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Circulatory Support

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https://www.readbyqxmd.com/read/29470245/intra-aortic-balloon-pump-use-before-left-ventricular-assist-device-implantation-insights-from-the-intermacs-registry
#1
Adam D DeVore, Bradley G Hammill, Chetan B Patel, Manesh R Patel, Joseph G Rogers, Carmelo A Milano, Adrian F Hernandez
Use of durable, continuous-flow left ventricular assist devices (LVADs) has expanded rapidly, although data are limited regarding optimization strategies before LVAD implantation. We examined current use of intra-aortic balloon pumps (IABPs) before LVAD implantation and compared outcomes of patients with IABP use to those without. We analyzed data from the Interagency Registry for Mechanical Assisted Circulatory Support (INTERMACS) on patients who underwent LVAD implantation between 2006 and 2014. We limited the analysis to patients with an admitting diagnosis of LVAD placement...
March 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29465438/the-evolving-role-of-percutaneous-ventricular-assist-devices-in-high-risk-cardiac-patients
#2
Ilan A Marcuschamer, Aryeh Abelow, Ran Kornowski
The Impella is a mechanical circulatory support device that supports ventricular function. Since 2008, when the first Impella device received Food and Drug Administration clearance, its use has become increasingly prevalent. A variety of Impella devices are available, and are differentiated by size, power, and insertion techniques. These versions of the Impella have been used in a multitude of clinical scenarios, both emergent and elective, including high-risk coronary interventions, acute myocardial infarction complicated by cardiogenic shock, decompensated left and right heart failure, high-risk ventricular tachycardia ablations, and aortic valvuloplasty...
February 20, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29465166/full-percutaneous-biventricular-support-with-two-impella-pumps-the-bi-pella-approach
#3
Federico Pappalardo, Anna Mara Scandroglio, Azeem Latib
Extracorporeal membrane oxygenation is used for acute respiratory distress syndrome, refractory cardiogenic shock, and out-of-hospital cardiac arrest with uncertain neurological status, and, until recently, it was the only minimally invasive option to achieve biventricular support. However, extracorporeal membrane oxygenation increases left ventricular afterload and requires systemic anticoagulation, which is a major contraindication in the context of thrombolytic therapy following an ischaemic stroke. Conversely, the Impella heart pumps by design unload the ventricle and require minimal anticoagulation...
February 21, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29465089/-combined-thorax-abdomen-extraction-in-a-maastricht-type-iii-donor
#4
M Barber Ansón, A N García Herrera, J Roldán Ramírez, M Loinaz Bordonabe, O Agudo Pascual, I Osés Munarriz
Donation after circulatory death (Maastricht type III donation) or controlled cardiac death refers to the retrieval of organs for transplantation purposes following death confirmed using circulatory criteria after the withdrawal of life support. The persistent shortfall in organ availability has prompted the development of donation programs following circulatory death for lung transplantation. The combined thorax-abdomen extraction in these cases is carried out in only twelve centres in Spain, while the combined use of abdominal normothermic regional perfusion (NRP) is even more exceptional...
February 21, 2018: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29462490/open-surgical-repair-of-post-dissection-thoraco-abdominal-aortic-aneurysms-early-and-late-outcomes-of-a-single-centre-study-involving-over-200-patients
#5
Jacopo Alfonsi, Giacomo Murana, Henri G Smeenk, Hans Kelder, Marc Schepens, Uday Sonker, Wim J Morshuis, Robin H Heijmen
OBJECTIVES: Chronic, post-dissection thoraco-abdominal aortic aneurysms (TAAAs) are increasingly being treated by (hybrid) endovascular means. Although it is less invasive, thoracic endovascular aortic repair is technically complex with the risk of incomplete aneurysm exclusion, necessitating frequent reinterventions with potentially reduced long-term outcomes. The aim of this study was to evaluate contemporary early and late outcomes after open surgical repair of post-dissection TAAA...
February 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29460404/the-five-key-ingredients-for-improving-outcomes-in-cardiogenic-shock-complicating-acute-myocardial-infarction
#6
EDITORIAL
Emmanouil S Brilakis, Peter Eckman
Cardiogenic shock in the setting of acute myocardial infarction (AMICS) carries high mortality. A systematic, protocol-driven, approach to AMICS may improve outcomes. The 5 key "ingredients" for the managements of AMICS are: (a) early diagnosis; (b) hemodynamic assessment; (c) culprit-only coronary revascularization; (d) judicious use of mechanic circulatory support; (e) expert in-hospital treatment.
February 15, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29458041/role-of-superoxide-ion-formation-in-hypothermia-rewarming-induced-contractile-dysfunction-in-cardiomyocytes
#7
Niccole Schaible, Young Soo Han, Torkjel Tveita, Gary C Sieck
Rewarming following accidental hypothermia is associated with circulatory collapse due primarily to impaired cardiac contractile (systolic) function. Previously, we found that reduced myofilament Ca2+ sensitivity underlies hypothermia/rewarming (H/R)-induced cardiac contractile dysfunction. This reduced Ca2+ sensitivity is associated with troponin I (cTnI) phosphorylation. We hypothesize that H/R induces reactive oxygen species (ROS) formation in cardiomyocytes, which leads to cTnI phosphorylation and reduced myofilament Ca2+ sensitivity...
February 16, 2018: Cryobiology
https://www.readbyqxmd.com/read/29457368/emergence-of-two-novel-sublineages-ind2001bd1-and-ind2001bd2-of-foot-and-mouth-disease-virus-serotype-o-in-bangladesh
#8
M A Siddique, M R Ali, A S M R U Alam, H Ullah, A Rahman, R P Chakrabarty, M A Amin, S A Hoque, S P Nandi, M Sultana, M A Hossain
Foot-and-mouth disease (FMD) is endemic in Bangladesh, and the implementation of a control programme for this disease is at an early stage, according to the FAO- and OIE-proposed Progressive Control Pathway for FMD (PCP-FMD) Roadmap. To develop an effective control programme, understanding of foot-and-mouth disease virus (FMDV) serotypes, even subtypes within the serotypes is essential. The present investigation aims at viral VP1 coding region sequence-based analysis of FMD samples collected from 34 FMD outbreaks during 2012-2016 in Bangladesh...
February 18, 2018: Transboundary and Emerging Diseases
https://www.readbyqxmd.com/read/29455831/thoracoscopic-sympathectomy-for-refractory-electrical-storm-after-coronary-artery-bypass-grafting
#9
Brody Wehman, Michael Mazzeffi, Robert Chow, A Claire Watkins, Brittany Aicher, Si Pham, Whitney Burrows, Bradley Taylor
We report a patient with refractory electrical storm after coronary artery bypass grafting who was successfully treated with thoracoscopic sympathectomy. Cardiac arrest with ventricular tachycardia occurred on postoperative day 2, and the patient required emergency support with venoarterial extracorporeal membrane oxygenation. Frequent episodes of ventricular tachycardia prevented cardiac recovery and weaning from mechanical circulatory support. A percutaneous left stellate ganglion block initially demonstrated successful prevention of ventricular tachycardia, and definitive sympathetic denervation was achieved by a left thoracoscopic sympathectomy...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29452978/the-management-of-antibodies-in-heart-transplantation-an-ishlt-consensus-document
#10
Jon Kobashigawa, Monica Colvin, Luciano Potena, Duska Dragun, Maria G Crespo-Leiro, Juan F Delgado, Michael Olymbios, Jayan Parameshwar, Jignesh Patel, Elaine Reed, Nancy Reinsmoen, E Rene Rodriguez, Heather Ross, Randall C Starling, Dolly Tyan, Simon Urschel, Andreas Zuckermann
Despite the successes from refined peri-operative management techniques and immunosuppressive therapies, antibodies remain a serious cause of morbidity and mortality for patients both before and after heart transplantation. Patients awaiting transplant who possess antibodies against human leukocyte antigen are disadvantaged by having to wait longer to receive an organ from a suitably matched donor. The number of pre-sensitized patients has been increasing, a trend that is likely due to the increased use of mechanical circulatory support devices...
January 31, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29451075/short-term-outcomes-of-preoperative-intra-aortic-balloon-pump-use-in-patients-undergoing-adjunctive-coronary-endarterectomy-a-retrospective-observational-study
#11
Liangshan Wang, Xing Hao, Xiaomeng Wang, Chengxiong Gu, Hong Wang, Xiaotong Hou
BACKGROUND: Coronary artery bypass grafting (CABG) combined with coronary endarterectomy (CE) can be associated with high operative mortality and morbidity. An intra-aortic balloon pump (IABP) has been the most widely used mechanical circulatory support device during perfusion treatment. However, the benefits of preoperative IABP in CABG combined with CE remain unknown. We conducted a retrospective observational study to evaluate the efficacy of preoperative IABP therapy in patients undergoing adjunctive right coronary artery (RCA) endarterectomy...
February 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29444276/extracorporeal-resuscitation-as-a-further-modifier-of-clinical-outcome-in-patients-with-left-ventricular-assist-device-implantation-and-interagency-registry-for-mechanically-assisted-circulatory-support-level-1
#12
Edis Ljajikj, Armin Zittermann, Andreas Koster, Jochen Börgermann, Michael Schönbrodt, Kavous Hakim-Meibodi, Jan Gummert, Michiel Morshuis
In cardiogenic shock patients with Interagency Registry for Mechanical Circulatory Support (INTERMACS) level 1, the need for temporary circulatory support is a predictor and modifier of patient outcome. Because this group includes patients with and without cardiopulmonary resuscitation (CPR) and is thus very heterogeneous, we investigated whether a further subclassification is useful. We compared 30-day and 1-year mortality of patients who underwent left ventricular assist device implantation after extracorporeal CPR with the aid of an extracorporeal life support system (CPR+ group; n = 40) with cardiogenic shock patients in which the extracorporeal life support system was implanted under non-CPR conditions (CPR- group, n = 68)...
February 12, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29437909/when-lightning-strikes-twice-in-pediatrics-case-report-and-review-of-recurrent-myocarditis
#13
Alisha Floyd, Ashwin Lal, Kimberly Molina, Michael Puchalski, Dylan Miller, Lindsay May
Myocarditis is an important but incompletely understood cause of cardiac dysfunction. Children with fulminant myocarditis often require inotropic or mechanical circulatory support, and researchers in some studies suggest that up to 42% of children who die suddenly have evidence of myocarditis. Recurrent myocarditis is extremely rare, and the vast majority of reported cases involve adult patients. Pediatric providers who suspect a recurrence of myocarditis have limited evidence to guide patient management because the literature in this domain is sparse...
February 8, 2018: Pediatrics
https://www.readbyqxmd.com/read/29437034/hemodynamic-impact-of-a-new-pulsatile-mechanical-circulatory-support-in-high-risk-coronary-stenting
#14
Marcelo Barros Bastos, Joost Daemen, Nicolas Van Mieghem
No abstract text is available yet for this article.
February 13, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29434806/extracorporeal-membrane-oxygenation-support-for-a-multitrauma-patient-with-ards-a-case-report-and-literature-review
#15
Yuexing Tu, Qi Jin, Renhua Sun, Qian Li
Extracorporeal membrane oxygenation (ECMO) provides rescue treatment for patients with severe acute respiratory distress syndrome (ARDS) when conventional management fails. The present study reported ECMO as a life-saving treatment for ARDS due to bilateral pulmonary contusion in a 24-year-old male multiple trauma patient. ECMO therapy lasted 7 days for the patient and was successively stopped without any complications. ECMO modality should be chosen according to the respiratory and circulatory condition of each individual...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29432374/development-of-an-outpatient-guideline-for-optimal-anticoagulation-bridging-in-patients-with-durable-mechanical-circulatory-support
#16
Amy A Levesque, Jessica M Rimsans, Katelyn W Sylvester, Erin N Lyons, Katie A Frankel, Lara L Coakley, Maryclare Hickey, Krystin A Montoya, Mandeep R Mehra, Michael M Givertz, Garrick C Stewart, Jean M Connors
Patients with durable mechanical circulatory support are at increased risk of thromboembolic and bleeding complications. Current guidelines recommend that these patients receive chronic anticoagulation with warfarin to maintain a target international normalized ratio (INR) as specified by device manufacturers. Limited data exist regarding management of subtherapeutic INRs in this setting. To standardize clinical practice at our institution, we assembled a multidisciplinary task force including members from various specialties to develop a guideline for managing subtherapeutic INRs that incorporates published data and expert opinion...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29428715/routine-clinical-anti-platelet-agents-have-limited-efficacy-in-modulating-hypershear-mediated-platelet-activation-associated-with-mechanical-circulatory-support
#17
Lorenzo Valerio, Jawaad Sheriff, Phat L Tran, William Brengle, Alberto Redaelli, Gianfranco B Fiore, Federico Pappalardo, Danny Bluestein, Marvin J Slepian
INTRODUCTION: Continuous flow ventricular assist devices (cfVADs) continue to be limited by thrombotic complications associated with disruptive flow patterns and supraphysiologic shear stresses. Patients are prescribed complex antiplatelet therapies, which do not fully prevent recurrent thromboembolic events. This is partially due to limited data on antiplatelet efficacy under cfVAD-associated shear conditions. MATERIALS AND METHODS: We investigated the efficacy of antiplatelet drugs directly acting on three pathways: (1) cyclooxygenase (aspirin), (2) phosphodiesterase (dipyridamole, pentoxifylline, cilostazol), and (3) glycoprotein IIb-IIIa (eptifibatide)...
December 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29419538/percutaneous-mechanical-circulation-support-combined-with-extracorporeal-membrane-oxygenation-oxyrvad-in-secondary-right-heart-failure
#18
Philipp M Lepper, Sabrina I Hörsch, Frederik Seiler, Annegret Kamp, Sören L Becker, Christian Lensch, Lars O Conzelmann, Hendrik Haake, Ralf M Muellenbach, Robert Bals, Markus Kredel, Frank Langer, Heinrike Wilkens, Franziska C Trudzinski
Right heart failure (RHF) because of pulmonary hypertension (PH) is a frequently encountered clinical problem with high mortality. The last resort, if pharmacological therapy fails, is mechanical circulatory support. There is a lack of percutaneous systems to support the right ventricle (RV). Venoarterial extracorporeal membrane oxygenation is widely used as a bailout in acute RHF in non-left ventricular assist device patients. Venoarterial extracorporeal membrane oxygenation does not unload the left ventricle and may cause failure of the left ventricle if used for a longer period of time...
February 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29415396/aats-mechanical-circulatory-support-symposium-21st-century-state-of-the-art-treatment-of-advanced-heart-and-lung-failure
#19
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29414790/histone-acetyltransferase-7-kat7-dependent-intragenic-histone-acetylation-regulates-endothelial-cell-gene-regulation
#20
Matthew S Yan, Paul J Turgeon, Hon Sum Jeffrey Man, Michelle K Dubinsky, Jr Jyun David Ho, Suzan El-Rass, You-Dong Wang, Xiao-Yan Wen, Philip A Marsden
Although the functional role of chromatin marks at promoters in mediating cell-restricted gene expression has been well characterized, the role of intragenic chromatin marks is not well understood, especially in endothelial cell (EC) gene expression. Here, we characterized the histone H3 and H4 acetylation profiles of 19 genes with EC-enriched expression via loci-wide chromatin immunoprecipitation followed by ultra high resolution (5 bp) tiling array analysis in ECs versus non-ECs throughout their genomic loci...
February 6, 2018: Journal of Biological Chemistry
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