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https://www.readbyqxmd.com/read/28777390/thrombosis-in-left-ventricular-assistance-device-with-centrifugal-technology-is-early-thrombolysis-a-better-solution
#1
Paolo Centofanti, Andrea Baronetto, Matteo Attisani, Davide Ricci, Erika Simonato, Michele W La Torre, Massimo Boffini, Mauro Rinaldi
BACKGROUND: Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. METHODS: We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016...
July 27, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28757150/temporal-differences-in-outcomes-during-long-term-mechanical-circulatory-support
#2
Simon Maltais, Lucman A Anwer, Nicholas A Haglund, Jennifer Cowger, Palak Shah, Keith D Aaronson, Francis D Pagani, Shannon M Dunlay, Ramesh Singh, Christopher T Salerno, John M Stulak
BACKGROUND: Device indications have changed for placement of continuous-flow left ventricular assist devices (CF-LVADs). We performed a multicenter analysis evaluating temporal variations in outcomes after CF-LVAD implantation. METHODS & RESULTS: We retrospectively defined three time intervals to reflect changes in CF-LVAD technology (Period 1: 2004 to 2009; Period 2: 2010 to 2012; and Period 3: 2012 to 2014). A total of 1,064 patients (HeartMate II (HMII)=835, HeartWare (HVAD)=229) underwent CF-LVAD implantation between May 2004 and October 2014...
July 27, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28746082/heartware-ventricular-assist-device-as-a-bridge-to-transplant-in-a-small-boy-with-complicated-kawasaki-disease
#3
Christopher E Mascio, Dhananjay P Malankar, Jonathan J Rome
We report a case of HeartWare ventricular assist device (HVAD) implant as a Bridge-to-Transplant in the smallest and the youngest known patient, a 32-month-old boy (body surface area of 0.66 m2) with known Kawasaki disease and giant coronary artery aneurysms. The disease course was complicated by coronary thromboembolism resulting in acute myocardial infarction, ventricular fibrillation, and cardiac arrest. After short-term support with extracorporeal membrane oxygenation for 7 days and long-term support with an HVAD for 5 months, he underwent heart transplantation and is doing well 2 months after the transplant...
July 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28741664/in-vitro-evaluation-of-an-immediate-response-starling-like-controller-for-dual-rotary-blood-pumps
#4
Andrew F Stephens, Michael C Stevens, Shaun D Gregory, Matthias Kleinheyer, Robert F Salamonsen
Rotary ventricular assist devices (VADs) are used to provide mechanical circulatory support. However, their lack of preload sensitivity in constant speed control mode (CSC) may result in ventricular suction or venous congestion. This is particularly true of biventricular support, where the native flow-balancing Starling response of both ventricles is diminished. It is possible to model the Starling response of the ventricles using cardiac output and venous return curves. With this model, we can create a Starling-like physiological controller (SLC) for VADs which can automatically balance cardiac output in the presence of perturbations to the circulation...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28734437/two-pumps-for-single-ventricle-mechanical-support-for-establishment-of-biventricular-circulation
#5
Stanislav Ovroutski, Oliver Miera, Thomas Krabatsch, Felix Berger, Joachim Photiadis, Evgenii Potapov
A 31-year-old patient with a univentricular heart and double-inlet left ventricle, moderate pulmonary stenosis, and severe mitral valve regurgitation experienced irreversible heart failure after mitral valve replacement. "Biventricular" mechanical circulatory support was initiated. The systemic circulation was supported using the HeartWare ventricular assist device (HVAD) (HeartWare, Framingham, MA) pump in the usual manner. The second pump was inserted into the right atrium and connected to the pulmonary artery after closure of the pulmonary valve and atrial separation...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28674109/left-ventricular-assist-device-malfunctions-it-s-more-than-just-the-pump
#6
Robert L Kormos, Michael McCall, Andrew D Althouse, Lagazzi Luigi, Richard D Schaub, Michael A Kormos, Jared A Zaldonis, Christopher M Sciortino, Kathleen L Lockard, Nicole M Kuntz, Elizabeth M Dunn, Jeffrey J Teuteberg
Background -Reports of left ventricular assist device (LVAD) malfunction have focused on pump thrombosis. However, the device consists of the pump, driveline and peripherals, all of which are potentially subject to failure. Methods -Prospectively collected data were reviewed for all LVAD device malfunctions (DM) occurring in rotary LVADs implanted at a single center between April 2004 and May 2016. Durable LVADs included 108 Heartmate II (HMII) and 105 HeartWare ventricular assist devices (HVAD). DM data were categorized according to device type and into categories related to the component that failed: a) controller, b) peripheral components and c) the implantable blood pump or its integral electrical driveline...
July 3, 2017: Circulation
https://www.readbyqxmd.com/read/28665826/unrecognized-left-heart-failure-in-lvad-recipients-the-role-of-routine-invasive-hemodynamic-testing
#7
Palak Shah, Nina Badoe, Sheila Phillips, Kamil Abdullah, Christopher W May, Jose L Nabut, Ramesh Singh, Christopher deFilippi, Shashank S Desai
The role of routine right heart catheterizations (RHCs) in left ventricular assist device (LVAD) patients is undefined. We analyzed 105 continuous-flow LVAD recipients who underwent an RHC approximately 3 months after implant. In 38 patients, LVAD speed was ramped with the goal of optimizing hemodynamics. Our cohort consisted of 71 (68%) HeartMate II (HMII) and 34 (32%) HeartWare (HVAD) patients. Thirty patients (29%) had either a reduced cardiac index (CI ≤ 2.2 L/min/m), elevated pulmonary capillary wedge pressure (PCWP > 18 mm Hg), or both...
June 24, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28645834/left-ventricular-assist-device-therapy-for-destination-therapy-is-less-invasive-surgery-a-safe-alternative
#8
Sebastian V Rojas, Jasmin S Hanke, Murat Avsar, Philipp R Ahrens, Ove Deutschmann, Kirstin A Tümler, Aitor Uribarri, Sara Rojas-Hernández, Pedro L Sánchez, José M González-Santos, Axel Haverich, Jan D Schmitto
INTRODUCTION AND OBJECTIVES: The number of older patients with congestive heart failure has dramatically increased. Because of stagnating cardiac transplantation, there is a need for an alternative therapy, which would solve the problem of insufficient donor organ supply. Left ventricular assist devices (LVADs) have recently become more commonly used as destination therapy (DT). Assuming that older patients show a higher risk-profile for LVAD surgery, it is expected that the increasing use of less invasive surgery (LIS) LVAD implantation will improve postoperative outcomes...
June 20, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28621882/exercise-capacity-and-functional-performance-in-heart-failure-patients-supported-by-a-left-ventricular-assist-device-at-discharge-from-inpatient-rehabilitation
#9
Thomas Schmidt, Birna Bjarnason-Wehrens, Petra Bartsch, Ezin Deniz, Jan Schmitto, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Adequate physical and functional performance is an important prerequisite for renewed participation and integration in self-determined private and (where appropriate) professional lives following left ventricular assist device (LVAD) implantation. During cardiac rehabilitation (CR), individually adapted exercise programs aim to increase exercise capacity and functional performance. A retrospective analysis of cardiopulmonary exercise capacity and functional performance in LVAD patients at discharge from a cardiac rehabilitation program was conducted...
June 16, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28604571/hvad-waveform-analysis-as-a-noninvasive-marker-of-pulmonary-capillary-wedge-pressure-a-first-step-toward-the-development-of-a-smart-left-ventricular-assist-device-pump
#10
Jonathan Grinstein, Daniel Rodgers, Sara Kalantari, Gabriel Sayer, Gene H Kim, Nitasha Sarswat, Sirtaz Adatya, Takeyoshi Ota, Valluvan Jeevanandam, Daniel Burkhoff, Nir Uriel
Flow waveforms are an important feature of the HVAD left ventricular assist device (LVAD) that provides information about HVAD function and patient hemodynamics. We assessed the properties of one specific aspect of the waveform, the slope of the ventricular filling phase (VFP), and its correlation with pulmonary capillary wedge pressure (PCWP). A total of 101 screenshots from the HVAD monitor and simultaneous hemodynamic measurements were obtained simultaneously during sequential stages of invasive hemodynamic ramp studies...
June 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28562236/left-ventricular-assist-device-exchange-the-toronto-general-hospital-experience
#11
Hideki Tsubota, Roberto V P Ribeiro, Filio Billia, Robert J Cusimano, Terrence M Yau, Mitesh V Badiwala, William E Stansfield, Vivek Rao
BACKGROUND: As support times for left ventricular assist devices (LVADs) become longer, several complications requiring device exchange may occur. To our knowledge, this is the first Canadian report regarding implantable LVAD exchange. METHODS: We retrospectively reviewed the cases of consecutive, unique patients implanted with an LVAD between June 2006 and October 2015 at Toronto General Hospital. RESULTS: In total, 122 patients were impanted with an LVAD during the study period...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28515757/emergency-heartware-ventricular-assist-device-hvad-exchange-due-to-pump-thrombosis-using-minimally-invasive-technique
#12
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/28475561/adverse-event-rates-change-favorably-over-time-for-patients-bridged-with-the-heartware-left-ventricular-assist-device
#13
Simon Maltais, Keith D Aaronson, Jeffrey J Teuteberg, Mark S Slaughter, Samer S Najjar, Valluvan Jeevanandam, Duc T Pham, Ed McGee, Katrin Leadley, Robert L Kormos
The HeartWare Ventricular Assist System (HVAD) provides significant improvements in survival and quality of life, and here, we seek to evaluate temporal differences in the adverse event (AE) rates. Patients (n = 382) in the ADVANCE bridge-to-transplant and continued access protocol trial were assessed for bleeding, cardiac arrhythmia, infection, ischemic and hemorrhagic stroke, and right heart failure during predetermined time periods (≤30, >30-180, >180-365, >365-730, >730-1,095 days) after HVAD implant...
May 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28467129/heartware-hvad-for-end-stage-heart-failure-a-review-of-clinical-experiences-with-%C3%A2-50-patients
#14
Luca Botta, Benedetta De Chiara, Francesca Macera, Aldo Cannata, Alessandro Costetti, Alessandra Voltolini, Antonella Moreo, Manlio Cipriani, Maria Frigerio, Claudio Francesco Russo
Despite the improvements in medical and surgical treatments, the incidence of end-stage heart failure (ESHF) continues to increase. Different mechanical systems have been adopted to support failing left ventricles. Among continuous-flow devices, the HeartWare-HVAD was the first to use a centrifugal pump rather than an axial one. Areas covered: In this review article, we provide an overview of the HeartWare-HVAD as a ventricular assist device for ESHF, discussing indications, echocardiographic assessment, surgical techniques, outcomes, concerns and controversies...
June 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28412431/3d-morphological-changes-in-lv-and-rv-during-lvad-ramp-studies
#15
Karima Addetia, Nir Uriel, Francesco Maffessanti, Gabriel Sayer, Sirtaz Adatya, Gene H Kim, Nitasha Sarswat, Savitri Fedson, Diego Medvedofsky, Eric Kruse, Keith Collins, Daniel Rodgers, Takayoshi Ota, Valluvan Jeevanandam, Victor Mor-Avi, Daniel Burkhoff, Roberto M Lang
OBJECTIVES: The purpose of this study was to investigate the differential impact of the 2 most commonly available left ventricular assist device (LVAD) types on the right (RV) and left (LV) ventricles using 3-dimensional (3D) echocardiography-based analysis of ventricular morphology. BACKGROUND: LVADs have emerged as common therapy for advanced heart failure. Recent data suggest that the heart responds differently to speed settings in the 2 main devices available (HeartMate II [HMII], St Jude Medical, Pleasanton, California, and HVAD, HeartWare International, Framingham, Massachusetts)...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329112/comparison-of-paracorporeal-and-continuous-flow-ventricular-assist-devices-in-children-preliminary-results
#16
Mohamed S Nassar, Asif Hasan, Teresa Chila, Stephan Schueler, Carola Pergolizzi, Zdenka Reinhardt, Stephen Lord, Fabrizio De Rita, Lee Ferguson, Jon Smith, Simon Haynes, John O'Sullivan, Bari Murtuza
Objectives: With the scarcity of organs, a durable, reliable ventricular assist device (VAD) is required. The Berlin Heart EXCOR ® (BH) remains the most established VAD in the paediatric population. Implantable continuous flow (CF) VADs have been introduced to the paediatric field with encouraging early results. In this study, we compared the results of a newly introduced CF VAD (HeartWare VAD [HVAD] ® ) to results in a matched group of BH recipients. Methods: The study included patients aged <16 years who received mechanical left VAD (LVAD) support between December 2005 and January 2016...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329060/first-series-of-left-ventricular-assist-device-exchanges-to-heartmate-3
#17
Jasmin S Hanke, Sebastian V Rojas, Günes Dogan, Christina Feldmann, Erik Beckmann, Ezin Deniz, Bettina Wiegmann, Jana-Elena Michaelis, L Christian Napp, Dominik Berliner, Malakh Shrestha, Johann Bauersachs, Axel Haverich, Jan D Schmitto
OBJECTIVES: Left ventricular assist device (LVAD) exchange is becoming a standard surgical procedure. The exchange procedure is an opportunity to upgrade patients to a new generation pump that offers advanced reduction of adverse events or longer battery hours. METHODS: We performed an analysis of 6 consecutive patients who underwent LVAD exchange to HeartMate 3 either from a HeartWare or HeartMate (HM) II device. Minimally invasive operations were performed through a lateral thoracotomy...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28323662/hvad-flow-waveform-morphologies-theoretical-foundation-and-implications-for-clinical-practice
#18
Jonathan D Rich, Daniel Burkhoff
Continuous flow ventricular assist device (cfVAD) performance and patient hemodynamic conditions are intimately interrelated and dynamic, changing frequently with alterations in physiologic conditions, particularly pre- and after-loading conditions. The Heartware cfVAD (HVAD) provides a unique feature among currently approved VADs of providing an estimated instantaneous flow waveform, the characteristics of which can provide significant insights into patient and device properties. Despite being readily available, HVAD waveforms are poorly understood, underutilized and insufficiently leveraged, even by clinicians who regularly manage HVAD patients...
March 16, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28238649/comprehensive-assessment-of%C3%A2-the-heartware-hvad-left%C3%A2-ventricular-assist-device-with-4-dimensional%C3%A2-cardiac-computed%C3%A2-tomography
#19
Manuel Barreiro-Pérez, Aitor Uribarri, Javier López-Rodríguez, Sebastián V Rojas, José M González-Santos, Pedro L Sánchez
No abstract text is available yet for this article.
February 23, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28195884/interventional-treatment-of-lvad-outflow-graft-stenosis-by-introduction-of-bare-metal-stents
#20
Dominik Wiedemann, Thomas Schlöglhofer, Thomas Haberl, Julia Riebandt, Kamen Dimitrov, Heinrich Schima, Johannes Kastner, Wolfgang Matzek, Günther Laufer, Daniel Zimpfer
LVAD outflow graft stenosis is a rare but life-threatening complication of MCS-therapy. Current treatment modalities (pump exchange or systemic thrombolytic therapy) are associated with significant mortality and morbidity.Implantation of bare metal stents within the stenosed outflow graft is an alternative. Herein we describe a series of 3-cases with successful stent placement. This seems to be safe and successful however correct and early diagnosis of outflow stenosis can be challenging. Information provided by the HeartWare HVAD logfiles are extremely helpful for diagnosis...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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