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82 papers 25 to 100 followers
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
March 2017: Anesthesiology
Sharven Taghavi, Senthil N Jayarajan, Vishnu Ambur, Abeel A Mangi, Elaine Chan, Elizabeth Dauer, Lars O Sjoholm, Abhijit Pathak, Thomas A Santora, Amy J Goldberg, Joseph F Rappold
As left ventricular assist devices (LVADs) are increasingly used for patients with end-stage heart failure, the need for noncardiac surgical procedures (NCSs) in these patients will continue to rise. We examined the various types of NCS required and its outcomes in LVAD patients requiring NCS. The National Inpatient Sample Database was examined for all patients implanted with an LVAD from 2007 to 2010. Patients requiring NCS after LVAD implantation were compared to all other patients receiving an LVAD. There were 1,397 patients undergoing LVAD implantation...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
M Megan Chacon, Emily A Hattrup, Sasha K Shillcutt
Ventricular assist devices (VADs) provide mechanical circulatory support for patients with advanced heart failure. Patients with VADs are presenting for noncardiac surgery with increasing frequency. Understanding anesthetic management of patients with VADs is timely and necessary for perioperative physicians. We present 2 patients supported by left VADs who required intraoperative prone positioning, and how transesophageal echocardiography and VAD variables can be used to guide management.
March 15, 2014: A & A Case Reports
Khawaja A Ammar, Matt M Umland, Christopher Kramer, Nasir Sulemanjee, M Fuad Jan, Bijoy K Khandheria, James B Seward, Timothy E Paterick
Echocardiography is an important imaging modality used to determine the indication of left ventricular assist device (LVAD) implantation for patients with advanced heart failure (HF) and for serial follow-up to make management decisions in patient care post-implant. Continuous axial-flow LVAD therapy provides effective haemodynamic support for the failing left ventricle, improving both the clinical functional status and quality of life. Echocardiographers must develop a systematic approach to echocardiographic assessment of LVAD implantation and post-LVAD implant cardiac morphology and physiology...
November 2012: European Heart Journal Cardiovascular Imaging
Michael Oleyar, Marc Stone, Steven M Neustein
No abstract text is available yet for this article.
October 2010: Journal of Cardiothoracic and Vascular Anesthesia
Kimberly A Slininger, Ala S Haddadin, Abeel A Mangi
No abstract text is available yet for this article.
August 2013: Journal of Cardiothoracic and Vascular Anesthesia
(no author information available yet)
No abstract text is available yet for this article.
October 2014: Harvard Heart Letter: From Harvard Medical School
Joshua C Grimm, J Trent Magruder, Clinton D Kemp, Ashish S Shah
Left ventricular assist devices have become standard therapy for patients with end-stage heart failure. They represent potential long-term solutions for a growing public health problem. However, initial enthusiasm for this technology has been tempered by challenges posed by long-term support. This review examines these challenges and out current understanding of their etiologies.
2015: Frontiers in Surgery
Ahmet Kilic
The widespread acceptance of left ventricular assist device (LVAD) implantation in the treatment of heart failure has revolutionized the way end stage heart failure is treated. Advances in LVAD technology combined with a better understanding of patient selection has led to unparalleled survival as well as a reduction in the adverse event profile of these pumps. As our understanding of heart failure continues to grow, there is little doubt that LVADs will continue to play a pivotal role as a therapeutic option for those suffering from heart failure...
December 2015: Journal of Thoracic Disease
George Makdisi, I-Wen Wang
There have been many factors that have allowed for progressive improvement in outcomes and lower complication rates. These include the improvement in left ventricular assist device (LVAD) technologies, combined with better understanding of patient management, all these. Nowadays the numbers of LVAD implantations exceed the number of annual heart transplants worldwide. Minimally invasive procedures are shown to improve the surgical outcome in both LVAD insertion and replacement. These minimally invasive techniques can be grouped grossly into shifting from on-pump to off-pump implantation, alternative access for implantation other than sternotomy, and a combination of both, which should be the ultimate aim of minimally invasive LVAD implantation...
September 2015: Journal of Thoracic Disease
Melana Yuzefpolskaya, Nir Uriel, Margaret Flannery, Natalie Yip, Kanika Mody, Barbara Cagliostro, Hiroo Takayama, Yoshifumi Naka, Ulrich P Jorde, Sumeet Goswami, Paolo C Colombo
Over the past decade, continuous flow left ventricular assist devices (CF-LVADs) have become the mainstay of therapy for end stage heart failure. While the number of patients on support is exponentially growing, at present there are no American Heart Association or European Society of Cardiology Advanced Cardiovascular Life Support guidelines for the management of this unique patient population. We propose an algorithm for the hospitalized unresponsive CF-LVAD patient outside of the intensive care unit setting...
December 2016: European Heart Journal. Acute Cardiovascular Care
Sanjay Orathi Patangi, Anthony George, Henning Pauli, Denis O'Leary, Chandrika Roysam, Tanveer Butt, Stephan Schueler, Mahesh Prabhu, Guy MacGowan
Left ventricular assist devices (LVAD) are increasingly used for mechanical circulatory support of patients with severe heart failure, primarily as a bridge to heart transplantation. Transesophageal echocardiography (TEE) plays a major role in the clinical decision making during insertion of the devices and in the post-operative management of these patients. The detection of structural and device-related mechanical abnormalities is critical for optimal functioning of assist device. In this review article, we describe the usefulness of TEE for optimal perioperative management of patients presenting for HeartWare LVAD insertion...
October 2013: Annals of Cardiac Anaesthesia
Arman Kilic, Michael A Acker, Pavan Atluri
Left ventricular assist devices (LVAD) will undoubtedly have an increasing role due to the aging population, anticipated concomitant increase in the prevalence of end-stage heart failure, and improvements in LVAD technology and outcomes. As with any surgical procedure, LVAD implantation is associated with an adverse event profile. Such complications of LVAD therapy include bleeding, infection, pump thrombosis, right heart failure, device malfunction, and stroke. Although each has a unique management, early recognition and diagnosis of these complications is uniformly paramount...
December 2015: Journal of Thoracic Disease
Mustafa Ahmed, Houng Le, Juan M Aranda, Charles T Klodell
As the number of heart failure patients supported with left ventricular assist devices (LVAD) increases, the frequency of elective, noncardiac surgery in this patient population will similarly rise. We retrospectively analyzed our LVAD patient database and identified six patients who underwent elective, noncardiac surgery while on LVAD support. These cases are discussed, with an emphasis on the anesthetic and perioperative considerations. These patients have an acceptable risk profile for elective surgery and should be treated similarly to their age-matched counterparts not on LVAD support...
September 2012: Journal of Cardiac Surgery
Jan M Griffin, Jason N Katz
Few innovations in medicine have so convincingly and expeditiously improved patient outcomes more than the development of the left ventricular assist device (LVAD). Where optimal pharmacotherapy once routinely failed those with end-stage disease, the LVAD now offers considerable hope for the growing advanced heart failure population. Despite improvements in mortality, however, mechanical circulatory support is not without its limitations. Those supported with an LVAD are at increased risk of several complications, including infection, bleeding, stroke and arrhythmic events...
November 2014: Arrhythmia & Electrophysiology Review
Basavana G Goudra, Preet Mohinder Singh
AIMS AND OBJECTIVES: Continuous flow left ventricular assist devices (LVAD) have emerged as a reliable treatment option for heart failure. Because of bleeding secondary to anticoagulation, these patients present frequently for gastrointestinal (GI) endoscopy. The presently available literature on perioperative management of these patients is extremely limited and is primarily based upon theoretical principles. MATERIALS AND METHODS: Perioperative records of patients with LVAD undergoing (GI) endoscopy between 2008 and 2012 were reviewed...
October 2013: Annals of Cardiac Anaesthesia
Lucas N Marzec, Amrut V Ambardekar
Right ventricular (RV) failure continues to be a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Preoperative evaluation of RV function with a variety of clinical, laboratory, echocardiographic, and hemodynamic variables is essential to ensure appropriate patient selection for LVAD therapy but remains imperfect. Therefore, clinicians involved in the care of these patients need to be prepared to manage RV failure after LVAD placement. Perioperative management of RV failure after LVAD implantation requires minimization of intraoperative RV ischemia, maintenance of appropriate filling pressure, supportive therapy with pulmonary vasodilators and inotropes, and surgical interventions such as RV assist devices in select cases...
December 2013: Seminars in Cardiothoracic and Vascular Anesthesia
Marc A Miller, Srinivas R Dukkipati, Jacob S Koruth, Andre d'Avila, Vivek Y Reddy
No abstract text is available yet for this article.
July 2012: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Casey Lo, Deirdre Murphy, Robyn Summerhayes, Margaret Quayle, Aiden Burrell, Michael Bailey, Silvana F Marasco
Postoperative right ventricular failure is a serious complication for up to 50% of patients following LVAD insertion. Predicting RV failure is an important factor for patients as planned BiVAD support has been shown to correlate with better outcomes compared to delayed BiVAD to LVAD conversion. This retrospective study examined prospectively collected data for 101 patients implanted with an LVAD between 2003 and 2013, aiming to establish preoperative predictive factors for RVF post-LVAD insertion, analyze outcomes, and validate existing RVF scoring systems...
September 2015: Clinical Transplantation
Mandeep R Mehra
No abstract text is available yet for this article.
October 2015: Trends in Cardiovascular Medicine
2016-02-16 02:42:55
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