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ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs

journal
https://read.qxmd.com/read/30762587/pulsatile-conduit-pressure-gradients-in-the-heartware-hvad
#1
Pankaj Jain, Sajad Shehab, Michael Stevens, Peter Macdonald, Paul Jansz, Christopher Hayward
We evaluated mean, peak, and instantaneous pressure gradients across the outflow conduit in a pulsatile mock circulation loop which incorporated Heartware HVADs for left ventricular (LV) and right ventricular (RV) support. Steady-state 50 Hz measurements of left ventricular assist device (LVAD) flow (Q) and pressures within the proximal and distal outflow conduit were obtained at varying pump speed, LV contractility, hematocrit (HCT), heart rate (HR), and conduit diameter and length. Experiments were conducted using polyvinyl chloride (PVC) tubing and results confirmed in HVAD Gelweave conduit...
February 11, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30720492/extracorporeal-membrane-oxygenation-for-massive-pulmonary-embolism-as-bridge-to-therapy
#2
Lukasz Kmiec, Alois Philipp, Bernhard Floerchinger, Matthias Lubnow, Christoph Unterbuchner, Markus Creutzenberg, Dirk Lunz, Thomas Mueller, Christof Schmid, Daniele Camboni
Pulmonary Embolism (PE) is a common illness in western countries. The purpose of this study is to report the institutional experience with massive PE and Extracorporeal Membrane Oxygenation (ECMO) in inoperable patients on admission. A retrospective analysis using the institutional ECMO-registry including the time between 2006 and 2017 was performed. During the study period, 75 patients (n = 46 patients venoarterial [VA], n = 29 patients venovenous [VV]) were placed on ECMO for massive PE. The primary support for massive PE consists of VA; however, VV support can be applied as well in selected cases as this work demonstrates...
January 29, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688696/increased-stroke-risk-in-children-and-young-adults-on-extracorporeal-life-support-with-carotid-cannulation
#3
Jane L Di Gennaro, Titus Chan, Reid W D Farris, Noel S Weiss, David M McMullan
Patients on extracorporeal life support (ECLS) are at risk for central nervous system (CNS) injury. One potentially modifiable risk factor is site of arterial cannulation in venoarterial (VA) ECLS, as in most cases one can choose the femoral or carotid artery. There is acute alteration in cerebral blood flow with carotid cannulation, potentially increasing the risk of stroke. Children may have lower risk of stroke with carotid cannulation compared with adults because of impaired cerebral circulation with aging...
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688695/risk-assessment-in-patients-with-a-left-ventricular-assist-device-across-intermacs-profiles-using-bayesian-analysis
#4
Manreet K Kanwar, Lisa C Lohmueller, Jeffrey Teuteberg, Robert L Kormos, Joseph G Rogers, Raymond L Benza, Joann Lindenfeld, Colleen McIlvennan, Stephen H Bailey, Srinivas Murali, James F Antaki
Current risk stratification models to predict outcomes after a left ventricular assist device (LVAD) are limited in scope. We assessed the performance of Bayesian models to stratify post-LVAD mortality across various International Registry for Mechanically Assisted Circulatory Support (INTERMACS or IM) Profiles, device types, and implant strategies. We performed a retrospective analysis of 10,206 LVAD patients recorded in the IM registry from 2012 to 2016. Using derived Bayesian algorithms from 8,222 patients (derivation cohort), we applied the risk-prediction algorithms to the remaining 2,055 patients (validation cohort)...
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688694/dual-propeller-cavopulmonary-pump-for-assisting-patients-with-hypoplastic-right-ventricle
#5
Jakin N Jagani, Alexandrina Untaroiu, Amit D Kalaria
Various congenital heart defects (CHDs) are characterized by the existence of a single functional ventricle, which perfuses both the systemic and pulmonary circulation. A three-stage palliation procedure, including the final Fontan completion, is often adopted by surgeons to treat patients with such CHDs. The completion Fontan involves the creation of a total cavopulmonary connection (TCPC), commonly accomplished with an extracardiac conduit. This TCPC results in nonphysiologic flow conditions that can lead to systemic venous hypertension, reduced cardiac output, and ultimately the need for heart transplantation...
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688693/experimental-study-of-the-tissue-repair-of-neo-esophagus-after-esophageal-muscularis-resection
#6
Yi-Chao Wen, Xian-Liang Liang, Jian-Hui Liang
Attempts have been made to observe the tissue repair of neo-esophagus after esophageal muscularis resection and to investigate possibility of the regeneration repair of esophageal muscularis resection in neo-esophagus. Sixteen pigs were divided into two groups: group A and group B. Pigs in group A were performed with the partial resection of mere esophageal muscularis propria reserved mucosa muscle layer in a segment of thoracic esophagus. Pigs in group B were performed with nitinol composite artificial esophagus with polyester sewing rings replacement a segment of thoracic esophagus resection...
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688692/detection-of-thromboembolic-events-and-pump-thrombosis-in-heartware-hvad-using-accelerometer-in-a-porcine-model
#7
Itai Schalit, Andreas Espinoza, Fred-Johan Pettersen, Steinar Snartland, Mari-Ann L Ringdal, Tom N Hoel, Helge Skulstad, Erik Fosse, Arnt E Fiane, Per S Halvorsen
We have recently demonstrated that accelerometer-based pump thrombosis and thromboembolic events detection is feasible in vitro. This article focuses on detection of these conditions in vivo. In an open-chest porcine model (n = 7), an accelerometer was attached to the pump casing of an implanted HeartWare HVAD. Pump vibration was analyzed by Fast Fourier Transform of the accelerometer signals, and the spectrogram third harmonic amplitude quantified and compared with pump power. Interventions included injection of thrombi into the left atrium (sized 0...
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688691/effect-of-heart-rate-reserve-on-exercise-capacity-in-patients-treated-with-a-continuous-left-ventricular-assist-device
#8
Kiran K Mirza, Kimberly Cuomo, Mette H Jung, Stuart D Russell, Finn Gustafsson
We hypothesized that an inadequate increase in heart rate (HR) during exercise was associated with low peak oxygen uptake (VO2 peak) seen in left ventricular assist device (LVAD) recipients and aimed to analyze the potential relation between HR and VO2 peak and use of drugs with negative chronotropic effect. Sixty-eight LVAD recipients (44 Heartmate 2 and 24 HVAD) with support duration >1 month and a VO2 peak were included from two centers. Patients were 57 ± 13 years at time of VO2 peak and LVAD support duration was 483 ± 545 days...
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688690/clinical-courses-of-heartmate-ii-left-ventricular-assist-device-thrombosis
#9
Veraprapas Kittipibul, Andrew Xanthopoulos, Thomas E Hurst, Kiyotaka Fukamachi, Eugene H Blackstone, Edward Soltesz, Randall C Starling
We observed different temporal patterns of HeartMate II left ventricular assist device (LVAD) thrombosis regarding clinical manifestations and lactate dehydrogenase (LDH) trends. We propose nomenclature for classification of LVAD thrombosis and compare patient characteristics and outcomes in each pattern of LVAD thrombosis. We reviewed electronic medical records of 362 consecutive HeartMate II devices implanted at Cleveland Clinic from October 2008 to July 2014. We categorized clinical courses of confirmed device thrombosis based on clinical manifestations and LDH patterns...
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30688689/prothrombin-complex-concentrate-use-in-durable-and-short-term-left-ventricular-assist-device-implantation
#10
Yaron D Barac, Adam Nevo, Oliver Jawitz, Nazish K Hashmi, Peter Henkel, Laura J Blue, Joseph Kelly, Chetan B Patel, Mani A Daneshmand, Jacob N Schroder, Carmelo A Milano, Ian Welsby
No abstract text is available yet for this article.
January 24, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30664019/improving-outcomes-in-intermacs-1-category-1-patients-with-pre-lvad-awake-venous-arterial-extracorporeal-membrane-oxygenation-support
#11
Makoto Mori, Gerard McCloskey, Arnar Geirsson, Abeel A Mangi, James J Yun, Daniel Jacoby, Tariq Ahmad, Lavanya Bellumkonda, Forrester Lee, Michael E Chen, Pramod Bonde
Effective strategies to optimize Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS 1) patients are in much need. A novel awake venous-arterial extracorporeal membrane oxygenation (aVA ECMO) allows for clinical assessments while temporarily supporting biventricular function and stabilizing end-organ functions. The aim of the study was to assess outcomes of patients with aVA ECMO support before durable left ventricular assist device (LVAD) implantation. We evaluated 83 patients who received durable LVAD in 2012-2015, of whom 19 received aVA ECMO support before durable LVAD...
January 16, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30681442/the-physiology-of-percutaneous-right-ventricular-assist-device-potential-effects-on-ventilation-perfusion-matching
#12
Hoong Sern Lim, Aaron Ranasinghe, Jorge Mascaro
No abstract text is available yet for this article.
January 14, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30681441/neurologic-outcomes-in-a-two-center-cohort-of-neonatal-and-pediatric-patients-supported-on-extracorporeal-membrane-oxygenation
#13
Melania M Bembea, Ryan J Felling, Sherrill D Caprarola, Derek Ng, Aylin Tekes, Katharine Boyle, Alvin Yiu, Nicole Rizkalla, Jamie Schwartz, Allen D Everett, And Cynthia Salorio
Contemporary studies of long-term outcomes in children supported on extracorporeal membrane oxygenation (ECMO) in the United States are limited. We enrolled 99 ECMO patients between July 2010 and June 2015 in a two-center prospective observational study that included neurologic and neuropsychologic evaluation at 6 and 12 months, using standardized outcome measures. Pre-ECMO, 20 (20%) had a pre-existing neurologic diagnosis, 40 (40%) had cardiac arrest, and 10 of 47 (21%) children with neuroimaging had acute abnormal findings...
January 14, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30681440/chronic-ovine-studies-demonstrate-low-thromboembolic-risk-in-the-penn-state-infant-ventricular-assist-device
#14
Branka Lukic, J Brian Clark, Jenelle M Izer, Timothy K Cooper, Heidi A Finicle, Johua Cysyk, Bradly Doxtater, Eric Yeager, John Reibson, Raymond K Newswanger, Patrick Leibich, Kirby Bletcher, William J Weiss
Mechanical circulatory support for children under 6 years of age remains a challenge. This article describes the preclinical status and the results of recent animal testing with the Penn State Infant Left Ventricular Assist Device (VAD). The objectives have been to 1) demonstrate acceptably low thromboembolic risk to support FDA approval, 2) challenge the device by using minimal to no anticoagulation in order to identify any design or manufacturing weaknesses, and 3) improve our understanding of device thrombogenicity in the ovine animal model, using multicomponent measurements of the coagulation system and renal ischemia quantification, in order to better correlate animal results with human results...
January 14, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30681439/understanding-urea-kinetic-factors-that-enhance-personalized-hemodialysis-prescription-in-children
#15
Verena Gotta, Olivera Marsenic, Marc Pfister
Urea dialyzer clearance (KD) has been suggested to be underpredicted from blood flow (QB), dialysate flow (QD), and in vitro mass transfer-area coefficient of urea (KoA) in pediatric hemodialysis (HD) patients using a widely accepted mechanistic equation. We characterize factors that could explain this, assuming that it results from a bias between reported in vitro and actual in vivo KoA. An adult urea kinetic model was scaled to 923 patients aged 1-29 years based on pediatric physiologic knowledge (intercompartmental clearance, volumes of distribution)...
January 14, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30681438/acute-pump-thrombosis-in-the-early-postoperative-period-after-heartmate-3-implantation
#16
Jeroen J H Bunge, Corstiaan A den Uil, Alina C Constantinescu, Ricardo P J Budde, Alexander P W M Maat, Kadir Caliskan
There are no reports of acute pump thrombosis in the latest, continuous flow left ventricular assist devices type HeartMate 3, other than thrombus ingestion. We present a case of early thrombosis of the pump and outflow graft, necessitating acute pump and outflow graft replacement. A combination of low-flow episodes and subtherapeutic levels of anticoagulation was the most likely cause.
January 14, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30640185/does-tolvaptan-have-any-therapeutic-roles-in-patients-with-left-ventricular-assist-device
#17
Teruhiko Imamura
No abstract text is available yet for this article.
January 9, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30640184/yes-or-no-tolvaptan-may-be-a-potential-alternative-to-loop-diuretics-in-patients-with-left-ventricular-assist-device
#18
Kazuhiko Kido, Maya Guglin
No abstract text is available yet for this article.
January 9, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30640183/lupus-and-left-ventricular-assist-devices-high-risk-for-bleeding
#19
Ann Gage, Vanessa Blumer, Emer Joyce
Continuous-flow left ventricular assist devices (LVAD) have become an increasingly utilized treatment strategy for patients with end-stage heart failure. Despite the improved outcomes evident with current generation pumps, proper patient selection remains crucial to minimize the risk of potential adverse events. The evolving use of these devices as destination therapy (DT) has led to growing numbers of patients with higher risk comorbid conditions being evaluated as potential LVAD candidates. Understanding which patient and disease-specific characteristics increase postoperative morbidity and mortality is paramount as this technology continues to expand and the experience with select populations remains limited...
January 9, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30640186/monitoring-platelet-function-in-children-with-ventricular-assist-devices-the-devil-is-in-the-details
#20
M Patricia Massicotte, Lisa Baumann Kreuziger
No abstract text is available yet for this article.
January 8, 2019: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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