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Mechanical Circulatory Support

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https://www.readbyqxmd.com/read/28526500/pulmonary-function-tests-do-not-predict-mortality-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation
#1
Edo K S Bedzra, Todd F Dardas, Richard K Cheng, Jay D Pal, Claudius Mahr, Jason W Smith, Kent Shively, S Carolina Masri, Wayne C Levy, Nahush A Mokadam
OBJECTIVES: To investigate the effect of pulmonary function testing on outcomes after continuous flow left ventricular assist device implantation. METHODS: A total of 263 and 239 patients, respectively, had tests of forced expiratory volume in 1 second and diffusing capacity of the lungs for carbon monoxide preoperatively for left ventricular assist device implantations between July 2005 and September 2015. Kaplan-Meier analysis and multivariable Cox regressions were performed to evaluate mortality...
April 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28525417/assessing-frailty-in-patients-undergoing-destination-therapy-left-ventricular-assist-device-observations-from-interagency-registry-for-mechanically-assisted-circulatory-support
#2
Lauren B Cooper, Bradley G Hammill, Larry A Allen, JoAnn Lindenfeld, Robert J Mentz, Joseph G Rogers, Carmelo A Milano, Chetan B Patel, Karen P Alexander, Adrian F Hernandez
Frailty and heart failure share common pathways with symptoms that often coexist. Assessment of frailty may inform patient selection for left ventricular assist device (LVAD) therapy. Using Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data of destination therapy (DT) LVAD patients from January 1, 2012, to March 31, 2014, we examined preimplantation provider-assessed frailty and gait speed testing and the association with 1 year postimplantation outcomes. Of 2,469 patients, 227 (9...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28521795/ex-vivo-recruitment-and-x-ray-assessment-of-donor-lungs-in-a-challenging-retrieval-from-a-donor-supported-by-lvad-using-the-portable-normothermic-perfusion-system-a-case-report
#3
Marco Schiavon, Francesca Calabrese, Guido Di Gregorio, Monica Loy, Giuseppe Marulli, Alessandro Rebusso, Fiorella Calabrese, Federico Rea
BACKGROUND: Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#4
Remigiusz Antończyk, Ewa Trejnowska, Jerzy Pacholewicz, Tomasz Wolny, Paweł Nadziakiewicz, Karolina Antończyk, Izabela Copik, Magdalena Piontek, Małgorzata Jasińska, Krzysztof Filipiak, Maciej Głowacki, Maciej Gawlikowski, Marcin Borowicz, Roman Kustosz, Jacek Waszak, Piotr Przybyłowski, Marian Zembala, Michał Zakliczyński, Michał Oskar Zembala
Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514261/doppler-ultrasound-evaluation-of-circulatory-support-devices
#5
Zachary Nuffer, Andrey Rupasov, Shweta Bhatt
In the setting of mechanical circulatory support devices, including ventricular assist devices, extracorporeal membrane oxygenation, intraaortic balloon pumps, and the total artificial heart, the spectral Doppler waveform is significantly altered, reflecting systemic hemodynamic changes. As the prevalence of these devices increases, a better understanding of both the devices themselves and their associated Doppler ultrasound findings is necessary for accurate image interpretation. This article reviews the clinical indications, pathophysiology, and sonographic findings of these devices, with emphasis on the variation in arterial Doppler waveforms that can be seen with normal function, as well as the major complications...
May 16, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28512702/an-intracardiac-soft-robotic-device-for-augmentation-of-blood-ejection-from-the-failing-right-ventricle
#6
Markus A Horvath, Isaac Wamala, Eric Rytkin, Elizabeth Doyle, Christopher J Payne, Thomas Thalhofer, Ignacio Berra, Anna Solovyeva, Mossab Saeed, Sara Hendren, Ellen T Roche, Pedro J Del Nido, Conor J Walsh, Nikolay V Vasilyev
We introduce an implantable intracardiac soft robotic right ventricular ejection device (RVED) for dynamic approximation of the right ventricular (RV) free wall and the interventricular septum (IVS) in synchrony with the cardiac cycle to augment blood ejection in right heart failure (RHF). The RVED is designed for safe and effective intracardiac operation and consists of an anchoring system deployed across the IVS, an RV free wall anchor, and a pneumatic artificial muscle linear actuator that spans the RV chamber between the two anchors...
May 16, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28512680/a-novel-idea-to-improve-cardiac-output-of-mechanical-circulatory-support-devices-by-optimizing-kinetic-energy-transfer-available-in-forward-moving-aortic-blood-flow
#7
Muhammad B Qureshi, Jacob Glower, Daniel L Ewert, Steven C Koenig
Mechanical circulatory support devices (MCSDs) have gained widespread clinical acceptance as an effective heart failure (HF) therapy. The concept of harnessing the kinetic energy (KE) available in the forward aortic flow (AOF) is proposed as a novel control strategy to further increase the cardiac output (CO) provided by MCSDs. A complete mathematical development of the proposed theory and its application to an example MCSDs (two-segment extra-aortic cuff) are presented. To achieve improved device performance and physiologic benefit, the example MCSD timing is regulated to maximize the forward AOF KE and minimize retrograde flow...
May 16, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28509676/isolated-right-ventricular-mechanical-support-outcomes-and-prognosis
#8
Teresa A Mulaikal, Laura H Bell, Boyangzi Li, Gebhard Wagener, Hiroo Takayama
Right ventricular (RV) failure that necessitates isolated mechanical support is extremely rare. Outcomes have not been described and are limited to case reports. We sought to evaluate this select group of patients and determine their 30 day and 1 year survival. We retrospectively reviewed the Mechanical Assist Device Database at Columbia University from 2007 to 2015. Inclusion criteria consisted of patients who received isolated RV assist devices (RVADs) without mechanical support of the left ventricle. We evaluated survival, duration of support, intensive care unit (ICU) length of stay, and adverse events...
May 12, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28504984/melding-a-high-risk-patient-for-continuous-flow-left-ventricular-assist-device-into-a-low-risk-patient
#9
Javier Amione-Guerra, Ana S Cruz-Solbes, Hilda Gonzalez Bonilla, Jerry D Estep, Ashrith Guha, Arvind Bhimaraj, Erik E Suarez, Brian A Bruckner, Guillermo Torre-Amione, Myung H Park, Barry H Trachtenberg
The model for end-stage liver disease (MELD) has been used as a predictor of mortality after left ventricular assist device (LVAD) placement. However, improvement or worsening of MELD and how those changes affect outcomes is unknown. We performed a retrospective analysis of 244 patients implanted with a continuous flow (CF) LVAD. Patients were dichotomized at admission into low- or high-risk categories using a cutoff of MELD ≥ 19, and they were reclassified at day of implant forming four groups: Group LL (remained low risk), LH (worsened to high risk), HH (remained high risk), and HL (improved to low risk)...
May 10, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28500136/percutaneous-mechanical-circulatory-support-devices-in-cardiogenic-shock
#10
REVIEW
Aditya Mandawat, Sunil V Rao
Despite a high rate of early revascularization and use of intra-aortic balloon pump counterpulsation therapy, the prognosis of patients with cardiogenic shock has remained poor. In the hopes of improving outcomes, clinicians are increasingly turning to percutaneous left and right mechanical circulatory support devices. Until recently, the evidence base for these devices had consisted only of observational data, meta-analyses, and small feasibility trials. In this article, we describe the contemporary outcomes of patients with cardiogenic shock, the hemodynamics of cardiogenic shock, and hemodynamic effects of percutaneous mechanical circulatory support devices...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28498942/effect-of-vitamin-d-on-all-cause-mortality-in-heart-failure-evita-a-3-year-randomized-clinical-trial-with-4000%C3%A2-iu-vitamin-d-daily
#11
Armin Zittermann, Jana B Ernst, Sylvana Prokop, Uwe Fuchs, Jens Dreier, Joachim Kuhn, Cornelius Knabbe, Ingvild Birschmann, Uwe Schulz, Heiner K Berthold, Stefan Pilz, Ioanna Gouni-Berthold, Jan F Gummert, Marcus Dittrich, Jochen Börgermann
Aims: Circulating 25-hydroxyvitamin D (25OHD) levels <75 nmol/L are associated with a nonlinear increase in mortality risk. Such 25OHD levels are common in heart failure (HF). We therefore examined whether oral vitamin D supplementation reduces mortality in patients with advanced HF. Methods and results: Four hundred HF patients with 25OHD levels <75 nmol/L were randomized to receive 4000 IU vitamin D daily or matching placebo for 3 years. Primary endpoint was all-cause mortality...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28493018/emerging-role-of-mirna-in-attention-deficit-hyperactivity-disorder-a-systematic-review
#12
REVIEW
Saurabh Srivastav, Susanne Walitza, Edna Grünblatt
Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder whose aetiology still remains elusive. Nevertheless, evidence supports a high genetic contribution that interacts with environmental factors, also known to modulate epigenetic processes. These epigenetic modulators are a class of non-coding RNAs, microRNAs (miRNAs), known as post-transcriptional regulators, which have emerged as prospective players in neuropsychiatric disorders since they play a role in brain development, synapse formation, and the fine-tuning of genes underlying synaptic and memory formation...
May 10, 2017: Attention Deficit and Hyperactivity Disorders
https://www.readbyqxmd.com/read/28492786/the-brazilian-registry-of-adult-patient-undergoing-cardiovascular-surgery-the-bypass-project-results-of-the-first-1-722-patients
#13
Walter J Gomes, Rita Simone Moreira, Alexandre Cabral Zilli, Luiz Carlos Bettiati, Fernando Augusto Marinho Dos Santos Figueira, Stephanie Steremberg Pires D' Azevedo, Marcelo José Ferreira Soares, Marcio Pimentel Fernandes, Roberto Vito Ardito, Renata Andrea Barberio Bogdan, Valquíria Pelisser Campagnucci, Diana Nakasako, Renato Abdala Karam Kalil, Clarissa Garcia Rodrigues, Anilton Bezerra Rodrigues, Marcelo Matos Cascudo, Fernando Antibas Atik, Elson Borges Lima, Vinicius José da Silva Nina, Renato Albuquerque Heluy, Lisandro Gonçalves Azeredo, Odilon Silva Henrique, José Teles de Mendonça, Katharina Kelly de Oliveira Gama Silva, Marcelo Pandolfo, José Dantas de Lima, Renato Max Faria, Jonas Pereira Dos Santos, Rodrigo Pereira Paez, Guilherme Henrique Biachi Coelho, Sergio Nunes Pereira, Roberta Senger, Enio Buffolo, Guido Marco Caputi, José Amalth do Espírito Santo, Juliana Aparecida Borges de Oliveira, Otavio Berwanger, Alexandre Biasi Cavalcanti, Fabio B Jatene
Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1)...
March 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28492570/-the-use-of-mechanical-chest-compression-devices-for-both-out-of-hospital-and-in-hospital-refractory-cardiac-arrest
#14
Alessandra Russo, Nicola Gasparetto, Luca Favero, Salvatore Ivan Caico, Silvia Orazio, Guido Garzena, Paolo Rosi, Zoran Olivari
The purpose of cardiopulmonary resuscitation after sudden cardiac arrest is to restore minimal blood flow to provide oxygen to the brain and other vital organs. Chest compressions and external defibrillation are the first line for circulatory support. Although early defibrillation is the main factor influencing survival, cardiopulmonary resuscitation must be characterized by high-quality external chest compressions. Unfortunately, the performance of manual chest compressions decreases during time and in hostile conditions...
April 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28491184/feasibility-of-transfemoral-hepatic-vein-wedged-portal-venous-pressure-measurement-in-total-artificial-heart
#15
Ashwani Kumar Sharma, Jonathan Huang, Himabindu Vidula, Jeffrey Alexis, Juan M Lehoux
The development of technology and limitation of numerous ventricular assist devices has increased usage of the total artificial heart (TAH) for mechanical circulatory support. A primary important feature of TAH is that it is one of the few mechanical circulatory support devices that provides biventricular support. As the number of patients with TAH rises, spreading awareness about the device in the interventional radiology community is important.
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489217/intra-aortic-balloon-pump-in-cardiogenic-shock-state-of-the-art
#16
Petronio Generoso Thomaz, Leonel Adelino Moura, Giovana Muramoto, Renato Samy Assad
The clinical definition of cardiogenic shock is that of a low cardiac output and evidence of tissue hypoxia in the presence of adequate blood volume. Cardiogenic shock is the main cause of death related to acute myocardial infarction (AMI), with a mortality rate of 45-70% in the absence of aggressive and highly specialized technical care. The intra-aortic balloon pump (IABP) is one of the most widely used mechanical assisting devices. During the last two decades, about 42% of patients with AMI who evolved with cardiogenic shock received mechanical circulatory assistance with IABP...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28488413/preventing-and-treating-coronary-perforations-lessons-from-disaster-management
#17
EDITORIAL
Yader Sandoval, Emmanouil S Brilakis
Coronary artery perforations (CAP) are rare in patients undergoing routine PCI with recent contemporary databases reporting an incidence ∼0.3%. Older age, cardiomyopathy or left ventricular dysfunction, mechanical circulatory support prior to PCI, and CTO lesions have the strongest association with CAP. Prevention, early detection, preparedness and familiarity with the equipment used to treat perforations (such as efficient use of covered stents, and fat or coil embolization) and regrouping to examine and educate about these experiences are key for improving our response to cath lab disasters...
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28472406/short-term-mechanical-circulatory-support-as-a-bridge-to-durable-left-ventricular-assist-device-implantation-in-refractory-cardiogenic-shock-a-systematic-review-and-meta-analysis
#18
Corstiaan A den Uil, Sakir Akin, Lucia S Jewbali, Dinis Dos Reis Miranda, Jasper J Brugts, Alina A Constantinescu, Arie Pieter Kappetein, Kadir Caliskan
Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016...
May 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28471759/advancing-the-science-of-myocardial-recovery-with-mechanical-circulatory-support-a-working-group-of-the-national-heart-lung-and-blood-institute
#19
Stavros G Drakos, Francis D Pagani, Martha S Lundberg, J Timothy Baldwin
The medical burden of heart failure (HF) has spurred interest in clinicians and scientists to develop therapies to restore the function of a failing heart. To advance this agenda, the National Heart, Lung, and Blood Institute (NHLBI) convened a Working Group of experts from June 2 to 3, 2016, in Bethesda, Maryland, to develop NHLBI recommendations aimed at advancing the science of cardiac recovery in the setting of mechanical circulatory support (MCS). MCS devices effectively reduce volume and pressure overload that drives the cycle of progressive myocardial dysfunction, thereby triggering structural and functional reverse remodeling...
April 29, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28470920/a-rationale-for-early-extracorporeal-membrane-oxygenation-in-patients-with-postinfarction-ventricular-septal-rupture-complicated-by-cardiogenic-shock
#20
Daniel Rob, Rudolf Špunda, Jaroslav Lindner, Vilém Rohn, Jan Kunstýř, Martin Balík, Jan Rulíšek, Petr Kopecký, Michal Lipš, Ondřej Šmíd, Tomáš Kovárník, František Mlejnský, Aleš Linhart, Jan Bělohlávek
AIMS: Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) for postinfarction VSR...
May 2017: European Journal of Heart Failure
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