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ventricular thrombus anticoagulation

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https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#1
Theodore J Cios, Yuliana Salamanca-Padilla, Dmitri Guvakov
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery...
March 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28329239/removal-of-a-giant-left-ventricular-thrombus-after-myocardial-infarction-due-to-dissection-of-left-anterior-descending-artery
#2
Philipp C Seppelt, Andreas Brcic, Matthias Karck, Gábor Szabó
Left ventricular thrombus is a frequent complication after myocardial infarction and is associated with high risk for arterial embolic complications. In addition to oral anticoagulation, surgical thrombectomy may be a promising treatment for large and mobile thrombus. We report the rare case of a 27-year-old patient who presented with a giant left ventricular thrombus after expanded and silent myocardial infarction caused by spontaneous dissection of the left anterior descending coronary artery. As conservative therapy by oral anticoagulation had failed, the thrombus was removed by performing left ventriculotomy...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28321882/optical-dynamic-analysis-of-thrombus-inside-a-centrifugal-blood-pump-during-extracorporeal-mechanical-circulatory-support-in-a-porcine-model
#3
Tatsuki Fujiwara, Daisuke Sakota, Katsuhiro Ohuchi, Shu Endo, Tomoki Tahara, Tomotaka Murashige, Ryo Kosaka, Keiji Oi, Tomohiro Mizuno, Osamu Maruyama, Hirokuni Arai
Complications due to pump thrombus remain the weak point of mechanical circulatory support (MCS), such as the use of a left ventricular assist device (LVAD) or extracorporeal membrane oxygenation, leading to poor outcomes. Hyperspectral imaging (HSI) is an effective imaging method using a hyperspectral (HS) camera, which comprises a spectrophotometer and a charge-coupled device camera to discriminate thrombus from whole blood. Animal experiments were conducted to analyze dynamic imaging of thrombus inside a prototype of a hydrodynamically levitated centrifugal blood pump using an HSI system...
March 20, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28253107/incidence-outcomes-and-predictors-of-ventricular-thrombus-after-reperfused-st-segment-elevation-myocardial-infarction-by-using-sequential-cardiac-mr-imaging
#4
Esther Cambronero-Cortinas, Clara Bonanad, Jose V Monmeneu, María Pilar Lopez-Lereu, Jose Gavara, Elena de Dios, Cesar Rios, Nerea Perez, Paolo Racugno, Ana Paya, David Escribano, Gema Minana, Mauricio Pellicer, Joaquim Cànoves, Julio Nunez, Francisco J Chorro, David Moratal, Vicente Bodi
Purpose To characterize the incidence, outcomes, and predictors of left ventricular (LV) thrombus by using sequential cardiac magnetic resonance (MR) imaging after ST-segment-elevation myocardial infarction (STEMI). Materials and Methods Written informed consent was obtained from all patients, and the study protocol was approved by the committee on human research. In a cohort of 772 patients with STEMI, 392 (mean age, 58 years; range, 24-89 years) were retrospectively selected who were studied with cardiac MR imaging at 1 week and 6 months...
March 2, 2017: Radiology
https://www.readbyqxmd.com/read/28194181/simultaneous-left-ventricular-and-deep-vein-thrombi-caused-by-protein-c-deficiency
#5
Harufumi Maki, Motohiro Nishiyama, Motoaki Shirakawa
Protein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography revealed a low-density mass in the left ventricle (LV), splenic infarction, and peripheral arterial obstructions in her right leg. Thrombosis extending from the renal vein to the inferior vena cava was also detected...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28184979/association-between-hematologic-and-inflammatory-markers-and-31-thrombotic-and-hemorrhagic-events-in-berlin-heart-excor-patients
#6
Amit Iyengar, Matthew L Hung, Kian Asanad, Oh Jin Kwon, Nicholas J Jackson, Brian L Reemtsen, Myke D Federman, Reshma M Biniwale
Bleeding and thrombotic events remain a significant cause of morbidity in pediatric patients supported with ventricular assist devices (VADs). The objective of this study is to identify the association between markers of anticoagulation and bleeding and thrombosis events during Berlin Heart ExCor support. A retrospective, single-center analysis of 9 patients supported with the Berlin Heart ExCor was performed. Inflammatory and anticoagulation parameters including C-reactive protein, fibrinogen, partial thromboplastin time (PTT), and platelet count were measured at 48 and 24 h before and after bleeding or thrombosis events...
February 10, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28154101/cardioembolic-stroke
#7
Hooman Kamel, Jeff S Healey
Cardiac embolism accounts for an increasing proportion of ischemic strokes and might multiply several-fold during the next decades. However, research points to several potential strategies to stem this expected rise in cardioembolic stroke. First, although one-third of strokes are of unclear cause, it is increasingly accepted that many of these cryptogenic strokes arise from a distant embolism rather than in situ cerebrovascular disease, leading to the recent formulation of embolic stroke of undetermined source as a distinct target for investigation...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28133551/large-left-ventricular-thrombus-in-a-patient-with-systemic-and-venous-thromboembolism-secondary-to-protein-c-and-s-deficiency
#8
Mohit Pahuja, Bujji Ainapurapu, Aiden Abidov
58-year-old Hispanic female presented with an altered mental status. A CT scan of the head demonstrated multiple scattered infarcts and a large right temporal lobe infarct. We also diagnosed the patient with right popliteal and femoral vein thrombosis, bilateral pulmonary embolism, and a transient right radial artery occlusion. Her 12-lead EKG showed lateral ST elevation. Emergent coronary angiogram revealed normal coronaries. Echocardiogram demonstrated a large mobile mass attached to the anterolateral free wall with overall normal contractility of the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28119407/blood-flow-competition-after-aortic-valve-bypass-an-evaluation-using-computational-fluid-dynamics
#9
Koji Kawahito, Naoyuki Kimura, Kenji Komiya, Masanori Nakamura, Yoshio Misawa
OBJECTIVES: Aortic valve bypass (AVB) (apico-aortic conduit) remains an effective surgical alternative for patients in whom surgical aortic valve replacement or transcatheter aortic valve implantation is not feasible. However, specific complications include thrombus formation, possibly caused by stagnation arising from flow competition between the antegrade and retrograde flow, but this has not been fully investigated. The aim of this study was to analyse flow characteristics after AVB and to elucidate mechanisms of intra-aortic thrombus using computational fluid dynamics (CFD)...
January 24, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28079110/left-ventricular-noncompaction-cardiomyopathy-cardiac-neuromuscular-and-genetic-factors
#10
REVIEW
Josef Finsterer, Claudia Stöllberger, Jeffrey A Towbin
Left ventricular hypertrabeculation (LVHT) or noncompaction is a myocardial abnormality of unknown aetiology, frequently associated with monogenic disorders, particularly neuromuscular disorders, or with chromosomal defects. LVHT is diagnosed usually by echocardiography by the presence of a bilayered myocardium consisting of a thick, spongy, noncompacted endocardial layer and a thin, compacted, epicardial layer. The pathogenesis of LVHT is unsolved, and the diagnostic criteria, prognosis, and optimal treatment of patients with LVHT are under debate...
April 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#11
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27999550/the-use-of-berlin-heart-excor-vad-in-children-less-than-10-kg-a-single-center-experience
#12
Arianna Di Molfetta, Fabrizio Gandolfo, Sergio Filippelli, Gianluigi Perri, Luca Di Chiara, Roberta Iacobelli, Rachele Adorisio, Isabella Favia, Alessandra Rizza, Giuseppina Testa, Matteo Di Nardo, Antonio Amodeo
Objective: Despite the improvement in ventricular assist device (VAD) therapy in adults and in adolescents, in infant population only Berlin Heart EXCOR (BHE) is licensed as long term VAD to bridge children to Heart Transplantation (HTx). Particularly demanding in terms of morbidity and mortality are smallest patients namely the ones implanted in the first year of life or with a lower body surface area. This work aims at retrospective reviewing a single center experience in using BHE in children with a body weight under 10 kg...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27994255/review-of-venoarterial-extracorporeal-membrane-oxygenation-and-development-of-intracardiac-thrombosis-in-adult-cardiothoracic-patients
#13
REVIEW
Brittney Williams, Wendy Bernstein
Venoarterial extracorporeal membrane oxygenation (VA ECMO) has become an indispensable treatment option for adult cardiothoracic patients experiencing acute refractory cardiogenic shock. VA ECMO is not without inherent complications as in-hospital mortality has ranged from 45% to 65% (1-3). Intracardiac thrombosis (ICT) is a rare but life-threatening complication associated with VA ECMO. VA ECMO cases complicated by ICT were searched for using the MEDLINE (PubMed and OVID), Society of Cardiovascular Anesthesiology Headquarters, and Google Scholar databases...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27942445/combination-therapy-with-riociquat-and-inhaled-treprostinil-in-inoperable-and-progressive-chronic-thromboembolic-pulmonary-hypertension
#14
John W Swisher, Dillon Elliott
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by formation of chronic, organized thrombus in pulmonary arteries resulting in development of pulmonary hypertension. We describe the favorable recovery of a patient with inoperable CTEPH treated with combination riociguat and inhaled treprostinil. The patient is a 77 year old female who presented with bilateral pulmonary emboli and was anticoagulated with warfarin for six months. One year later the patient developed recurrent dyspnea and multiple bilateral pulmonary emboli were again noted...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27925225/preclinical-study-of-anticoagulation-regimens-in-sheep-after-implantation-of-ch-vad-blood-pump
#15
Chuangye Xu, Guanghui Wu, Xiujian Liu, Yuna He, Xiaotong Hou, Haiyang Li, Chen Chen, Peng Yang, Changyan Lin
Effective anticoagulation regimens are needed to reduce risks of thrombosis and bleeding in animal models of ventricular assist device to verify its hemocompatibility, biologic safety and reliability. This study is to develop a validated anticoagulation procedure for a sheep model to test the newly developed CH-VAD. CH-VAD models were established in six healthy sheep by constructing blood bypass of left ventricle → ventricular assist device → descending aorta. Heparin infusion was used during operation and in the prior 4 days to maintain activated clotting time 1...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27905492/high-fidelity-computational-simulation-of-thrombus-formation-in-thoratec-heartmate-ii-continuous-flow-ventricular-assist-device
#16
Wei-Tao Wu, Fang Yang, Jingchun Wu, Nadine Aubry, Mehrdad Massoudi, James F Antaki
Continuous flow ventricular assist devices (cfVADs) provide a life-saving therapy for severe heart failure. However, in recent years, the incidence of device-related thrombosis (resulting in stroke, device-exchange surgery or premature death) has been increasing dramatically, which has alarmed both the medical community and the FDA. The objective of this study was to gain improved understanding of the initiation and progression of thrombosis in one of the most commonly used cfVADs, the Thoratec HeartMate II...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27896330/biventricular-thrombus-in-hypereosinophilic-syndrome-presenting-with-shortness-of-breath
#17
Abdul Baqi, Shahan Waheed, Fateh Ali Tipoo, Aamir Hameed Khan
A 48 years old male presented to clinic with 12 months of low grade fever with shortness of breath which has progressively worsened with no associated weight loss, night sweats or loss of appetite. There was no prior history of chronic illness before the current illness. Laboratory workup revealed a high white blood cell count with predominant eosinophils. Chest X-ray was normal. Transthoracic echocardiography and Cardiac Magnetic Resonance showed biventricular thrombi. On further extensive workup the findings were consistent with hypereosinophilic syndrome...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27883351/-rivaroxaban-resistant-right-ventricular-thrombus-successfully-treated-with-vitamin-k-antagonist-in-a-patient-with-dilated-cardiomyopathy
#18
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Teresa Ganowicz-Kaatz, Andrzej Bolewski, Paweł Skrzywanek
Rivaroxaban, a selective inhibitor of active factor X belongs to the group of direct-acting oral anticoagulants (DOAC), more and more often replacing vitamin K antagonists (VKA) in venous thromboembolic disease and nonvalvular atrial fibrillation. Attempts are also being made to use DOAC to treat locally formed intracardiac thrombi, mainly in the left atrium and its appendage, in atrial fibrillation and in heart failure. Rarely diagnosed local right ventricular thrombus (RVT) may be a complication of dilated cardiomyopathy (DCM)...
November 25, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27797850/resolution-of-left-ventricular-postinfarction-thrombi-in-patients-undergoing-percutaneous-coronary-intervention-using-rivaroxaban-in-addition-to-dual-antiplatelet-therapy
#19
Constantinos Andreas Makrides
Left ventricular (LV) thrombus is usually seen in situations with reduced LV function, and is mostly seen in patients with large anterior ST-elevation myocardial infarction (MI). Most embolic events, in patients with LV thrombus formation, occur within the first 3-4 months, thus the recommendations regarding the duration of anticoagulant therapy. According to guidelines, an oral vitamin K antagonist, warfarin, is being used as an anticoagulant for this period. Novel oral anticoagulants were found to be either non-inferior or superior compared with warfarin in prevention of thromboembolism in patients with non-valvular atrial fibrillation...
October 26, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27790495/acute-right-heart-failure-in-a-patient-with-right-heart-thrombus-and-pulmonary-thromboembolism
#20
Mohammad Mostafa Ansari-Ramandi, Samaneh Ansari-Ramandi, Nasim Naderi
Right Heart Thrombus (RiHT) management is really controversial, and appropriate guidelines are not present for the management. In patients referring with RiHT and Pulmonary Embolism (PE), there are three ways of managing these patients. Out of the three, one is thrombectomy, which is with high risk taking in mind the comorbidities these patients have. The other is using thrombolytic which, in many cases is contraindicated or with high risk. The other less effective way is full anticoagulation. It is really controversial to choose between these ways of management and no clear approach is present...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
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