACP discussion, and SDM before and after protocol implementation...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28716039/extra-corporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-after-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#8
Maziar Khorsandi, Scott Dougherty, Omar Bouamra, Vasudev Pai, Philip Curry, Steven Tsui, Stephen Clark, Stephen Westaby, Nawwar Al-Attar, Vipin Zamvar
BACKGROUND: Postcardiotomy cardiogenic shock (PCCS) refractory to inotropic support and intra-aortic balloon pump (IABP) occurs rarely but is almost universally fatal without mechanical circulatory support. In this systematic review and meta-analysis we looked at the evidence behind the use of veno-arterial extra-corporeal membrane oxygenation (VA ECMO) in refractory PCCS from a patient survival rate and determinants of outcome viewpoint. METHODS: A systematic review was performed in January 2017 using PubMed (with no defined time period) using the keywords "postcardiotomy", "cardiogenic shock", "extracorporeal membrane oxygenation" and "cardiac surgery"...
July 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28712584/the-advantage-of-early-plication-in-children-diagnosed-with-diaphragm-paresis
#9
Alejandro A Floh, Intikhab Zafurallah, Cathy MacDonald, Osami Honjo, Chun-Po S Fan, Peter C Laussen
BACKGROUND: In this single-center study, we sought to determine the frequency of phrenic nerve injury leading to diaphragm paresis (DP) in children following open cardiac surgery over the last 10 years, and to identify possible variables that predict the need for plication and associated clinical outcomes. METHODS: Patients diagnosed with DP were identified from departmental databases and a review of clinical diaphragm ultrasound images. A cohort was analyzed for predictors of diaphragm plication and associations with clinical outcomes...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28707188/hemodynamic-benefits-of-counterpulsation-implantable-percutaneous-and-intraaortic-rotary-blood-pumps-an-in-silico-and-in-vitro-study
#10
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/28706587/management-of-ventricular-tachycardia-storm-in-patients-with-structural-heart-disease
#11
REVIEW
Daniele Muser, Pasquale Santangeli, Jackson J Liang
Electrical storm (ES) is a medical emergency characterized by repetitive episodes of sustained ventricular arrhythmias (VAs) in a limited amount of time (at least 3 within a 24-h period) leading to repeated appropriate implantable cardioverter defibrillator therapies. The occurrence of ES represents a major turning point in the natural history of patients with structural heart disease being associated with poor short- and long-term survival particularly in those with compromised left ventricular ejection fraction (LVEF) that can develop hemodynamic decompensation and multi-organ failure...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28706127/percutaneous-mechanical-circulatory-support-for-cardiac-disease-temporal-trends-in-use-and-complications-between-2009-and-2015
#12
Bradley W Ternus, Jacob C Jentzer, Abdallah El Sabbagh, Mackram F Eleid, Malcolm R Bell, Joseph G Murphy, Charanjit S Rihal, Gregory W Barsness
BACKGROUND: We present the indications for use, temporal trends, complications, and 1-year clinical outcomes after single-access percutaneous mechanical circulatory support device placement from years 2009-2015 at our institution. METHODS AND RESULTS: Patients with an intraaortic balloon pump (IABP) or Impella device placed in the catheterization suite between January 1, 2009 and December 31, 2015 were included. There were a total of 778 patients in this study. The mean number of devices placed per year was 111...
July 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28703280/the-oregonheart-total-artificial-heart-design-and-performance-on-a-mock-circulatory-loop
#13
Jeremy Glynn, Howard Song, Bryan Hull, Stanley Withers, Jill Gelow, James Mudd, Albert Starr, Richard Wampler
Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation...
July 13, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28698113/patient-specific-biomechanical-model-of-hypoplastic-left-heart-to-predict-post-operative-cardio-circulatory-behaviour
#14
Elena Cutrì, Alessio Meoli, Gabriele Dubini, Francesco Migliavacca, Tain-Yen Hsia, Giancarlo Pennati
Hypoplastic left heart syndrome is a complex congenital heart disease characterised by the underdevelopment of the left ventricle normally treated with a three-stage surgical repair. In this study, a multiscale closed-loop cardio-circulatory model is created to reproduce the pre-operative condition of a patient suffering from such pathology and virtual surgery is performed. Firstly, cardio-circulatory parameters are estimated using a fully closed-loop cardio-circulatory lumped parameter model. Secondly, a 3D standalone FEA model is build up to obtain active and passive ventricular characteristics and unloaded reference state...
July 8, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28694491/measuring-the-energy-of-ventilation-and-circulation-during-human-walking-using-induced-hypoxia
#15
Masahiro Horiuchi, Yoshiyuki Fukuoka, Yoko Handa, Daijiro Abe, Herman Pontzer
Energy expenditure (EE) during walking includes energy costs to move and support the body and for respiration and circulation. We measured EE during walking under three different oxygen concentrations. Eleven healthy, young, male lowlanders walked on a treadmill at seven gait speeds (0.67-1.83 m s(-1)) on a level gradient under normobaric normoxia (room air, 21% O2), moderate hypoxia (15% O2), and severe hypoxia (11% O2). By comparing the hypoxia-induced elevation in heart rate (HR [bpm]), ventilation (VE [L min(-1)]) with the change in energy expenditure (EE [W]) at each speed, we were able to determine circulatory and respiratory costs...
July 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28692527/sildenafil-in-left-ventricular-assist-device-is-safe-and-well-tolerated
#16
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/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#17
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28690174/clinical-outcomes-of-donation-after-circulatory-death-liver-transplantation-in-primary-sclerosing-cholangitis
#18
Palak J Trivedi, Irene Scalera, Emma Slaney, Richard W Laing, Bridget Gunson, Gideon M Hirschfield, Andrea Schlegel, James Ferguson, Paolo Muiesan
BACKGROUND AND AIM: Primary sclerosing cholangitis (PSC) is a progressive fibro-inflammatory cholangiopathy for which liver transplantation is the only life-extending intervention. These patients may benefit from accepting liver donation after circulatory death (DCD), however their subsequent outcome is unknown. METHODS: Clinical outcomes were prospectively evaluated in PSC patients undergoing transplantation from 2006 to 2016 stratified by donor type (DCD, n=35 vs...
July 6, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28687339/inflammation-and-myointimal-hyperplasia-correlation-with-hemodynamic-forces
#19
Antonio V Sterpetti, Alessandra Cucina, Valeria Borrelli, Marco Ventura
OBJECTIVES: The aim of our study was to correlate flow dynamics and the release of inflammatory cytokines Interleukin 1, 2, 6, TNF (Tumour Necrosis Factor) alfa, both in vitro and in vivo. MATERIALS AND METHODS: Endothelial cells were exposed to laminar flow (6dyne/cm(2)) in an in vitro circulatory system and the release of Interleukin 1, 2, 6 and TNF alfa was quantified by ELISA. Interleukin 1, 2, 6 and TNF alfa release was also assessed in vein grafts implanted in the arterial circulation of Lewis rats...
July 5, 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28680268/driveline-infection-in-ventricular-assist-devices-and-its-implication-in-the-present-era-of-destination-therapy
#20
REVIEW
Gabriel A Hernandez, Jonatan D Nunez Breton, Sandra V Chaparro
Advances in mechanical circulatory support devices provided the technology to develop long-term, implantable left ventricular assist devices as bridge to transplant, destination therapy, and in a lesser group of patients, as bridge to recovery. Despite the benefits from this innovative therapy, with their increased use, many complications have been encountered, one of the most common being infections. With the driveline acting as a portal to the exterior environment, an infection involving this structure is the most frequent one...
2017: Open Journal of Cardiovascular Surgery
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