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https://www.readbyqxmd.com/read/28058856/effective-treatment-with-a-new-protocol-using-tissue-type-plasminogen-activator-thrombolysis-for-pump-thrombosis-with-the-hvad-device
#1
Benedikt Schrage, Hanno Grahn, Florian M Wagner, Alexander Bernhardt, Meike Rybczynski, Stefan Blankenberg, Hermann Reichenspurner, Markus J Barten
BACKGROUND: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis. METHODS: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28033184/effect-of-outflow-graft-size-on-flow-in-the-aortic-arch-and-cerebral-blood-flow-in-continuous-flow-pumps-possible-relevance-to-strokes
#2
Sindhoor Bhat, Jayakala Mathews, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is a stroke, with a higher incidence in Heartware HVAD as compared to HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Since outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates.A Computational fluid structure interaction model was created from the CT scan of a patient. Pressures were used as the boundary condition and the flow through the cerebral vessels was derived as outputs...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28029573/mechanical-circulatory-support-and-heart-transplantation-in-the-asia-pacific-region
#3
EDITORIAL
Cumaraswamy Sivathasan, Choon Pin Lim, Ka Lee Kerk, David K L Sim, Mandeep R Mehra
Globalization has resulted in epidemiologic transition in developing countries from infectious disease and nutritional deficiencies to non-communicable diseases. Epidemiologic data on heart failure (HF), particularly advanced HF therapy, in Asia are increasingly becoming available, although they remain sparse. Heart transplantation for advanced stage HF remains very low in Asia-approximately 0.075 heart transplants per 1 million population. North America, which comprises 7.5% of the world population, accounted for 55...
September 29, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28009711/surgical-technique-for-ventricular-device-exchange-from-heartmate-ii-to-hvad
#4
Michele Gallo, Jaimin R Trivedi, Michael A Sobieski, Todd H Massey, Allen Cheng, Mark S Slaughter
Implantable continuous-flow left ventricular assist devices (VAD) have improved the survival of end-stage heart failure patients. Recent studies have shown an increased occurrence of device replacement in the axial-flow pumps particularly for thrombosis. In some patients, to try and avoid recurrent pump thrombosis, it might be advantageous to switch from the axial flow LVAD to a newer generation centrifugal flow LVAD. Technically, this requires some adaption of the LVAD inflow and outflow connections. We describe our technique and outcomes in patients that underwent the conversion from an axial flow LVAD to a centrifugal flow LVAD...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27984314/medical-management-of-pump-related-thrombosis-in-patients-with-continuous-flow-left-ventricular-assist-devices-a-systematic-review-and-meta-analysis
#5
Geetanjali Dang, Narendranath Epperla, Vijayadershan Mupiddi, Natasha Sahr, Amy Pan, Pippa Simpson, Lisa Baumann Kreuziger
Pump thrombosis is a dreaded complication of left ventricular assist device (LVADs). We completed a systematic review to evaluate the efficacy and complications associated with medical management of LVAD thrombosis. Databases were searched using the terms "vad*" or "ventricular assist device" or "heart assist device" and "thrombus" or "thrombosis" or "thromboembolism". Of 2383 manuscripts, 49 articles met the inclusion criteria. The risk of partial or no resolution of LVAD thrombosis did not significantly differ between thrombolytic and non-thrombolytic regimens (OR 0...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27899134/a-modified-park-s-stitch-to-correct-aortic-insufficiency-for-bioprosthetic-valve-at-time-of-left-ventricular-assist-device-implant-a-case-report
#6
Toshinobu Kazui, Nicole Sydow, Mark Friedman, Samuel Kim, Scott Lick, Zain Khalpey
BACKGROUND: Aortic valve insufficiency (AI) at the time of left ventricular assist device (LVAD) insertion needs to be corrected, however there is little known about how to manage bioprosthetic valvular AI. CASE PRESENTATION: A 55-year-old female with dilated cardiomyopathy who previously had a bioprosthetic aortic valve replacement needed a LVAD as a bridge to transplant. Her left ventricular ejection fraction was 10% and had mild to moderate transvalvular AI. She underwent a HeartWare HVAD insertion along with aortic valvular coaptation stitch repair (Park's stitch) to the bioprosthetic valve...
November 30, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27863356/left-ventricular-assist-devices-and-gastrointestinal-evaluation-results-of-a-consecutive-case-series
#7
Sultan Alotaibi, Raimund Erbel, Till Neumann
AIMS: To evaluate the benefit of preoperative gastrointestinal endoscopic evaluation in patients undergoing continuous flow left ventricular assist devices (CF-LVADs) implantation. METHODS AND RESULTS: A retrospective review of all fifty-three patients undergoing CF-LVADs at West-German Heart and Vascular Center, University of Duisburg-Essen was performed. A routine preoperative esophagogastroduodenoscopy was performed in seven patients to assess gastrointestinal (GI) bleeding...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27851282/1647-giant-cell-myocarditis-destination-therapy-with-hvad-bivad
#8
Laura Lombardi-Karl, Jonathan Hastie
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27765177/survival-after-orthotopic-heart-transplantation-in-patients-undergoing-bridge-to-transplantation-with-the-heartware-hvad-versus-the-heartmate-ii
#9
J Trent Magruder, Joshua C Grimm, Todd C Crawford, Ryan J Tedford, Stuart D Russell, Christopher M Sciortino, Glenn J R Whitman, Ashish S Shah
BACKGROUND: Our objective was to determine whether the choice of a HeartWare HVAD as opposed to a Heartmate II left ventricular assist device (HMII LVAD), impacts survival after heart transplantation after controlling for patient, donor, and center characteristics. METHODS: We queried the United Network for Organ Sharing (UNOS) database, which has recently made pretransplantation device duration available, for all adult patients undergoing bridge to transplantation (BTT) between January 2011 and March 2016...
October 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27749316/comparing-the-effectiveness-of-an-axial-and-a-centrifugal-left-ventricular-assist-device-in-ventricular-unloading
#10
David M Turer, Kelly L Koch, Todd M Koelling, Audrey H Wu, Francis D Pagani, Jonathan W Haft
Centrifugal (CFG) and axial flow (AX) left ventricular assist devices have different hydrodynamic properties that may impact the effectiveness of left ventricular unloading. We sought to determine whether patients implanted with the HeartWare HVAD (CFG) and HeartMate II (AX) had a similar degree of hemodynamic support by comparing parameters measured using echocardiography and right heart catheterization. Using our prospectively collected database, we identified 268 patients implanted with the AX and 93 with the CFG...
November 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27676411/short-term-experience-with-off-pump-versus-on-pump-implantation-of-the-heartware-left-ventricular-assist-device
#11
Igor D Gregoric, Rajko Radovancevic, Mehmet H Akay, Mateja K Jezovnik, Sriram Nathan, Manish Patel, Jayeshkumar A Patel, Elena Nedelcu, Nghia D Nguyen, Pranav Loyalka, Biswajit Kar
Implantation of left ventricular assist devices while avoiding cardiopulmonary bypass (CPB) may decrease bleeding and improve postoperative recovery. To understand the effectiveness of this approach, we reviewed the charts of 26 patients who underwent HeartWare left ventricular assist device (HVAD) implantation without use of CPB (off-CPB group) and 22 patients who had HVAD implanted with CPB (CPB group) with an emphasis on the 30 day postoperative period. Preoperatively, both groups had similar demographic, functional, and hemodynamic characteristics...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27660906/heat-generation-in-axial-and-centrifugal-flow-left-ventricular-assist-devices
#12
Gardner Yost, Christine Rachel Joseph, Thomas Royston, Antone Tatooles, Geetha Bhat
Despite increasing use of left ventricular assist devices (LVADs) as a surgical treatment for advanced heart failure in an era of improved outcomes with LVAD support, the mechanical interactions between these pumps and the cardiovascular system are not completely understood. We utilized an in vitro mock circulatory loop to analyze the heat production incurred by operation of an axial flow and centrifugal flow LVAD.A HeartMate II and a HeartWare HVAD were connected to an abbreviated flow loop and were implanted in a viscoelastic gel...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27660575/mechanical-circulatory-support-for-the-failing-heart-continuous-flow-left-ventricular-assist-devices
#13
REVIEW
Joseph A R Englert, Jennifer A Davis, Selim R Krim
BACKGROUND: Heart transplantation remains the definitive therapy for patients with advanced heart failure; however, owing to limited donor organ availability and long wait times, continuous-flow left ventricular assist devices (LVADs) have become standard therapy. METHODS: This review summarizes the history, progression, function, and basic management of LVADs. Additionally, we provide some clinical pearls and important caveats for managing this unique patient population...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27605222/evaluation-of-the-heartware-ventricular-assist-device-lavare-cycle-in-a-particle-image-velocimetry-model-and-in-clinical-practice
#14
Daniel Zimpfer, Martin Strueber, Philipp Aigner, Jan D Schmitto, Arnt E Fiane, Robert Larbalestier, Steven Tsui, Paul Jansz, Andre Simon, Stephan Schueler, Francesco Moscato, Heinrich Schima
OBJECTIVES: Ventricular blood stasis is a concern for continuous flow mechanical support devices and might contribute to the formation of thromboembolic events. The HeartWare® Ventricular Assist System (HVAD®) is equipped with the Lavare™ cycle that is a periodic speed modulation feature designed to alter flow patterns within the left ventricle and reduce areas of potential blood stasis. Here, we report in vitro and clinical findings on the effects of the Lavare cycle. METHODS: The effect of pump speed changes on the intraventricular flow field was examined with an in vitro particle image velocimetry model...
November 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27531092/flow-patterns-in-the-carotid-arteries-of-patients-with-left-ventricular-assist-devices
#15
Loay Kabbani, Semeret Munie, Judith Lin, Mauricio Velez, Iyad Isseh, Sara Brooks, Stephanie Leix, Alexander Shepard
OBJECTIVE: To evaluate and define the expected flow pattern changes of carotid artery duplex ultrasound after LVAD placement. METHODS: Retrospective review of Henry Ford Hospital database of patients who had undergone LVAD placement between March 2008 and July 2012 was performed. All patients who had carotid artery duplex scanning before and after LVAD placement within two years of each other and showed less than 50% stenosis were included in this study. Type of waveform, carotid peak systolic velocity and end-diastolic velocities were analyzed, and the values were compared before and after LVAD placement...
August 12, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27521176/heartware-ventricular-assist-device-as-a-bridge-to-heart-transplantation-in-a-patient-with-congenitally-corrected-transposition-of-the-great-arteries-and-dextrocardia
#16
Muhammad A Soofi, Andrew P Ignaszewski, Anson W Cheung, Jamil G Bashir
Congenitally corrected transposition of the great arteries (ccTGA) is a rare condition with prevalence of <0.5%. Dextrocardia is reported among 20% of them. Among patients with ccTGA, heart failure is a common presentation, especially in the fourth or fifth decade of life and survival is dismal without heart transplantation. A left ventricular assist device (LVAD) is considered for bridge to transplantation if early heart transplantation is not available or as destination therapy for patients ineligible for heart transplant...
December 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27465093/surgical-treatment-of-mediastinitis-with-omentoplasty-in-ventricular-assist-device-patients-report-of-referral-center-experience
#17
Marina Pieri, Marcus Müller, Anna Mara Scandroglio, Panagiotis Pergantis, Alexandra Kretzschmar, Friedrich Kaufmann, Volkmar Falk, Thomas Krabatsch, Georg Arlt, Marian Kukucka, Evgenij Potapov
Mediastinitis is more frequent in patients with implantable ventricular assist devices (VAD) than in other cardiac surgery patients and carries significant mortality. We report our experience with a stepwise approach including aggressive debridement, jet lavage, vacuum assisted closure (VAC) dressing and finally coverage with well-vascularized and immune active omental flaps in VAD patients with infective mediastinitis.We retrospectively collected and analyzed data of patients with continuous flow VAD who underwent plasty with the omental flap due to mediastinitis at Deutsches Herzzentrum Berlin beween 1 January 2008 and 30 October 2015 ...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27412342/long-term-support-of-patients-receiving-a-left-ventricular-assist-device-for-advanced-heart-failure-a-follow-up-analysis-of-the-registry-to-evaluate-the-heartware-left-ventricular-assist-system
#18
Jan D Schmitto, Daniel Zimpfer, Arnt E Fiane, Robert Larbalestier, Steven Tsui, Paul Jansz, Andre Simon, Stephan Schueler, Martin Strueber
OBJECTIVES: The Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE) is an investigator-initiated multicentre, prospective, single-arm database established to collect post-Conformité Européenne Mark clinical information on patients receiving the HeartWare® Ventricular Assist System (HVAD®). The number of patients requiring longer periods of mechanical circulatory support is ever increasing and so further investigation into long-term outcomes in bridge-to-transplant populations is necessary...
November 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27354253/cold-atmospheric-plasma-a-new-tool-for-the-treatment-of-superficial-driveline-infections
#19
Lutz Hilker, Thomas von Woedtke, Klaus Dieter Weltmann, Hans-Georg Wollert
Percutaneous driveline infections (DI) are leading factors for morbidity and mortality in ventricular assist device (VAD) patients. In recent years, cold atmospheric plasma (CAP) has been safely and effectively used in clinical settings to treat topical infections. We describe the first use of CAP to treat a superficial DI. CAP was applied with the kinPen® MED plasma jet device (neoplas tools GmbH, Greifswald, Germany), in the treatment of a DI in a 66-year-old VAD patient in Klinikum Karlsburg, Germany. The patient received a daily application of CAP of 1 min for 12 days...
June 28, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27347709/outcomes-of-patients-implanted-using-a-left-thoracotomy-technique-for-a-miniaturized-centrifugal-continuous-flow-pump
#20
Bantayehu Sileshi, Brian K O'Hara, Mary E Davis, Nicholas A Haglund, Xu Meng, Robert Deegan, John M Stulak, Sudhir S Kushwaha, Andrew Shaw, Simon Maltais
As ventricular-assist devices (VADs) are increasingly employed in heart failure management, a leading cause of mortality, new literature is consistently published on less-invasive implantation techniques. Although early perioperative outcomes have been shown to be favorable with minimally invasive left thoracotomy (LT) approaches compared with conventional sternotomy (CS), studies comparing long-term outcomes are lacking. We set out to evaluate long-term follow up between LT and CS approach. In a single center, retrospective review, data on patients with similar demographic profiles were collected...
September 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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