Enrico Ammirati, Michela Brambatti, Oscar Ö Braun, Palak Shah, Manlio Cipriani, Quan M Bui, Jesse Veenis, Euyhyun Lee, Ronghui Xu, Kimberly N Hong, Caroline M Van de Heyning, Enrico Perna, Philippe Timmermans, Maja Cikes, Jasper J Brugts, Giacomo Veronese, Jonathan Minto, Saige Smith, Grunde Gjesdal, Yan K Gernhofer, Cynthia Partida, Luciano Potena, Marco Masetti, Silvia Boschi, Antonio Loforte, Nina Jakus, Davor Milicic, Johan Nilsson, Dina De Bock, Caroline Sterken, Klaartje Van den Bossche, Filip Rega, Hao Tran, Ramesh Singh, Jonathan Montomoli, Michele Mondino, Barry Greenberg, Claudio F Russo, Victor Pretorius, Klein Liviu, Maria Frigerio, Eric D Adler
BACKGROUND: Geographic variations in management and outcomes of individuals supported by continuous-flow left ventricular assist devices (CF-LVAD) between the United States (US) and Europe (EU) is largely unknown. METHODS: We created a retrospective, multinational registry of 524 patients who received a CF-LVAD (either HVAD or Heartmate II) between January 2008 and April 2017. Follow up spanned from date of CF-LVAD implant to post-HTx period with a median follow up of 44...
September 17, 2020: International Journal of Cardiology
Cumaraswamy Sivathasan, Christopher Hayward, Paul Jansz, Amul Kumar Sibal, ChenChen, Ho Ka Lai Cally, Komarakshi Rajagopalan Balakrishnan, Yang Hyun Cho, Mohd Nazeri Nordin, Joseph B Barril, Feras Khaliel, Mandeep R Mehra
No abstract text is available yet for this article.
September 3, 2020: Journal of Heart and Lung Transplantation
Anubodh S Varshney, Sameer A Hirji, Michael M Givertz
The United Network for Organ Sharing (UNOS) implemented a revised donor heart allocation system on October 18, 2018 with principle aims to reduce waitlist mortality, enhance geographic organ sharing, and improve organ distribution equity. Five recently published analyses compared outcomes of heart transplant (HT) recipients transplanted under the revised versus previous system. All demonstrated increased pre-transplant temporary mechanical circulatory support use and graft ischemic times under the revised system...
August 26, 2020: Journal of Heart and Lung Transplantation
Douglas Farmer, Ernesto Jimenez
PURPOSE OF REVIEW: The use of coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS) has markedly declined during the past decade, with an increase in the use of percutaneous coronary intervention (PCI). However, long-term data continues to show survival advantages for patients undergoing CABG over PCI. We describe the current indications for and outcomes of CABG in patients who present with ACS. RECENT FINDINGS: Real-world studies demonstrate better long-term outcomes with CABG than with PCI after NSTE-ACS...
September 17, 2020: Current Cardiology Reports
Sonal Sharma, Abraham Sonny, Adam A Dalia, Kunal Karamchandani
Acute heart failure (AHF) is an under recognized yet potentially lethal complication after liver transplantation (LT) surgery. The increase in incidence of liver transplantation amongst high risk patients and the leniency in the criteria for transplantation, predisposes these patients to postoperative AHF and the antecedent morbidity and mortality. The inability of conventional pre-operative cardiovascular testing to accurately identify patients at risk for post-LT AHF poses a considerable challenge to clinicians caring for these patients...
September 17, 2020: Clinical Transplantation
Stacey Chen, Darien Paone, Lilly Spellman, Neel K Ranganath, Julius A Carillo, Claudia G Gidea, Alex Reyentovich, Craig A Thompson, Louai Razzouk, Zachary N Kon, Nader Moazami, Deane E Smith
BACKGROUND: The Impella (Abiomed) ventricular support system is a family of temporary mechanical circulatory support (MCS) devices used to treat patients with cardiogenic shock, acute cardiogenic decompensation, and for high-risk percutaneous or surgical revascularization. These devices include the percutaneously implanted 2.5/cardiac power (CP) and the surgically implanted 5.0/left direct (LD). Despite the beneficial effects and increased usage of these devices, data to assess adverse outcomes and guide clinician decision-making between the Impella CP and 5...
September 16, 2020: Journal of Cardiac Surgery
María Monteagudo-Vela, Vasileios Panoulas, Diana García-Saez, Fabio de Robertis, Ulrich Stock, Andre Simon
INTRODUCTION: The Impella® (Abiomed, Danvers, MA) has become an important adjunct treatment modality in bridging patients with end stage heart failure to recovery or orthotopic heart transplantation (HTx). We compared the outcome of patients directly bridged to HTx with the Impella 5.0 versus patients without mechanical circulatory support (MCS). METHODS: Patients with no previous sternotomy or MCS, who were transplanted between September 2014 and March 2019 were included in this retrospective analysis...
September 16, 2020: Artificial Organs
Ahmed Seliem, Shelley A Hall
PURPOSE OF REVIEW: In recent decades, multiple left and right ventricular assist devices (VAD) have been developed, and the utilization of these devices has grown exponentially. We discuss the most common temporary mechanical circulatory support (tMCS) devices used for patients in cardiogenic shock, including the intra-aortic balloon pump (IABP), transvalvular axial flow support systems (Impella®), the Tandem™ collection, and extracorporeal membrane oxygenation (ECMO). RECENT FINDINGS: In 2018 the United Network for Organ Sharing (UNOS) introduced new listing criteria for candidates awaiting heart transplantation in the USA...
September 16, 2020: Current Heart Failure Reports
Nili Schamroth Pravda, Ran Kornowski
The use of VA-ECMO for patients with cardiac arrest or cardiogenic shock in the cardiac catheterization laboratory may be associated with improved survival. Clinicians should be aware of a high complication rate of this therapy. Further data is needed to best select the appropriate form of mechanical circulatory support in this clinical context.
September 1, 2020: Catheterization and Cardiovascular Interventions
Anirudh Kumar, Chetan P Huded, Leon Zhou, Chayakrit Krittanawong, Laura D Young, Amar Krishnaswamy, Venu Menon, A Michael Lincoff, Stephen G Ellis, Grant W Reed, Samir R Kapadia, Umesh N Khot
Mortality in patients with STEMI-associated cardiogenic shock (CS) is increasing. Whether a comprehensive ST-elevation myocardial infarction (STEMI) protocol (CSP) can improve their care delivery and mortality is unknown. We evaluated the impact of a CSP on incidence and outcomes in patients with STEMI-associated CS. We implemented a 4-step CSP including: (1) Emergency Department catheterization lab activation; (2) STEMI Safe Handoff Checklist; (3) immediate catheterization lab transfer; (4) and radial-first percutaneous coronary intervention (PCI)...
August 15, 2020: American Journal of Cardiology
Kristen T Carter, Robert O'Brien, Sharon B Larson, Lawrence L Creswell, Matthew Kutcher, David A Baran, Jack G Copeland, Hannah Copeland
OBJECTIVE: Venoarterial extracorporeal membrane oxygenation is a rescue therapy for patients in cardiogenic shock. We hypothesize that patients bridged to heart transplant with extracorporeal membrane oxygenation have decreased survival. METHODS: The United Network of Organ Sharing database was retrospectively reviewed from January 1, 1999, to March 31, 2018, for heart transplant recipients. Recipients bridged with any form of mechanical support and those without support were compared with recipients bridged with extracorporeal membrane oxygenation...
August 16, 2020: Journal of Thoracic and Cardiovascular Surgery
Tomoki Ushijima, Hiromichi Sonoda, Yoshihisa Tanoue, Akira Shiose
INTRODUCTION: Ecpella, a combination of veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) and Impella, may result in the differential hypoxia in patients with cardiogenic shock and severe lung dysfunction. Here, we report a solution of this Ecpella-induced unfavorable phenomenon. CASE REPORT: A 70-year-old man developed cardiogenic shock from fulminant myocarditis. As we established Ecpella but immediately significant differential hypoxia became apparent, the ECMO configuration was switched from V-A to veno-arteriovenous (V-AV): a combination of V-AV ECMO and Impella, newly termed VAVEcpella, was instituted...
September 15, 2020: Perfusion
Geoffrey Southmayd, Azizul Hoque, Amir Kaki, Rajiv Tayal, S Tanveer Rab
OBJECTIVES: To systematically review relevant literature regarding cardiovascular outcomes of large-bore axillary arterial access via percutaneous and surgical approaches. BACKGROUND: In patients with severe peripheral arterial disease (PAD) undergoing cardiac interventions, large-bore femoral access may be prohibitive. The axillary artery provides an alternative vascular access for transcatheter aortic valve replacement (TAVR) or mechanical circulatory support...
September 14, 2020: Catheterization and Cardiovascular Interventions
Tarek Omran, Cornelia S Carr, Lateef Wani, Imad Mahmoud, Rula Taha, Bassam Shoman, Amr Salah Omar, Abdulaziz M Alkhulaifi
Temporary mechanical circulatory support device (tMCS) failure could qualify patients with advanced heart failure to receive a long-term solution. We report on a patient who presented with cardiorespiratory arrest that required a tMCS and developed acute type A aortic dissection. Data Sources: our case adds further evidence regarding the support of a patient with a second (or more) incidence of tMCS. This patient subsequently underwent left ventricular assist device insertion and type A aortic dissection repair, as a combined procedure, with a satisfactory outcome...
2020: SAGE Open Medical Case Reports
Masaru Seguchi, Kenichi Sakakura, Takunori Tsukui, Kei Yamamoto, Yousuke Taniguchi, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
Since the number of elderly patients suffering from acute myocardial infarction (AMI) has been increasing in developed countries, primary percutaneous coronary intervention (PCI) for the very elderly aged ≥80 years old is already common. The study aimed to examine the determinants of in-hospital death among the very elderly with AMI in current PCI era. We included 412 consecutive AMI patients aged ≥ 80 years old who received PCI to the culprit lesion; however, 42 patients (10.2%) died during the index hospitalization...
September 12, 2020: International Heart Journal
Kristin Stawiarski, Harish Ramakrishna
Ventricular assist devices continue to play a significant role in the surgical management of advanced heart failure. Left ventricular assist devices in particular have seen a rapid evolution in design, technology, implantation, and outcomes. This concise review focuses on the key data that have been published in the past 5 years that have demonstrated this rapid evolution in left-sided mechanical circulatory support from principally bridge to transplantation to destination therapy, with an increasing emphasis on quality-of-life measures and durability...
August 21, 2020: Journal of Cardiothoracic and Vascular Anesthesia
Qiudong Chen, Jaime Moriguchi, Ryan Levine, Joshua Chan, Sadia Dimbil, Jignesh Patel, Michelle Kittleson, Dominick Megna, Dominic Emerson, Danny Ramzy, Alfredo Trento, Joanna Chikwe, Jon Kobashigawa, Fardad Esmailian
BACKGROUND: Indications for heart transplantation are expanding to include amyloid light chain (AL) and transthyretin-related (TTR) amyloidosis. Previously, AL amyloid had been a contraindication to heart transplantation given inferior outcomes. These patients typically have biventricular failure requiring mechanical circulatory support (MCS). We report the outcomes of patients with end-stage cardiac amyloidosis who underwent cardiac transplantation, including some who were bridged to transplantation with a durable biventricular MCS METHODS: The records for patients with cardiac amyloidosis who underwent cardiac transplant between 2010 and 2018 were reviewed...
September 8, 2020: Transplantation Proceedings
Armin Zittermann, Jana B Ernst, Sylvana Prokop, Uwe Fuchs, Heiner K Berthold, Ioanna Gouni-Berthold, Jan F Gummert, Stefan Pilz
AIMS: Vitamin D supplementation is widely used in the clinical setting, but its effects on mortality and cardiovascular outcomes in patients with heart failure are unclear. This paper reports outcome data that were collected during follow-up of 3 years after closure of the EVITA trial (a 3 year randomized, placebo-controlled, intervention study with 4000 IU vitamin D daily in patients with advanced heart failure), to capture potential latency effects of vitamin D supplementation on clinical outcomes...
September 11, 2020: ESC Heart Failure
Farhad Rikhtegar Nezami, Farhan Khodaee, Elazer R Edelman, Steven P Keller
Extracorporeal membrane oxygenation (ECMO) is increasingly deployed to provide percutaneous mechanical circulatory support despite incomplete understanding of its complex interactions with the failing heart and its effects on hemodynamics and perfusion. Using an idealized geometry of the aorta and its major branches and a peripherally inserted return cannula terminating in the iliac artery, computational fluid dynamic simulations were performed to (1) quantify perfusion as function of relative ECMO flow and (2) describe the watershed region produced by the collision of antegrade flow from the heart and retrograde ECMO flow...
July 27, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Yojiro Koda, Hiroto Kitahara, Hidefumi Nishida, Valluvan Jeevanandam, Takeyoshi Ota
BACKGROUND: Recently, del Nido cardioplegia solution (DN) has been utilized in adult cardiac surgery. However, adequate interval of maintenance dose(s) is still unclear. The purpose of this study was to assess the safety and efficacy of our DN protocol by comparing with conventional cold whole blood cardioplegia (CWB). METHODS: A total of 1003 consecutive patients (DN group, N = 350 vs. CWB group, N = 653) underwent cardiovascular surgery between July 2013 and September 2018 were included in this study...
September 10, 2020: Perfusion
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