Yuji Tominaga, Koichi Toda, Shigeru Miyagawa, Daisuke Yoshioka, Satoshi Kainuma, Takuji Kawamura, Ai Kawamura, Kei Nakamoto, Yasushi Sakata, Yoshiki Sawa
We report an effective therapeutic approach of mechanical circulatory support for a patient with cardiogenic shock and respiratory insufficiency due to fulminant myocarditis. An Impella® 5.0 was utilized as a left ventricular assist device (VAD) and percutaneous veno-pulmonary extracorporeal membrane oxygenation (ECMO) as a right VAD. These devices were implanted without sternotomy or thoracotomy. Although a combination of Impella and veno-arterial ECMO has been reported as percutaneous biventricular support, there are concerns that this combination is not beneficial for myocardial recovery in patients with respiratory insufficiency, because Impella expels insufficiently oxygenated blood from the left ventricle to the coronary arteries...
August 4, 2020: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Hoong Sern Lim, Aaron Ranasinghe, Colin Chue, David Quinn, Majid Mukadam, Jorge Mascaro
OBJECTIVES: To evaluate the value of cardiac power output index (CPOi) in predicting severe primary graft dysfunction (PGD) after heart transplantation (defined as mechanical circulatory support [MCS] and/or mortality <30 days after transplant). DESIGN: Observational cohort study. SETTING: A heart transplant center in the United Kingdom. PARTICIPANTS: Consecutive patients who underwent heart transplantation from January 2014 to December 2019 (n = 160)...
July 10, 2020: Journal of Cardiothoracic and Vascular Anesthesia
Aron Frederik Popov, R Berger, Christian Schlensak, Malte N Bongers, Helene Haeberle, Metesh Acharya, Henning F Lausberg
BACKGROUND: The current coronavirus (COVID-19) pandemic is associated with severe pulmonary and cardiovascular complications. CASE PRESENTATION: This report describes a young patient with COVID-19 without any comorbidity presenting with severe cardiovascular complications, manifesting with pulmonary embolism, embolic stroke, and right heart failure. CONCLUSION: Management with short-term mechanical circulatory support, including different cannulation strategies, resulted in a successful outcome despite his critical cardiovascular status...
August 2, 2020: Journal of Cardiac Surgery
Getanshu Malik, Tara Pidborochynski, Holger Buchholz, Darren H Freed, Mohammed Al-Aklabi, Sabin J Bozso, Swati Choudhry, Vijay Anand, Paula Holinski, Jennifer Conway
Short-term continuous-flow ventricular assist devices (STCF-VADs) are increasingly being utilized in pediatrics. End-stage liver disease (ELD) models have been associated with outcomes in adult patients on mechanical circulatory support. We sought to determine the relationship between outcomes in children on STCF-VADs and three ELD models: model for end-stage liver disease-excluding international normalized ratio (MELD-XI; all) and MELD-XI (> 1 year), PELD, and a novel score, PedMELD-XI. All patients (< 19 years) supported with STCF-VADs, between June 2009 and December 2016 were included...
August 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Liza Grosman-Rimon, Erez Kachel, Michael A McDonald, Spencer D Lalonde, Paul Yip, Roberto V P Ribeiro, Mitchell B Adamson, David Z Cherney, Vivek Rao
Continuous-flow left ventricular assist device (CF-LVAD) recipients exhibit impaired exercise capacity. Long-term continuous blood flow also elevates norepinephrine (NE) and aldosterone (Aldo) levels. However, the relationship between exercise capacity and neurohormonal activation has not been elucidated. Our study objective was to assess the association between cardiopulmonary exercise testing (CPT) measures and neurohormonal levels in CF-LVAD recipients. Symptom-limited CPT on a treadmill, using the modified Bruce protocol was performed in 15 CF-LVAD recipients...
August 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Kai Von Petersdorff-Campen, Jonas Abeken, Diane De Zélicourt, Vartan Kurtcuoglu, Mirko Meboldt, Marianne Schmid Daners
Additive manufacturing (AM) is an effective tool for accelerating knowledge gain in development processes, as it enables the production of complex prototypes at low cost and with short lead times. In the development of mechanical circulatory support, the use of cheap polymer-based AM techniques for prototype manufacturing allows more design variations to be tested, promoting a better understanding of the respective system and its optimization parameters. Here, we compare four commonly used AM processes for polymers with respect to manufacturing accuracy, surface roughness, and shape fidelity in an aqueous environment...
July 23, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Makiko Nakamura, Teruhiko Imamura, Masakazu Hori, Masaki Nakagaito, Hiroshi Ueno, Shigeki Yokoyama, Toshio Doi, Kazuaki Fukahara, Koichiro Kinugawa
Gastrointestinal bleeding (GIB) during mechanical circulatory support (MCS) is a major unsolved comorbidity. Inadequate activation of angiopoietin-2-related systems is considered as a major cause of GIB. However, the regulation of angiopoietin-2 remains unknown. Consecutive 20 patients who received continuous-flow MCS therapy (MCS group) and 12 with advanced heart failure (HF; HF group) were prospectively enrolled and their angiopoetin-2 levels were compared. Angiopoietin-2 level had a moderate correlation with log10 B-type natriuretic peptide (BNP; r = 0...
July 23, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Michelle M Kittleson, Heather Barone, Robert M Cole, Megan Olman, Alisa Fishman, Linda Olanisa, Carmelita Runyan, Jennifer Hajj, Newman Huie, Michael Lindsay, Nancy Sun, Eric Luong, Susan Cheng, Elizabeth Passano, Jon A Kobashigawa, Fardad Esmailian, Danny Ramzy, Jaime D Moriguchi
Patient adherence is vital to the success of durable mechanical circulatory support (MCS), and the pre-MCS assessment of adherence by the multidisciplinary advanced heart failure team is a critical component of the evaluation. We assessed the impact of a high-risk psychosocial assessment before durable MCS implantations on post-MCS outcomes. Between January 2010 and April 2018, 319 patients underwent durable MCS at our center. We excluded those who died or were transplanted before discharge. The remaining 203 patients were grouped by pre-MCS psychosocial assessment: high-risk (26; 12...
July 23, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Laura Seese, Faezeh Movahedi, James Antaki, Arman Kilic, Rema Padman, Yiye Zhang, Manreet Kanwar, Sarah Burki, Christopher Sciortino, Mary Keebler, Sameer Hirji, Robert Kormos
BACKGROUND: This study delineates the sequences of adverse events (AE) preceding mortality attributed to multisystem organ failure (MSOF) in patients with a left ventricular assist device (LVAD). METHODS: We analyzed 3,765 AEs following 554 LVAD implants recorded in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) data registry between 2006 and 2015 that resulted in MSOF death. Hierarchical clustering identified and visualized quantitatively unique clusters of patients with similar AE profiles...
July 30, 2020: Annals of Thoracic Surgery
Antony P McNamee, Geoff D Tansley, Michael J Simmonds
Blood exposure to supraphysiological shear stress within mechanical circulatory support is suspected of reducing red blood cell (RBC) deformability and being primal in the pathogenesis of several secondary complications. No prior works have explored RBC dynamics with the resolution required to determine shear elastic modulus, and/or cell capillary velocity, following exposure to mechanical stresses. Healthy RBCs were exposed to 0,5,50, and 100Pa in a Couette shearing system. For comparison, blood was also exposed to heat treatment - a method that predictably increases RBC rigidity...
August 1, 2020: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Helen Kest, Ashlesha Kaushik, William DeBruin, Mario Colletti, David Goldberg
We report three critically ill pediatric patients (aged 6-10 years), presenting with features of multisystem inflammatory syndrome in children (MIS-C) from April 4 to May 10, 2020, to a tertiary-care center in New Jersey, United States. All patients tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and were previously healthy. Clinical presentations were similar with fever, abdominal pain, gastrointestinal complaints, and/or rash. One patient had altered mental status with cerebrospinal fluid (CSF) findings consistent with aseptic meningitis...
2020: Case Reports in Pediatrics
Tomasz K Urbanowicz, Hanna Baszyńska-Wachowiak, Anna Olasińska-Wiśniewska, Marcin Misterski, Sebastian Stefaniak, Marcin Ligowski, Marek Jemielity
Introduction: Severe heart failure decompensation requires circulatory mechanical support in emergency situations. Polish paracorporeal pulsatile pumps, POLVAD-MEV, are designed for biventricular end-stage heart dysfunction. Aim: To evaluate long-term POLVAD-MEV therapy by multiple pump exchange in patients on a transplant list. Material and methods: There were 3 patients in INTERMACS level 1 referred for emergency POLVAD-MED implantation due to acute heart failure deterioration...
June 2020: Polish Journal of Cardio-Thoracic Surgery
Zhiyuan Guan, Xiaoqing Guan, Kaiyun Gu, Yanqi Li, Jin Lin, Wenjun Zhou, Ming Xu, Chunli Song, Zhe Zhang, Feng Wan
OBJECTIVES: Sample size may limit the ability of individual studies to detect differences in clinical outcomes between extracorporeal membrane oxygenation (ECMO) alone and ECMO plus intra-aortic balloon pump (IABP) after adult cardiac surgery. Therefore, we undertook a meta-analysis of the best evidence available on the comparison of clinical outcomes of ECMO alone and ECMO plus IABP after adult cardiac surgery. METHODS: PubMed, EMBASE, Web of Science, and Cochrane Center Registry of Controlled Trials were searched for studies comparing the use of ECMO alone and ECMO plus IABP after adult cardiac surgery...
July 27, 2020: Heart Surgery Forum
Petar Risteski, Tanja Anguseva, Rodney Rosalia, Sonija Grazdani, Milka Klincheva, Venko Filipce, Marjan Sokarovski, Aron-Frederik Popov, Sasko Jovev, Zan Mitrev
INTRODUCTION: Mechanical circulatory support by a continuous-flow ventricular assist device (VAD) improves survival and quality of life in selected patients with advanced heart failure. Developing countries have been struggling to construct a contemporary and effective health care system to manage advanced heart failure. This observation represents the first annual report on clinical outcomes with VAD for patients with advanced heart failure in the Republic of North Macedonia. METHODS: Data from all patients with VAD implantations between November 2018 and December 2019 were collected...
June 26, 2020: Heart Surgery Forum
Omar Sheikh, Tung Nguyen, Shweta Bansal, Anand Prasad
Acute kidney injury (AKI) is an ominous predictor of mortality in cardiogenic shock. The present review examines the pathophysiology of AKI in cardiogenic shock (CS), summarizes the pertinent literature including the diagnostic criteria/definitions for AKI and possible role of biomarkers, and identifies risk factors and possible therapeutic interventions for AKI in CS. Our review finds that AKI is common in patients with CS and is associated with increased morbidity and mortality. Urinary biomarkers of renal tubular injury appear more sensitive for detection of AKI but have yet to be incorporated into daily practice...
July 29, 2020: Catheterization and Cardiovascular Interventions
Andrea Montalto, Francesca Nicolò, Vincenzo Polizzi, Marina Comisso, Francesco Musumeci
BACKGROUND: Pheochromocytoma is a rare catecholamine-secreting tumor derived from chromaffin cells in the adrenal glands. An excessive stimulation of cardiac myocytes, when pheochromocytoma 'crisis' occurs, lead to myocardial damage with cardiogenic shock. AIM OF THE STUDY: We present the case of a A 28-year old female patient admitted with signs of severe cardiogenic shock. She was successfully supported with extracorporeal membrane oxygenation (ECMO) combined with IMPELLA CP heart pump (Abiomed Danvers, MA), for left ventricular unloading...
July 27, 2020: Journal of Cardiac Surgery
Florian R Kirchner, Salomé LeibundGut-Landmann
Keeping a stable equilibrium between the host and commensal microbes to which we are constantly exposed, poses a major challenge for the immune system. The host mechanisms that regulate homeostasis of the microbiota to prevent infection and inflammatory disorders are not fully understood. Here, we provide evidence that CD4+ tissue-resident memory T (TRM ) cells act as central players in this process. Using a murine model of C. albicans commensalism we show that IL-17 producing CD69+ CD103+ CD4+ memory T cells persist in the colonized tissue long-term and independently of circulatory supplies...
July 27, 2020: Mucosal Immunology
Izabella Miśkiewicz-Migoń, Justyna Miśkiewicz-Bujna, Monika Rosa, Anna Kubica-Cielińska, Joanna Bladowska, Szymon Janczar, Marek Ussowicz
Peripheral blood hematopoietic stem cell mobilization is widely performed in a variety of clinical facilities and is believed to be a safe outpatient procedure. In this report, we describe a child with neuroblastoma who developed an extremely severe acute lung injury after granulocyte colony-stimulating factor was used for peripheral hematopoietic stem cell mobilization. A 3-year-old boy with a medical history of patent foramen ovale and secundum atrial septal defect was diagnosed with an MYCN-amplified neuroblastoma and treated with chemotherapy...
July 23, 2020: Transplantation Proceedings
Abigail L Latimer, Melanie D Otis, Christopher Flaherty, Miriam A Ross
BACKGROUND: Patients receiving left ventricular assisted device (LVAD) require the expertise of specialty trained nurses referred to as VAD coordinators. The long-term use of these devices has created morally distressing situations for VAD coordinators. OBJECTIVE: This pilot study sought to explore the association between ventricular assistance device (VAD) coordinators' unique roles and responsibilities and moral distress. METHODS: An online survey was distributed to VAD coordinators through a listserv...
July 20, 2020: Heart & Lung: the Journal of Critical Care
Manreet K Kanwar, Colleen K McIlvennan, Lisa C Lohmueller, Stephen H Bailey, Joseph G Rogers, Jeffrey Teuteberg, Jennifer Cowger
Left ventricular assist devices (LVADs) have consistently and successfully improved mortality associated with end-stage heart failure. However, the definition of an "optimal" outcome post LVAD as a benchmark remains debatable. We retrospectively examined patients in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) between 2012 and 2016 to assess 1 year post-LVAD "optimal outcome" defined as a patient who was alive on device or transplanted, New York Heart Association functional class I/II, had no more than 2 hospitalizations at year 1, and no major adverse event...
July 16, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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