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https://read.qxmd.com/read/30770106/centrifugal-flow-ventricular-assist-device-support-in-children-a-single-center-experience
#1
Iki Adachi, Rodrigo Zea-Vera, Hari Tunuguntla, Susan W Denfield, Barbara Elias, Rija John, Jun Teruya, Charles D Fraser
BACKGROUND: Our institutional policy is to continue centrifugal-flow ventricular assist device support for 3 months or more without activation on the transplant wait-list for physical recovery and assessment of possible myocardial recovery. We evaluated our single-institutional outcomes with centrifugal-flow ventricular assist device support in children. METHODS: Prospectively collected outcomes data in consecutive patients aged 18 years or less with centrifugal-flow ventricular assist device support were reviewed...
December 27, 2018: Journal of Thoracic and Cardiovascular Surgery
https://read.qxmd.com/read/30765031/left-ventricular-unloading-during-extracorporeal-membrane-oxygenation-in-patients-with-cardiogenic-shock
#2
Juan J Russo, Natasha Aleksova, Ian Pitcher, Etienne Couture, Simon Parlow, Mohammad Faraz, Sarah Visintini, Trevor Simard, Pietro Di Santo, Rebecca Mathew, Derek Y So, Koji Takeda, A Reshad Garan, Dimitrios Karmpaliotis, Hiroo Takayama, Ajay J Kirtane, Benjamin Hibbert
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a widely used form of mechanical circulatory support in patients with refractory cardiogenic shock. A common drawback of this modality is a resultant increase in left ventricular afterload. OBJECTIVES: The purpose of this meta-analysis was to examine the efficacy and safety of left ventricular unloading strategies during VA-ECMO in adult patients with cardiogenic shock. METHODS: The authors performed a systematic search of studies examining left ventricular unloading during VA-ECMO in Medline, EMBASE, and the Cochrane library...
February 19, 2019: Journal of the American College of Cardiology
https://read.qxmd.com/read/30763560/reversal-and-resumption-of-antithrombotic-therapy-in-lvad-associated-intracranial-hemorrhage
#3
Sung-Min Cho, Nader Moazami, Stuart Katz, Randall Starling, Jennifer A Frontera
BACKGROUND: Little data exists regarding reversal and resumption of antithrombotics following left ventricular assist device (LVAD)-associated intracranial hemorrhage (ICH). METHODS: Prospectively collected data of LVAD patients with ICH was reviewed. Coagulopathy reversal agents, antithrombotic regimens and thrombotic (venous thromboembolism, ischemic stroke, myocardial infarction) and hemorrhagic (recurrent ICH, gastrointestinal bleed, anemia requiring transfusion) complications were recorded...
February 11, 2019: Annals of Thoracic Surgery
https://read.qxmd.com/read/30708381/outcomes-in-patients-with-left-ventricular-assist-devices-pacemakers-and-implantable-cardioverter-defibrillators-undergoing-single-balloon-enteroscopy
#4
Brijesh Patel, Ashok Shiani, Andrea C Rodriguez, Seth Lipka, Ashley H Davis-Yadley, Kirbylee K Nelson, Roshanak Rabbanifard, Ambuj Kumar, Patrick G Brady
OBJECTIVES: Obscure overt gastrointestinal bleeding can be challenging to evaluate in patients with electronic cardiac devices such as continuous flow left ventricular assist devices (LVADs), pacemakers (PPMs), and implantable cardioverter defibrillators (ICDs). Limited data exist on the utility and safety of single balloon enteroscopy (SBE) in patients with cardiac devices. We aimed to evaluate the safety, efficacy, diagnostic, and therapeutic outcomes of the aforementioned devices in patients undergoing SBE...
February 2019: Southern Medical Journal
https://read.qxmd.com/read/30704292/correction-to-novel-model-to-predict-gastrointestinal-bleeding-during-left-ventricular-assist-device-support-the-utah-bleeding-risk-score
#5
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Circulation. Heart Failure
https://read.qxmd.com/read/30700535/left-ventricular-assist-device-associated-gastrointestinal-bleeding-recognition-of-an-iatrogenic-etiology-on-technetium-99m-tagged-red-blood-cell-scintigraphy
#6
Dale Kenneth Jamison, Aaron F Yang, Reza Arsanjani, Yuxiang Zhou, Ming Yang
Technetium-99m (99m Tc) tagged RBC scintigraphy is the imaging modality of choice in the diagnosis of active gastrointestinal bleeding (GIB). Continuous-flow left ventricular assist devices (CF-LVADs) are the state-of-the-art treatment for advanced heart failure, with GIB as the most common complication. Recognition of the distinctive imaging feature of CF-LVADs on scintigraphic images could aid diagnosis of GIB.
January 29, 2019: Journal of Nuclear Medicine Technology
https://read.qxmd.com/read/30691593/the-society-of-thoracic-surgeons-intermacs-database-annual-report-evolving-indications-outcomes-and-scientific-partnerships
#7
Robert L Kormos, Jennifer Cowger, Francis D Pagani, Jeffrey J Teuteberg, Daniel J Goldstein, Jeffrey P Jacobs, Robert S Higgins, Lynne W Stevenson, Josef Stehlik, Pavan Atluri, Kathleen L Grady, James K Kirklin
BACKGROUND: The Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs), a joint effort among the National Heart, Lung, and Blood Institute, the Food and Drug Administration, the Centers for Medicare and Medicaid Services, and others, was established in 2005 at the University of Alabama at Birmingham. The registry examined clinical outcomes and quality-of-life metrics of patients who received an Food and Drug Administration-approved durable mechanical circulatory support (MCS) device to treat advanced heart failure...
February 2019: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/30691584/the-society-of-thoracic-surgeons-intermacs-database-annual-report-evolving-indications-outcomes-and-scientific-partnerships
#8
Robert L Kormos, Jennifer Cowger, Francis D Pagani, Jeffrey J Teuteberg, Daniel J Goldstein, Jeffrey P Jacobs, Robert S Higgins, Lynne W Stevenson, Josef Stehlik, Pavan Atluri, Kathleen L Grady, James K Kirklin
BACKGROUND: The Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs), a joint effort among the National Heart, Lung, and Blood Institute, the Food and Drug Administration, the Centers for Medicare and Medicaid Services, and others, was established in 2005 at the University of Alabama at Birmingham. The registry examined clinical outcomes and quality-of-life metrics of patients who received an Food and Drug Administration-approved durable mechanical circulatory support (MCS) device to treat advanced heart failure...
February 2019: Annals of Thoracic Surgery
https://read.qxmd.com/read/30651215/safe-exchange-of-a-transfemoral-impella-pump
#9
Jörn Tongers, Ulrike Flierl, Jan-Thorben Sieweke, Johann Bauersachs, Andreas Schäfer, L Christian Napp
Mechanical circulatory support with the Impella pump is established in many centers treating patients with cardiogenic shock. While Impella pumps usually run very stable, it may still be possible that one needs to remove the pump for using the same vascular access for different reasons. Unfortunately, until now it had been nearly impossible to remove the pump while preserving arterial access without severe bleeding. Here we describe a prototypical approach of exchanging an Impella pump in a 47-year-old female supported with veno-arterial ECMO for cardiogenic shock from myocarditis...
December 19, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://read.qxmd.com/read/30644585/use-of-cangrelor-as-a-bridge-to-left-ventricular-assist-device-implantation-in-a-patient-with-a-recent-drug-eluting-stent-who-developed-acute-tirofiban-related-thrombocytopenia
#10
Rajiv A Kabadi, Ilya M Danelich, John W Entwistle, Gregary D Marhefka, Gordon Reeves, Andrew J Boyle, Ataul Qureshi
Current guidelines emphasize the need for at least 6-12 months of oral dual antiplatelet therapy consisting of aspirin and a P2Y12 inhibitor following drug-eluting coronary artery stent implantation. In patients with recently implanted coronary artery stents who require urgent cardiac or noncardiac surgery, the benefits of maintaining oral dual antiplatelet therapy must be carefully weighed against the risks of excessive bleeding, and current practice is largely guided by individual surgeon preferences. When the effects of a second oral antiplatelet agent are undesirable during the perioperative period, the use of a short-acting intravenous antiplatelet agent as "bridge" therapy that can be discontinued shortly before surgery has been associated with a reduced occurrence of adverse clinical events in patients with recently implanted coronary stents requiring urgent coronary artery bypass graft surgery...
January 15, 2019: Pharmacotherapy
https://read.qxmd.com/read/30640183/lupus-and-left-ventricular-assist-devices-high-risk-for-bleeding
#11
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/30625252/surgical-transaxillary-placement-of-the-impella-5-0-ventricular-assist-device
#12
Luca Bertoglio, Maria Katsarou, Mara Scandroglio, Letizia Bertoldi, Roberto Chiesa, Federico Pappalardo
OBJECTIVE: The aim of this study is to evaluate the open transaxillary placement of the Impella 5.0 with a modified surgical technique. METHODS: From January to July 2018, nine patients (eight males; mean age 60 years) underwent surgical transaxillary Impella 5.0 (Abiomed Inc., Danvers, MA) implantation. Patient and periprocedural data were recorded in a prospectively maintained institutional database. The primary endpoint was technical success. The secondary endpoints were: neurological complications (peripheral or central), bleeding, and wound infection, duration of Impella support, and device failure requiring device replacement...
January 9, 2019: Journal of Cardiac Surgery
https://read.qxmd.com/read/30614639/design-and-rationale-of-haemodynamic-guidance-with-cardiomems-in-patients-with-a-left-ventricular-assist-device-the-hemo-vad-pilot-study
#13
Jesse F Veenis, Olivier C Manintveld, Alina A Constantinescu, Kadir Caliskan, Ozcan Birim, Jos A Bekkers, Nicolas M van Mieghem, Corstiaan A den Uil, Eric Boersma, Mattie J Lenzen, Felix Zijlstra, William T Abraham, Philip B Adamson, Jasper J Brugts
AIMS: We aim to study the feasibility and clinical value of pulmonary artery pressure monitoring with the CardioMEMS™ device in order to optimize and guide treatment in patients with a HeartMate 3 left ventricular assist device (LVAD). METHODS AND RESULTS: In this single-centre, prospective pilot study, we will include 10 consecutive patients with New York Heart Association Class IIIb or IV with Interagency Registry for Mechanically Assisted Circulatory Support Classes 2-5 scheduled for implantation of a HeartMate 3 LVAD...
January 7, 2019: ESC Heart Failure
https://read.qxmd.com/read/30614366/anticoagulation-of-a-percutaneous-left-ventricular-assist-device-using-a-low-dose-heparin-purge-solution-protocol-a-case-series
#14
Andrea Sikora Newsome, Ashley Taylor, Seth Garner
BACKGROUND: Impella CP® is a percutaneous left ventricular assist device that requires a heparin-dextrose purge solution. The manufacturer recommends heparin 50 units/mL, but supratherapeutic anticoagulation has been observed with this concentration. OBJECTIVE: The purpose of this evaluation was to observe the efficacy and safety of a low-dose heparin-based purge solution (25 units/mL in dextrose 20%). The primary outcome evaluated percentage of activated clotting times (ACTs) below therapeutic range...
January 6, 2019: Journal of Pharmacy Practice
https://read.qxmd.com/read/30592363/optimal-haemodynamics-during-left-ventricular-assist-device-support-are-associated-with-reduced-haemocompatibility-related-adverse-events
#15
Teruhiko Imamura, Ann Nguyen, Gene Kim, Jayant Raikhelkar, Nitasha Sarswat, Sara Kalantari, Bryan Smith, Colleen Juricek, Daniel Rodgers, Takeyoshi Ota, Tae Song, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
AIMS: Left ventricular assist device (LVAD) therapy improves the haemodynamics of advanced heart failure patients. However, it is unknown whether haemodynamic optimization improves haemocompatibility-related adverse events (HRAEs). This study aimed to assess HRAEs in patients with optimized haemodynamics. METHODS AND RESULTS: Eighty-three outpatients [aged 61 (53-67) years, 50 male] underwent a haemodynamic ramp test at 253 (95-652) days after LVAD implantation, and 51 (61%) had optimized haemodynamics (defined as central venous pressure < 12 mmHg, pulmonary artery wedge pressure < 18 mmHg, cardiac index > 2...
December 28, 2018: European Journal of Heart Failure
https://read.qxmd.com/read/30590475/acquired-von-willebrand-syndrome-in-paediatric-patients-during-mechanical-circulatory-support
#16
Rouven Kubicki, Brigitte Stiller, Johannes Kroll, Matthias Siepe, Friedhelm Beyersdorf, Christoph Benk, René Höhn, Jochen Grohmann, Thilo Fleck, Barbara Zieger
OBJECTIVES: Bleeding signs can become life-threatening complications in patients on mechanical circulatory support (MCS). Clinical phenotyping and comprehensive analyses of the cause of bleeding are, therefore, essential, especially when risk-stratifying patients during MCS workup. We conducted coagulation analyses and determined von Willebrand factor (VWF) parameters in a paediatric cohort on temporary extracorporeal life support, extracorporeal membrane oxygenation or long-term ventricular assist device support...
December 22, 2018: European Journal of Cardio-thoracic Surgery
https://read.qxmd.com/read/30586577/a-novel-toroidal-flow-left-ventricular-assist-device-minimizes-blood-trauma-implications-of-improved-ventricular-assist-device-hemocompatibility
#17
Carlo R Bartoli, Samson Hennessy-Strahs, Jeff Gohean, Maryann Villeda, Erik Larson, Raul Longoria, Mark Kurusz, Michael Acker, Richard Smalling
BACKGROUND: Continuous-flow left ventricular assist devices (LVADs) cause blood trauma - von Willebrand factor degradation, platelet activation, and subclinical hemolysis. Blood trauma contributes to bleeding, thrombosis, and stroke, which cause significant morbidity and mortality. The TORVAD is a first-of-its kind, toroidal-flow LVAD designed to minimize blood trauma. We tested the hypothesis that the TORVAD causes less blood trauma than the HeartMate II LVAD. METHODS: Whole human blood was circulated for 6 hours in ex vivo circulatory loops with a HeartMate II (n=8, 10,000 RPM, 70±6 mmHg, 4...
December 23, 2018: Annals of Thoracic Surgery
https://read.qxmd.com/read/30585872/management-of-antiplatelet-therapy-during-continuous-flow-left-ventricular-assist-device-support-after-thrombotic-hemorrhagic-events
#18
Michele Gallo, Jaimin R Trivedi, Nandan K Mondal, Emma J Birks, Mark Slaughter
Hemorrhagic or thrombotic events are common complications in heart failure patients with continuous-flow left ventricular assist device (CF-LVAD) support. Aim of this study is to investigate the effect of change in antiplatelet therapy after thrombotic or hemorrhagic events in patients with CF-LVAD support. A total of 231 CF-LVAD patients were included in this study. Patients with CF-LVAD were categorized into three groups: (1) high antiplatelet regimen as control group (aspirin [ASA] 325 mg; n = 115), (2) low antiplatelet regimen (ASA 81 mg; n = 82), started after hemorrhagic complications, and (3) double antiplatelet therapy (ASA/clopidogrel; n = 34) started after thrombotic complications...
December 18, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://read.qxmd.com/read/30571195/novel-model-to-predict-gastrointestinal-bleeding-during-left-ventricular-assist-device-support
#19
Michael Yaoyao Yin, Shane Ruckel, Abdallah G Kfoury, Stephen H McKellar, Iosef Taleb, Edward M Gilbert, Jose Nativi-Nicolau, Josef Stehlik, Bruce B Reid, Antigone Koliopoulou, Gregory J Stoddard, James C Fang, Stavros G Drakos, Craig H Selzman, Omar Wever-Pinzon
BACKGROUND: Gastrointestinal bleeding (GIB) is a leading cause of morbidity during continuous-flow left ventricular assist device (CF-LVAD) support. GIB risk assessment could have important implications for candidate selection, informed consent, and postimplant therapeutic strategies. The aim of the study is to derive and validate a predictive model of GIB in CF-LVAD patients. METHODS AND RESULTS: CF-LVAD recipients at the Utah Transplantation Affiliated Hospitals program between 2004 and 2017 were included...
November 2018: Circulation. Heart Failure
https://read.qxmd.com/read/30527506/acid-suppression-to-prevent-gastrointestinal-bleeding-in-patients-with-ventricular-assist-devices
#20
Abby W Hickman, Nick W Lonardo, Mary C Mone, Angela P Presson, Chong Zhang, Richard G Barton, Craig H Selzman, Stavros G Drakos, Antigone Koliopoulou, Stephen H McKellar
BACKGROUND: The high incidence of gastrointestinal bleeding (GIB) in patients with ventricular assist devices (VAD) is well known, but there is limited evidence to support the use of proton pump inhibitors (PPIs) or histamine receptor antagonists (H2RA) for preventing GIB in patients with VAD. MATERIALS AND METHODS: The surgical ICU and VAD databases within a large regional academic cardiac mechanical support and transplant center were queried for patients who underwent VAD implantation between 2010 and 2014...
February 2019: Journal of Surgical Research
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