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https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#1
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29766321/acute-kidney-injury-after-implantation-of-a-left-ventricular-assist-device-a-comparison-of-axial-flow-heartmate-ii-and-centrifugal-flow-heartware-hvad-devices
#2
Azeen Anjum, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Whitson B Etheridge, Reynolds M Delgado, Leo Simpson, Joggy K George, Ajith P Nair, O H Frazier, Jeffrey A Morgan
Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly being used to treat advanced, refractory chronic heart failure. Herein, we sought to determine the incidence of postoperative acute kidney injury (AKI) in axial-flow (HeartMate II; HM-II) and centrifugal-flow (HVAD) CF-LVAD recipients, as well as the effect of AKI on mortality. The study cohort comprised 520 patients who received a HM-II (n = 398) or HVAD (n = 122) at our center between November 2003 and March 2016. Their records were reviewed to determine the incidence of RIFLE-defined AKI after LVAD implantation...
May 15, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29759673/characterization-of-ventricular-tachycardia-after-left-ventricular-assist-device-implantation-as-destination-therapy-a-single-center-ablation-experience
#3
Joshua D Moss, Erin E Flatley, Andrew D Beaser, John H Shin, Hemal M Nayak, Gaurav A Upadhyay, Martin C Burke, Valluvan Jeevanandam, Nir Uriel, Roderick Tung
OBJECTIVES: This study sought to report mechanisms of ventricular tachycardia (VT) and outcomes of VT ablation in patients with a left ventricular assist device (LVAD) as destination therapy. BACKGROUND: Continuous flow LVAD implantation plays a growing role in the management of end-stage heart failure, and VT is common. There are limited reports of VT ablation in patients with a destination LVAD. METHODS: Patients with a continuous-flow LVAD referred for VT ablation from 2010 to 2016 were analyzed retrospectively...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29734257/noninvasive-measures-of-pulsatility-and-blood-pressure-during-continuous-flow-left-ventricular-assist-device
#4
Sabarivinoth Rangasamy, Shivank Madan, Omar Saeed, Daniel J Goldstein, Ulrich P Jorde, Abdissa Negassa, Snehal R Patel
The reliability and validity of a palpable pulse and other noninvasive measures of pulsatility in patients on continuous-flow (CF) left ventricular assist device (LVAD) support have not been rigorously evaluated. We prospectively enrolled 23 patients who had CF-LVAD and an arterial catheter for blood pressure (BP) monitoring. Pulse pressure (PP) via the arterial line was compared with three noninvasive measures of pulsatility: presence of a palpable pulse, pulsatility index (PI), and aortic valve opening (AVO)...
April 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29726019/speed-modulation-of-the-heartware-hvad-to-assess-in-vitro-hemocompatibility-of-pulsatile-and-continuous-flow-regimes-in-a-rotary-blood-pump
#5
Jarod T Horobin, Michael J Simmonds, Deepika Nandakumar, Shaun D Gregory, Geoff Tansley, Jo P Pauls, Angela Girnghuber, Nicoletta Balletti, John F Fraser
Although rotary blood pumps (RBPs) sustain life, blood exposure to continuous supra-physiological shear stress induces adverse effects (e.g., thromboembolism); thus, pulsatile flow in RBPs represents a potential solution. The present study introduced pulsatile flow to the HeartWare HVAD using a custom-built controller and compared hemocompatibility biomarkers (i.e., platelet aggregation, concentrations for ADAMTS13, von Willebrand factor (vWf), and free-hemoglobin in plasma (pfHb), red blood cell (RBC) deformability, and RBC-nitric oxide synthase (NOS) activity) between continuous and pulsatile flow in a blood circulation loop over 5 h...
May 3, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29626453/meld-xi-scoring-system-to-predict-outcomes-in-patients-who-undergo-lvad-implantation
#6
Andre Critsinelis, Chitaru Kurihara, Nastasya Volkovicher, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Suwei Wang, Andrew B Civitello, Jeffrey A Morgan
BACKGROUND: The use of continuous flow left ventricular assist devices (CF-LVAD) to treat advanced heart failure is increasing. While risk score such as MELD and the HeartMate II Risk Score require the use of INR, many patients are on anticoagulation prior to CF-LVAD implantation. The aim of this study was to evaluate the ability of the Model of End-Stage Liver Disease-eXcluding INR (MELD-XI) scoring system to predict clinical outcomes in patients with advanced heart failure who undergo CF-LVAD implantation...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29567308/ventricular-flow-dynamics-with-varying-lvad-inflow-cannula-lengths-in-silico-evaluation-in-a-multiscale-model
#7
Sam Liao, Michael Neidlin, Zhiyong Li, Benjamin Simpson, Shaun D Gregory
Left ventricular assist devices are associated with thromboembolic events, which are potentially caused by altered intraventricular flow. Due to patient variability, differences in apical wall thickness affects cannula insertion lengths, potentially promoting unfavourable intraventricular flow patterns which are thought to be correlated to the risk of thrombosis. This study aimed to present a 3D multiscale computational fluid dynamic model of the left ventricle (LV) developed using a commercial software, Ansys, and evaluate the risk of thrombosis with varying inflow cannula insertion lengths in a severely dilated LV...
March 10, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29551744/worldwide-experience-of-a-durable-centrifugal-flow-pump-in-pediatric-patients
#8
Jennifer Conway, Oliver Miera, Iki Adachi, Katsuhide Maeda, Pirooz Eghtesady, Heather T Henderson, Kristine Guleserian, Chu-Po S Fan, Richard Kirk
The primary objectives of this study were to describe the characteristics and survival outcomes for children supported with the HeartWare HVAD® system from the global community. This was a retrospective survey of patients <18 years of age with an HVAD® system. Questionnaires were sent to sites worldwide in April 2015 and collected between May 2015 and 2016. Information on 205 patients was collected. The median age at implantation was 13.1 years (interquartile range [IQR] 9.8-15.8 years) and the weight was 42 kg (IQR 28-60 kg)...
March 15, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29550313/noninvasive-assessment-of-hemodynamic-status-in-heartware-left-ventricular-assist-device-patients-validation-of-an-echocardiographic-approach
#9
Simone Frea, Paolo Centofanti, Stefano Pidello, Francesca Giordana, Virginia Bovolo, Andrea Baronetto, Beatrice Franco, Marco Matteo Cingolani, Matteo Attisani, Mara Morello, Serena Bergerone, Mauro Rinaldi, Fiorenzo Gaita
OBJECTIVES: The aim of this prospective study was to validate an echocardiographic protocol derived from 5 HeartWare left ventricular assist device (HVAD) patients for the noninvasive evaluation of right atrial pressure (RAP) and left atrial pressure (LAP) in HVAD patients. BACKGROUND: Echocardiography is an invaluable tool to optimize medical treatment and pump settings and also for troubleshooting residual heart failure. Little is known about the echocardiographic evaluation of hemodynamic status in HVAD patients...
March 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29530775/construction-of-an-apical-plug-for-explantation-of-heartware-hvad-left-ventricular-assist-device
#10
Shawn M Shah, Nicholas R Teman, Eileen Dearth, Leora T Yarboro, John A Kern
Utilization of a left ventricular assist device (LVAD) as a bridge to myocardial recovery is an established therapy for acute systolic heart failure. However, device removal can present a technical challenge with no clear consensus on preferred method. In this case report, we describe a complex patient who underwent successful explantation of an LVAD using an intraoperatively constructed apical plug. This method utilizes inexpensive and easily accessible materials, minimizes ventricular distortion during device removal, and preserves the ventricular sewing ring for future reimplantation...
March 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29512410/experimental-measurement-and-numerical-modelling-of-dye-washout-for-investigation-of-blood-residence-time-in-ventricular-assist-devices
#11
Alessandra Molteni, Zubair Ph Masri, Kenny Wq Low, Haitham N Yousef, Johann Sienz, Katharine H Fraser
Ventricular assist devices have become the standard therapy for end-stage heart failure. However, their use is still associated with severe adverse events related to the damage done to the blood by fluid dynamic stresses. This damage relates to both the stress magnitude and the length of time the blood is exposed to that stress. We created a dye washout technique which combines experimental and numerical approaches to measure the washout times of ventricular assist devices. The technique was used to investigate washout characteristics of three commercially available and clinically used ventricular assist devices: the CentriMag, HVAD and HeartMate II...
April 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29501323/antithrombotic-therapies-in-children-on-durable-ventricular-assist-devices-a-literature-review
#12
Joanna Y Huang, Paul Monagle, M Patricia Massicotte, Christina J VanderPluym
INTRODUCTION: Ventricular Assist Devices (VADs) are increasingly utilised in children with end-stage heart failure, and experience high bleeding and clotting rates. In particular, pediatric VAD patients are more challenging than adults to anticoagulate due to developmental hemostasis, lack of suitable drug preparations, and difficult anticoagulation monitoring often due to poor vascular access; in addition to difficulties of VAD design in smaller children. This review aims to summarize the current evidence related to antithrombotic therapy in pediatric VAD patients...
February 28, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29485425/effect-of-preoperative-atrial-fibrillation-on-patients-with-chronic-heart-failure-who-undergo-long-term-continuous-flow-lvad-implantation
#13
Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Jeffrey A Morgan
Although preoperative atrial fibrillation (AF) is common in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation, how AF affects outcomes remains unclear. We analyzed our single-center experience with CF-LVAD implantation to determine whether preoperative AF was associated with inferior outcomes. From November 2003 through March 2016, 526 patients with chronic heart failure underwent implantation with the HeartMate II (HMII; n = 403) or HeartWare VAD (HVAD; n = 123). We identified 229 patients (165 HMII, 65 HVAD) who had preoperative AF and compared them with non-preoperative AF patients regarding the incidence of postoperative stroke, as well as long-term survival...
February 24, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29461279/individualized-antithrombotic-therapy-in-heartware-hvad-recipients
#14
Erik N Sorensen, Hannah J Voorhees, Lynn M Dees, Si M Pham, Zachary N Kon, Bartley P Griffith, Erika D Feller
There are no evidence-based guidelines for antithrombotic therapy in left ventricular assist device patients. We evaluated the efficacy of a multi-agent, test-guided protocol, which remained consistent throughout our use of the Heartware HVAD. Thrombelastography and PFA-100 guide antiplatelet titration. Goals are normal kaolin thrombelastography maximum amplitude and prolonged PFA-100. We analyzed incidence and rates of nonprocedural bleeding, stroke, and pump thrombosis for all 81 primary Heartware left ventricular assist devices implanted since 2011...
February 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29436010/changes-in-total-cardiac-output-and-oxygen-extraction-during-exercise-in-patients-supported-with-an-hvad-left-ventricular-assist-device
#15
Thomas Schmidt, Birna Bjarnason-Wehrens, Stephanie Mommertz, Meike Hannig, Sebastian Schulte-Eistrup, Detlev Willemsen, Nils Reiss
Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO2 ). We investigated the changes in CO and avDO2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29436002/peripheral-artery-disease-and-continuous-flow-left-ventricle-assist-device-an-engaging-complement-analysis-may-help-to-guide-treatment
#16
Calogero Falletta, Salvatore Pasta, Giuseppe Maria Raffa, Francesca Crinò, Sergio Sciacca, Francesco Clemenza
Use of continuous flow left ventricle assist device (CF-LVAD) in advanced heart failure (HF) patients results in clinically relevant improvements in survival, functional capacity, and quality of life. Peripheral artery disease (PAD) can occur in patients with CF-LVAD due to the high rate of concomitance between risk factors for atherosclerosis and HF. Diagnosis of PAD can be difficult in the specific setting of a patient supported by this kind of device because of the marked alteration in waveform morphology and velocity created by the artificial physiology of an LVAD...
February 13, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29433532/is-there-a-difference-in-bleeding-after-left-ventricular-assist-device-implant-centrifugal-versus-axial
#17
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29372417/effect-of-obesity-on-outcomes-in-patients-undergoing-implantation-of-continuous-flow-left-ventricular-assist-devices
#18
Nastasya Volkovicher, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Andrew B Civitello, Jeffrey A Morgan
The purpose of this study was to analyze the effect of obesity on outcomes after continuous-flow left ventricular assist device (CF-LVAD) implantation. A single-center retrospective analysis was performed on 526 chronic heart failure patients who were implanted with the HeartMate II CF-LVAD (n = 403) or HeartWare HVAD (n = 123) between November 2003 and March 2016. Patients were stratified into 4 groups based on BMI: underweight (< 18.5 kg/m2 , n = 18, 3.4%), normal-weight (18.5-25 kg/m2 , n = 173, 32...
January 25, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29364552/troubleshooting-electromagnetic-interference-in-a-patient-with-centrifugal-flow-left-ventricular-assist-device-and-subcutaneous-implantable-cardioverter-defibrillator
#19
Asim S Ahmed, Parin J Patel, Shiv Bagga, Jasen L Gilge, Thomas Schleeter, Baqir A Lakhani, Ashwin K Ravichandran, Steve Donnelley, Venu Allavatam, Eric N Prystowsky, Benzy J Padanilam
A 25-year-old man with severe nonischemic dilated cardiomyopathy underwent subcutaneous implantable cardioverter defibrillator (S-ICD) implant and subsequently underwent HeartWare ventricular assist device (HVAD) placement. Postoperative interrogation revealed both primary and secondary S-ICD vectors inappropriately regarded sinus rhythm as "noise," and the alternate vector significantly undersensed sinus rhythm. The S-ICD was reinterrogated using high-resolution capture to visually confirm EMI with a dominant frequency in both the primary and secondary vectors of 46...
March 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29341175/investigation-of-the-axial-gap-clearance-in-a-hydrodynamic-passive-magnetically-levitated-rotary-blood-pump-using-x-ray-radiography
#20
Bente Thamsen, Mathieu Plamondon, Marcus Granegger, Marianne Schmid Daners, Rolf Kaufmann, Antonia Neels, Mirko Meboldt
The HeartWare HVAD is a radial rotary blood pump with a combination of passive magnetic and hydrodynamic bearings to levitate the impeller. The axial gap size between impeller and housing in this bearing and its sensitivity to speed, flow, and pressure difference is difficult to assess. Shear stresses are exceptionally high in this tiny gap making it important for blood damage and related adverse events. Therefore, the aim of this study was to measure the axial gap clearance in the HVAD at different operating conditions employing radiography...
January 17, 2018: Artificial Organs
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