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https://www.readbyqxmd.com/read/29290308/continuous-flow-left-ventricular-assist-device-implantation-in-patients-with-a-small-left-ventricle
#1
Masashi Kawabori, Chitaru Kurihara, Tadahisa Sugiura, William E Cohn, Andrew B Civitello, O Howard Frazier, Jeffrey A Morgan
BACKGROUND: Having a preoperative small left ventricle (LV) has been associated with higher complication and mortality rates after left ventricular assist device (LVAD) implantation; however, the outcomes after continuous-flow LVAD implantation have not been well studied. This is the first large-scale analysis of long-term survival after continuous-flow LVAD implantation in patients with a preoperative small LV. METHODS: Our cohort comprised 511 patients who underwent primary implantation of a HeartMate II (n = 393 [Thoratec, Pleasanton, CA]) or HeartWare HVAD (n = 118 [HeartWare International, Framingham, MA]) at our institution between November 2003 and March 2016...
December 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29282819/platelet-activation-is-a-preoperative-risk-factor-for-the-development-of-thromboembolic-complications-in-patients-with-continuous-flow-left-ventricular-assist-device
#2
Filippo Consolo, Giulia Sferrazza, Giulia Motolone, Rachele Contri, Lorenzo Valerio, Rosalba Lembo, Loris Pozzi, Patrizia Della Valle, Michele De Bonis, Alberto Zangrillo, Gianfranco B Fiore, Alberto Redaelli, Marvin J Slepian, Federico Pappalardo
AIMS: To correlate the dynamics of platelet activation with the development of thromboembolic events in patients with continuous-flow left ventricular assist device (cf-LVAD). METHODS AND RESULTS: The platelet activity state (PAS) assay was utilized to evaluate platelet activation in 68 cf-LVAD patients implanted with the HeartMate II (n = 15, 22%), HeartMate 3 (n = 15, 22%), or HeartWare HVAD (n = 38, 56%). PAS was measured preoperatively, early post-implant, and at long-term follow-up (1, 3, 6, 12, 18, and 24 months post-implant)...
December 28, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29206805/axial-to-centrifugal-continuous-flow-lvad-pump-exchange-using-minimally-invasive-technique
#3
Amit A Pawale, Ariel Farkash, Dimosthenis Pandis, Anelechi C Anyanwu
Driveline or device infection may complicate left ventricular assist device implants, and only curative option may be pump exchange. Replacement with similar device may be liable to reinfection, because pump configuration is such that the new device and driveline may partly lie within the pocket of the previous pump. One approach to overcome this is using a different pump design such that the new pump would lie in a different location from the old pump. We describe treatment of severe HeartMate II (Abbott, [St Jude Thoratec Corp], Pleasanton, CA USA) left ventricular assist device infection by minimally invasive exchange to an intrapericardial HVAD (HeartWare International, Inc, Framingham, MA USA) left ventricular assist device...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29197135/biventricular-support-with-heartware-ventricular-assist-device-in-a-pediatric-patient
#4
Shriprasad R Deshpande, Mallory M Carroll, Chad Mao, William T Mahle, Kirk Kanter
Use of ventricular assist devices is increasing in the pediatric population. This has included the extended use of adult continuous-flow devices in the pediatric population. In a minority of cases, biventricular support may be needed. In these situations, biventricular support with continuous-flow devices can be surgically challenging, and therefore, only few cases have been reported. Here, we present a case of implantation of two HeartWare HVAD devices for biventricular support for a decompensating patient with acute myocarditis as well as present an alternative implantation surgical strategy...
December 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29141690/resternotomy-does-not-adversely-affect-outcome-after-left-ventricular-assist-device-implantation
#5
Maria Papathanasiou, Loukas Tsourelis, Nikolaus Pizanis, Achim Koch, Markus Kamler, Tienush Rassaf, Peter Luedike
BACKGROUND: Resternotomy in cardiac surgery is considered a risk factor for postoperative complications. Previous studies have demonstrated an ambiguous relationship between resternotomy and clinical outcomes. Registry data from a mixed population of durable circulatory support devices suggest that history of cardiac surgery is a risk factor for mortality. Our study investigates the prognostic significance of resternotomy in a homogenous cohort of left ventricular assist device (LVAD) recipients...
November 15, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/29117041/repeated-ramp-tests-on-stable-lvad-patients-reveal-patient-specific-hemodynamic-fingerprint
#6
Teruhiko Imamura, Daniel Burkhoff, Daniel Rodgers, Sirtaz Adatya, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, Colleen Juricek, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
Hemodynamic speed ramp tests are used in left ventricular assist device (LVAD) patients to guide speed adjustment and medical therapies. However, the reproducibility of these tests is unknown. In this prospective study, clinically stable LVAD patients underwent echocardiography and right heart catheterization ramp tests followed by a repeat test within 2 years as per institutional protocol. Sixteen patients (61.8 ± 10.5 years old, 50% male, eight with HeartMate II and eight with HVAD) underwent repeated ramp testing...
November 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29095733/left-lateral-thoracotomy-for-centrifugal-continuous-flow-left-ventricular-assist-device-placement-an-analysis-from-the-mechanical-circulatory-support-research-network
#7
Simon Maltais, Lucman A Anwer, Vakhtang Tchantchaleishvili, Nicholas A Haglund, Shannon M Dunlay, Keith D Aaronson, Francis D Pagani, Jennifer Cowger, Christopher T Salerno, Palak Shah, Zain Khalpey, Jan Schmitto, John M Stulak
Continuous-flow left ventricular assist devices (CF-LVADs) have revolutionized the management of patients with advanced heart failure. Alternative implant strategies are increasingly used for device placement. We reviewed our experience from the Mechanical Circulatory Support Research Network registry with the HeartWare centrifugal CF-LVAD (HVAD). From May 2004 to August 2015, 1,150 patients underwent primary CF-LVAD implantation at our institutions. Within this group, a total of 283 patients (25%) were implanted with the HVAD...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29059075/extracorporeal-membrane-oxygenation-berlin-and-ventricular-assist-devices-a-primer-for-the-cardiologist
#8
Charlotte S Van Dorn, Devon O Aganga, Jonathan N Johnson
PURPOSE OF REVIEW: Mechanical circulatory support (MCS) has become an indispensable tool in the management of children with impending respiratory and cardiac failure. Though extracorporeal membrane oxygenation (ECMO) was classically the only form of support available to pediatric patients, considerable advances have allowed ventricular assist devices (VADs) to become increasingly utilized in children. This review provides an update of recent advances in ECMO and VAD management in children...
October 20, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29049614/anticoagulation-management-following-left-ventricular-assist-device-implantation-is-similar-across-all-provider-strategies
#9
Asia McDavid, Kelly MacBrair, Sitaramesh Emani, Lianbo Yu, Peter H U Lee, Bryan A Whitson, Brent C Lampert, Riddhima Agarwal, Ahmet Kilic
OBJECTIVES: Thromboembolic and bleeding events are potential complications following left ventricular assist device implantation. A tight control of the international normalized ratio (INR) is believed to be crucial in the reduction of postimplant complications. There is significant variability among institutions as to whether a device implanting centre should be managing the INR. In this study, we evaluated the effect of INR management strategies in maintaining a therapeutic INR. METHODS: A retrospective review was utilized to identify patients implanted with either the HeartMate II or the HeartWare HVAD between January 2011 and February 2016...
August 14, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29048703/a-pilot-study-on-the-efficacy-and-safety-of-a-minimally-invasive-surgical-and-anesthetic-approach-for-ventricular-assist-device-implantation
#10
Jonida Bejko, Demetrio Pittarello, Gianclaudio Falasco, Guido Di Gregorio, Vincenzo Tarzia, Giulio Rizzoli, Dario Gregori, Gino Gerosa, Tomaso Bottio
BACKGROUND: The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation. METHODS: 68 patients (50.4 ± 17.1 years old) were supported with the HeartWare® HVAD (32 patients) and the Jarvik 2000 VAD (36 patients) between January 2010 and August 2016. Two surgical techniques were applied: a minimally invasive approach with the aid of paravertebral-block (mini-invasive group, 41 patients) and a standard-surgical-approach with the aid of general anesthesia (27 patients)...
October 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29035899/driveline-site-is-not-a-predictor-of-infection-after-ventricular-assist-device-implantation
#11
Billie-Jean Martin, Jessica G Y Luc, Michiko Maruyama, Roderick MacArthur, Angela R Bates, Holger Buchholz, Darren H Freed, Jennifer Conway
Driveline infections (DLIs) remain a major source of morbidity for patients requiring long-term ventricular assist device (VAD) support. We aimed to assess whether VAD driveline exit site (DLES) (abdomen versus chest wall) is associated with DLI. All adult patients who underwent insertion of a HeartWare HVAD or HeartMate II (HMII) between 2009 and 2016 were included. Driveline infection was defined as clinical evidence of DLI accompanied by a positive bacterial swab and need for antibiotics. Competing risks analysis was used to assess the association between patient characteristics and DLI...
October 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29032583/third-generation-ventricular-assist-device-mid-term-outcomes-of-the-heartware-hvad-in-pediatric-patients
#12
Mustafa Pac, Sinan Sabit Kocabeyoglu, Umit Kervan, Dogan Emre Sert, Serhat Koca, Ibrahim Ece, Feyza Aysenur Pac
The HeartWare HVAD is a small, third generation continuous flow pump that is intracorporeally placed for support of a failing ventricle in adult patients. This device is small in size when compared to other left ventricular assist devices and can therefore be used in smaller sized pediatric patients. We present our initial experience using the HVAD as a bridge to heart transplantation in the pediatric population. We performed a retrospective, single center, nonrandomized review of 17 pediatric patients who underwent HVAD implantation between June 2013 and March 2016...
October 15, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28988400/left-ventricle-assist-devices-and-driveline-s-infection-incidence-a-single-centre-experience
#13
Jonida Bejko, Francesca Toto, Dario Gregori, Gino Gerosa, Tomaso Bottio
Different left ventricular assist devices (LVADs) are provided of different driveline exit sites: HeartWare HVAD presents abdominal power-cable-supply, while the Jarvik 2000 LVAD is powered by a retroauricular driveline. We analyzed 93 LVAD-implanted patients from January-2009 to October-2016 (41 HeartWare and 52 Jarvik 2000), hypothesizing a different incidence of infection, according to driveline exit site. The two populations were propensity matched for the demographic data and preoperative variables, and the outcomes were further analyzed...
October 7, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28982636/cannula-and-pump-positions-are-associated-with-left-ventricular-unloading-and-clinical-outcome-in-patients-with-heartware-left-ventricular-assist-device
#14
Teruhiko Imamura, Sirtaz Adatya, Ben Chung, Ann Nguyen, Daniel Rodgers, Gabriel Sayer, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, Colleen Juricek, Diego Medvedofsky, Valluvan Jeevanandam, Roberto Lang, Jerry D Estep, Daniel Burkhoff, Nir Uriel
BACKGROUND: Cannula and pump positions are associated with clinical outcomes such as device thrombosis in patients with HeartMate II. However, clinical implications of HVAD cannula position are unknown. This study aims to assess the relationship between cannula position, left ventricular (LV) unloading and patient prognosis. METHODS AND RESULTS: Twenty-seven HVAD patients (60.0 ± 12.6 years old and 19 male [70%]) underwent ramp test. Device position was quantified from chest X-ray parameters obtained at time of hemodyamic ramp test: (1) cannula coronal angle, (2) pump depth, (3) cannula sagittal angle and (4) pump area...
October 2, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28958451/preoperative-prealbumin-level-as-a-predictor-of-outcomes-in-patients-who-underwent-left-ventricular-assist-device-implantation
#15
Andre C Critsinelis, Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Malnutrition has been associated with an increased risk of morbidity and mortality in patients who undergo cardiac surgery. However, many measurements of malnutrition have been inadequate prognostic markers. In this study, we sought to determine whether low preoperative serum prealbumin level was associated with morbidity and mortality in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. From November 2003 to March 2016, 526 patients with chronic heart failure underwent implantation of a CF-LVAD (HeartMate II, n = 403; HeartWare HVAD, n = 123)...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28947307/prognostic-implications-of-changes-in-albumin-following-left-ventricular-assist-device-implantation-in-patients-with-severe-heart-failure
#16
Dipika J Gopal, Thomas C Hanff, Jeremy A Mazurek, Wilson E Grandin, Jessica Howard, Rhondalyn Forde-McLean, Joyce Wald, Kathie King, Michael A Acker, Lee R Goldberg, Mariell Jessup, Pavan Atluri, Kenneth B Margulies, Eduardo J Rame, Edo Y Birati
Mechanical assist devices have emerged as an established therapeutic option for patients with end-stage heart failure. Because preimplant hypoalbuminemia is a known risk factor for adverse outcomes, we hypothesized that change in albumin may be a prognostic indicator in patients with continuous-flow left ventricular assist devices (cfLVADs). This is a retrospective single-center study of patients who underwent cfLVAD implantation (HeartMate II and HeartWare HVAD) at an academic center from 2008 to 2014. After excluding those who died, were transplanted, or hospitalized during the first 3 months post-implant, albumin values were obtained and stratified by an increase or a decrease from pre-implant to 3 months post-implant on 171 (81% male, mean age 57 ± 16 years) patients (139 for the survival analysis and 90 for the hospitalization analysis)...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28938306/different-clinical-course-and-complications-in-interagency-registry-for-mechanically-assisted-circulatory-support-1-patients-managed-with-or-without-extracorporeal-membrane-oxygenation
#17
Jason J Han, Jennifer Chung, Carol W Chen, Ann C Gaffey, Alex Sotolongo, Christyna Justice, Alyse E Ameer, J Eduardo Rame, Christian Bermudez, Michael A Acker, Pavan Atluri
Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28887110/percutaneous-decommissioning-of-left-ventricular-assist-device
#18
Jia-Lin Soon, Ju-Le Tan, Choon-Pin Lim, Teing-Ee Tan, Swee-Yaw Tan, Ka-Lee Kerk, Kheng-Leng David Sim, Cumaraswamy Sivathasan
BACKGROUND: The Left Ventricular Assist Device (LVAD) has revolutionised our treatment of advanced stage heart failure, giving debilitated patients a new lease on life. A small proportion of these LVAD patients can be bridged-to-recovery. The identification of these patients and decision to wean, however, can be challenging. METHODS: The need to fully explant the device upon recovery has evolved to a minimalist approach aiming to avoid injury to the 'recovered' heart...
August 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28846527/kinking-of-the-outflow-graft-consequent-ventricular-tachycardia-and-the-need-for-reoperation-in-a-patient-with-left-ventricular-assist-device
#19
Dusko Terzic, Emilija Nestorovic, Svetozar Putnik, Dejan Markovic, Miljko Ristic
BACKGROUND: Left ventricular assist devices (LVAD) have become a lifesaving solution for patients awaiting heart transplantation as well as an option to support the failing hearts of non-transplant candidates as a lifelong, or destination therapy (DT). Improvements in LVAD design have enabled greater durability and broader patient applicability, but not without complications. Ventricular arrhythmias in LVAD patients were considered benign in the early days of LVADs, but today are increasingly recognized for their harmful impact on morbidity and quality of life...
August 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28841580/durable-biventricular-support-using-right-atrial-placement-of-the-heartware-hvad
#20
Hao A Tran, Travis L Pollema, Jorge Silva Enciso, Barry H Greenberg, Denise D Barnard, Eric D Adler, Victor G Pretorius
Patients with Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1-2 who either have or are at risk for right ventricular failure face significant morbidity and mortality after continuous flow left ventricular assist device (CF-LVAD) implantation. Currently, the options for biventricular support are limited the Total Artificial Heart (TAH; CardioWest, Syncardia, Tuscon, AZ) or biventricular assist device (BiVAD), which uses bulky extracorporeal or implantable displacement pumps...
August 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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