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ventricular thrombus anticoagulation

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https://www.readbyqxmd.com/read/29305613/optimized-time-resolved-echo-piv-ptv-measurements-elucidate-blood-flow-in-patients-with-left-ventricular-thrombus
#1
Kaushik Sampath, Thura T Harfi, Ricard/T George, Joseph Katz
Contrast ultrasound is a widely used clinical tool to obtain real-time qualitative blood flow assessments in the heart, liver, etc. Echocardiographic particle image velocimetry (echo-PIV) is a technique for obtaining quantitative velocity maps from contrast ultrasound images. However, unlike optical PIV, routine echo images are prone to non-uniform spatiotemporal variations in tracer distribution, making analysis difficult for standard PIV algorithms. This study introduces optimized procedures that integrate image enhancement, PIV and particle tracking velocimetry (PTV) to obtain reliable time-resolved 2D velocity distributions...
January 5, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29276599/rapid-resolution-of-left-ventricular-thrombus-with-apixaban-therapy
#2
Abeer Berry, Daniel Brancheau, Marcel Zughaib
It is a common medical practice to anticoagulate an asymptomatic left ventricular mural thrombus following an ST-elevation myocardial infarction using a vitamin K antagonist. Novel oral anticoagulants have not been studied extensively in this context, and therefore, no recommendations have been made for their use. A 67-year-old male physician with no significant medical history presented to the cardiology clinic complaining of shortness of breath that had been gradually worsening over a 2-week period and was found to have an anterior wall myocardial infarction with apical left ventricular thrombus that was treated with apixaban...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/29248101/design-and-rationale-of-a-randomized-trial-comparing-standard-versus-ultrasound-assisted-thrombolysis-for-submassive-pulmonary-embolism
#3
Efthymios D Avgerinos, Abhisekh Mohapatra, Belinda Rivera-Lebron, Catalin Toma, Christopher Kabrhel, Larry Fish, Joan Lacomis, Iclal Ocak, Rabih A Chaer
BACKGROUND: Catheter-directed interventions for the treatment of patients with submassive pulmonary embolism (sPE) have shown promise in rapidly improving right-sided heart strain and preventing decompensation to massive pulmonary embolism. Among various catheter interventions, ultrasound-assisted thrombolysis (USAT) has attracted interest as potentially having more efficient lytic effect that could achieve thrombolysis faster and with a reduced lytic dose. However, based on clinical evidence, it is unclear whether USAT is superior to standard catheter-directed thrombolysis (SCDT)...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29222320/anticoagulation-with-vads-and-ecmo-walking-the-tightrope
#4
REVIEW
Leslie Raffini
The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, resulting in device failure or embolic stroke...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29181265/off-label-use-of-direct-oral-anticoagulants-for-left-ventricular-thrombus-is-it-appropriate
#5
George Degheim, Abeer Berry, Marcel Zughaib
A 57 year old gentleman with a history of non-ischemic cardiomyopathy and paroxysmal atrial fibrillation presented with worsening lower extremity edema and dyspnea on exertion. He had been compliant with his medications including rivaroxaban (Xarelto) for atrial fibrillation that he takes with the evening meal daily. His echocardiogram showed an ejection fraction of 10-15% and a new left ventricle (LV) apical thrombus. During his hospital stay, he developed right sided weakness. Magnetic Resonance Imaging showed a subacute infarct involving the left parietal lobe...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/29181174/rapid-occurrence-of-left-ventricular-thrombus-associated-with-platinum-based-chemotherapy-plus-cetuximab-for-the-treatment-of-metastatic-squamous-cell-carcinoma-of-the-head-and-neck-a-case-report
#6
Atsushi Ikeda, Eiki Yamachika, Masahide Mizutani, Masakazu Matsubara, Norifumi Moritani, Kazuki Nakatsuji, Seiji Iida
Platinum-based chemotherapy plus cetuximab represents the first-line treatment for recurrent or metastatic squamous cell carcinoma of the head and neck. The most common adverse events associated with cetuximab are infusion reactions and skin reactions, and a risk of venous thromboembolic events has also recently been reported in association with cetuximab. It is well known that thrombosis is a common complication of malignancy, and represents the second most frequent cause of mortality in cancer patients. The present study reports the case of a 79-year-old man who presented with lung and liver metastases from tongue squamous cell carcinoma, for which platinum-based chemotherapy plus cetuximab was administered...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29177686/preclinical-animal-study-of-the-nipro-ventricular-assist-device-for-use-in-pediatric-patients
#7
Noritsugu Naito, Yoshiaki Takewa, Satoru Kishimoto, Kei Iizuka, Toshihide Mizuno, Tomonori Tsukiya, Minoru Ono, Eisuke Tatsumi
Although the outcomes of patients with end-stage heart failure treated with implantable left ventricular assist devices have improved, extracorporeal left ventricular assist devices continue to play an important role, especially in pediatric patients. The present study aimed to examine the long-term biocompatibility of a small-sized extracorporeal pneumatic left ventricular assist device (NIPRO-LVAD) used in a 30- to 90-day animal experiment. The NIPRO-LVAD was designed for pediatric patients or small-sized adults...
November 24, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29174781/utilization-of-veno-arterial-extracorporeal-membrane-oxygenation-for-massive-pulmonary-embolism
#8
Chetan Pasrija, Anthony Kronfli, Praveen George, Maxwell Raithel, Francesca Boulos, Daniel L Herr, James S Gammie, Si M Pham, Bartley P Griffith, Zachary N Kon
BACKGROUND: The management of massive pulmonary embolism remains challenging, with a considerable mortality rate. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for massive pulmonary embolism has been reported, its use as salvage therapy has been associated with poor outcomes. We reviewed our experience utilizing an aggressive, protocolized approach of VA-ECMO to triage, optimize, and treat these patients. METHODS: All patients with a massive pulmonary embolism who were placed on VA-ECMO, as an initial intervention determined by protocol, were retrospectively reviewed...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29172999/left-ventricular-thrombus-formation-in-patients-undergoing-femoral-veno-arterial-extracorporeal-membrane-oxygenation
#9
Carolyn Weber, Antje-Christin Deppe, Anton Sabashnikov, Ingo Slottosch, Elmar Kuhn, Kaveh Eghbalzadeh, Maximilian Scherner, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
INTRODUCTION: Profoundly impaired left ventricular (LV) function in patients undergoing femoral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) can result in intra-cardiac stasis and thrombus formation. There have been several attempts to improve LV unloading in patients with peripheral VA-ECMO, either by improving contractility or by venting the LV. METHODS: Data from all patients who underwent femoral VA-ECMO between 2007 and 2015 due to cardiogenic decompensation were retrospectively analysed regarding intra-cardiac thrombus formation...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29151526/recent-inferior-myocardial-infarction-complicated-with-a-right-ventricular-thrombus-detected-by-three-cardiac-imaging-modalities
#10
Toshiki Kuno, Syohei Imaeda, Kenji Hashimoto, Toshinobu Ryuzaki, Tetsuya Saito, Hiroyuki Yamazaki, Ryota Tabei, Masaki Kodaira, Manabu Hase, Yohei Numasawa
We report the case of a 71-year-old woman diagnosed with recent inferior myocardial infarction complicated with right ventricular infarction and a right ventricular thrombus. Three-dimensional transthoracic echocardiography, contrast-enhanced computed tomography, and cardiac magnetic resonance imaging clearly detected a thrombus. We consider cases with a recent right ventricular infarction to require assessment for thrombus formations in the right ventricle. Fortunately, vigorous anticoagulation therapy resolved the thrombi in both the right ventricle and right coronary artery...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29129259/comparison-of-prevalence-and-management-of-left-atrial-appendage-thrombi-under-old-and-new-anticoagulants-prior-to-left-atrial-catheter-ablation
#11
COMPARATIVE STUDY
Antoine Da Costa, Clarisse Delolme, Jean Baptiste Guichard, Antoine Gerbay, Romain Pierrard, Cécile Romeyer-Bouchard, Karl Isaaz
BACKGROUND: The prevalence and management of left atrial appendage (LAA) thrombi associated with new anticoagulants remain to be elucidated, especially prior to atrial fibrillation (AFib) ablation. This study sought to (1) compare the prevalence of LAA thrombi and/or severe LAA contrast under vitamin K antagonist (VKA) agents and novel oral anticoagulants (NOACs), (2) evaluate the rate of LAA thrombus resolution after anticoagulation modification, and (3) determine the predictive factors of LAA thrombi and severe LAA contrast in patients prior to LA AFib ablation...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29070745/incidence-characteristics-and-management-of-venous-thromboembolism-in-japan-during-2011
#12
Satoshi Ota, Akimasa Matsuda, Yoshito Ogihara, Norikazu Yamada, Mashio Nakamura, Takuya Mori, Masayuki Hamada, Takao Kobayashi, Masaaki Ito
BACKGROUND: This study aimed to determine the incidence, characteristics and management of venous thromboembolism (VTE) in Japan during 2011.Methods and Results:A retrospective study assessed responses to a questionnaire regarding treating newly diagnosed VTE at all admitting hospitals throughout Japan during 2011. More individuals were diagnosed with VTE than ever before, with 16,096 cases of diagnosed pulmonary embolism (PE) and 24,538 cases of diagnosed deep vein thrombosis (DVT)...
October 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29063065/paradoxical-embolism-experiences-from-a-single-center
#13
Hong-Liang Zhang, Zhi-Hong Liu, Qin Luo, Yong Wang, Zhi-Hui Zhao, Chang-Ming Xiong
OBJECTIVE: To present our treatment experiences and the follow-up data of patients with paradoxical embolism (PDE). METHODS: The clinical characteristics, management, and follow-up data of all included patients who were diagnosed with PDE at Fuwai Hospital from January 1994 to October 2015 were recorded. RESULTS: Twelve patients were included; all had a pulmonary embolism, and 8 had deep venous thrombosis. The artery embolisms involved the cerebral artery (7 patients), renal artery (2 patients), mesentery artery (2 patients), popliteal artery (1 patient), descending aorta thrombus (1 patient), and thrombus-straddled patent foramen ovale (PFO) (1 patient)...
June 25, 2017: Chronic Diseases and Translational Medicine
https://www.readbyqxmd.com/read/29042831/the-impact-of-antithrombin-iii-use-in-achieving-anticoagulant-goals-in-pediatric-patients
#14
Allison J Jones, Keliana L O'Mara, Brian J Kelly, Ravi S Samraj
OBJECTIVES: To determine the percentage of patients with >10% reduction in heparin infusion rate within 48 hours of antithrombin III (ATIII) administration. Secondary objectives include the achievement of therapeutic anticoagulation and determining the days of subtherapeutic infusion prior to supplementation. METHODS: Retrospective chart review of 12 patients younger than 18 years of age who received ATIII concentrate supplementation while on continuous heparin infusion...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29029233/anticoagulation-combined-with-antiplatelet-therapy-in-patients-with-left-ventricular-thrombus-after-first-acute-myocardial-infarction
#15
Naoki Maniwa, Masashi Fujino, Michikazu Nakai, Kunihiro Nishimura, Yoshihiro Miyamoto, Yu Kataoka, Yasuhide Asaumi, Yoshio Tahara, Michio Nakanishi, Toshihisa Anzai, Kengo Kusano, Takashi Akasaka, Yoichi Goto, Teruo Noguchi, Satoshi Yasuda
Aims: There are limited data about the optimal anti-thrombotic therapy for preventing embolism while minimizing bleeding events in patients with first acute myocardial infarction (AMI) complicated by left ventricular thrombus (LVT). Methods and results: Among 2301 consecutive patients with AMI hospitalized between 2001 and 2014, we studied 1850 patients with first AMI who discharged alive to investigate clinical characteristics, incidence of systemic embolism (SE), and association between anticoagulation and embolic or bleeding events...
October 3, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29016369/newly-developed-left-ventricular-apical-thrombus-under-dabigatran-treatment
#16
Adem Adar, Orhan Onalan, Fahri Cakan
: Left ventricular (LV) thrombi are mostly formed in the aneurysmal or akinetic segment of the LV apex. Thromboembolism to the brain is usually fatal. There is not enough information available regarding the use of these new oral anticoagulant agents in LV thrombi. In this case, we present a 56-year-old male patient who was given dabigatran (150 mg, twice a day) for paroxysmal atrial fibrillation after experiencing anterior myocardial infarction. During the use of dabigatran, thrombus formation, which was not present earlier, was observed in the LV apical aneurysm...
October 7, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28989934/takotsubo-cardiomyopathy-with-a-rapidly-resolved-left-ventricular-thrombus
#17
Abdel Anabtawi, Paola C Roldan, Carlos A Roldan
This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28972957/comparison-of-different-oral-anticoagulant-regimens-in-patients-with-atrial-fibrillation-undergoing-ablation-or-cardioversion
#18
Monika Gawałko, Agnieszka Kapłon-Cieślicka, Monika Budnik, Aldona Babiarz, Aleksandra Bodys, Robert Uliński, Maciej Żochowski, Michał Peller, Piotr Scisło, Janusz Kochanowski, Krzysztof J Filipiak, Grzegorz Opolski
INTRODUCTION    Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative to vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF). OBJECTIVES    The aim of the study was to assess the incidence of left atrial appendage (LAA) thrombus and dense spontaneous echo contrast (SEC), as well as to compare the clinical characteristics of patients with AF treated with different anticoagulant regimens. PATIENTS AND METHODS    We studied 1033 consecutive patients with AF, who underwent transesophageal echocardiography (TEE) before AF ablation or cardioversion...
December 22, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28948507/oral-factor-xa-inhibitors-for-the-treatment-of-left-ventricular-thrombus-a-case-series
#19
Keaton S Smetana, Jessie Dunne, Kevin Parrott, George A Davis, Amy C Schmelzer Collier, Mary Covell, Susan Smyth
Left ventricular thrombus (LVT) formation usually necessitates short term anticoagulation for thrombus resolution and to prevent embolic events. Historically, vitamin K antagonist therapy has been the treatment of choice. However, with the advent of direct acting anticoagulants, their role in the management of LVT is not clear. Patients were included if they had received rivaroxaban or apixaban for more than 1 day for LVT documented on imaging. The primary objective was resolution of LVT at 3 months based on assessment by an independent cardiologist review of initial and subsequent imaging results...
November 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28941605/prevention-of-left-ventricular-thrombus-formation-and-systemic-embolism-after-anterior-myocardial-infarction-a%C3%A2-systematic-literature-review
#20
REVIEW
Alexandra Bastiany, Marie-Eve Grenier, Alexis Matteau, Samer Mansour, Benoit Daneault, Brian J Potter
BACKGROUND: Anterior myocardial infarction (MI) with apical dysfunction is associated with an increased risk of left ventricular thrombus (LVT) formation and systemic embolism (SE). However, the role for prophylactic anticoagulation in current practice is a matter of debate. METHODS: We conducted a systematic review of peer-reviewed original articles in either English or French on the benefit of combining anticoagulation with standard therapy for the prevention of LVT/SE after MI by searching PubMed, Ovid/MedLine/Embase, the Cochrane Library, and Google Scholar...
October 2017: Canadian Journal of Cardiology
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