Toshiki Kuno, Hisato Takagi, Tomo Ando, Masaki Kodaira, Yohei Numasawa, John Fox, Sripal Bangalore
BACKGROUND: Mechanical circulatory support (MCS) with Impella or intra-aortic balloon pump (IABP) is used for high-risk percutaneous coronary intervention (PCI) and/or for cardiogenic shock (CS) due to acute myocardial infarction. We aimed to investigate the efficacy and safety of Impella or IABP when compared with no MCS using a network meta-analysis of randomized controlled trials (RCTs). METHODS: EMBASE and MEDLINE were searched through February 2020 for RCT evaluating efficacy of Impella vs...
September 7, 2020: Catheterization and Cardiovascular Interventions
Priyesh A Patel, Cynthia L Green, Yuliya Lokhnygina, Jared Christensen, Carmelo A Milano, Joseph G Rogers, Chetan B Patel, Lynne M Koweek, Melissa A Daubert
BACKGROUND: Left ventricular assist devices (LVAD) are increasingly used for durable mechanical circulatory support in advanced heart failure. While LVAD therapy provides substantial improvement in mortality and quality of life, long-term therapy confers increased risk for device complications. We evaluated if cardiac computed tomography (CCT) improves the detection of cardiomechanical complications among patients with LVAD and suspected device malfunction. METHODS: In this study, we compared the diagnostic performance of CCT and transthoracic echocardiography (TTE) for the identification of cardiomechanical LVAD complications, including thrombus or neointimal hyperplasia, inflow cannula malposition with dynamic obstruction, fixed outflow obstruction, device infection, and severe aortic regurgitation...
August 28, 2020: Journal of Cardiovascular Computed Tomography
María Monteagudo-Vela, Fernando Riesgo-Gil, Hassiba Smail, Diana García-Saez, Bass Hassan, André Simon
BACKGROUND: Primary cardiac tumors are exceedingly rare. Amongst the malignant types, sarcomas are the most frequently encountered. Treatment includes attempted aggressive surgical resection as the only curative option. We report our experience. METHODS: During the last five years, six patients presented at our institution with complex cardiac tumors with different underlying diagnoses and were at different stages of their disease. RESULTS: 6 patients with median age of 30-years-old underwent surgery in our centre...
September 2020: Surgical Oncology
Lisa K Lee, Lejla Medzikovic, Mansoureh Eghbali, Holger K Eltzschig, Xiaoyi Yuan
Acute respiratory distress syndrome (ARDS) is a significant cause of morbidity and mortality in the intensive care unit (ICU) and is characterized by lung epithelial and endothelial cell injury, with increased permeability of the alveolar-capillary membrane, leading to pulmonary edema, severe hypoxia, and difficulty with ventilation. The most common cause of ARDS is sepsis, and currently, treatment of ARDS and sepsis has consisted mostly of supportive care because targeted therapies have largely been unsuccessful...
September 1, 2020: Anesthesia and Analgesia
Prashant Mohite, Rita Garda, Kabeer Umakumar, Sundip Kaul, Nandor Marczin, Bartlomiej Zych, Diana Garcia, Maria Monteagudo Vela, Balakrishnan Mahesh, Ulrich Stock, Fabio DeRobertis, Andre Simon
INTRODUCTION: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) serves as a conventional short-term mechanical circulatory assist to support heart and lung functions. The short-term ventricular assist devices (ST-VAD) can, on the contrary, offer only circulatory support. A combination of VAD and oxygenator (Oxy-VAD) help overcome this potential disadvantage. METHODS: This is a retrospective case note study of patients supported on ST-VAD which required adding an oxygenator for extra respiratory support...
September 3, 2020: Artificial Organs
Juan Diego Sánchez Vega, Gonzalo Luis Alonso Salinas, José María Viéitez Flórez, Albert Ariza Solé, Esteban López de Sá, Ricardo Sanz Ruiz, Virginia Burgos Palacios, Sergio Raposeiras-Roubín, Susana Gómez Varela, Juan Sanchis, Lorenzo Silva Melchor, Xurxo Martínez-Seara, Lorena Malagón López, José Luis Zamorano Gómez, Marcelo Sanmartín Fernández
INTRODUCTION AND OBJECTIVES: Postinfarction ventricular septal rupture is a rare but severe complication of myocardial infarction with high mortality rates. Our goal was to analyze which factors could have an impact on mortality due to this entity over the past decade, including those related to mechanical circulatory support. METHODS: The CIVIAM registry is an observational, retrospective, multicenter study carried out in Spain. We designed a comparative analysis, focused on description of in-hospital management and in-hospital and 1-year total mortality as the primary endpoints, dividing the total observation time into 2 equal temporal periods (January 2008 to June2013 and July 2013 to December 2018)...
August 31, 2020: Revista Española de Cardiología
Hidefumi Nishida, Yojiro Koda, Sara Kalantari, Ann Nguyen, Bow Chung, Jonathan Grinstein, Gene Kim, Nitasha Sarswat, Bryan Smith, Tae Song, David Onsager, Valluvan Jeevanandam, Takeyoshi Ota
BACKGROUND: The axillary intra-aortic balloon pump (IABP) is utilized frequently in selected patients for circulatory support as a bridge to heart transplantation. The purpose of this study is to investigate the safety and efficacy of axillary intra-aortic balloon pump support for heart transplant candidates. METHODS: We collected data regarding 133 patients who underwent axillary IABP support as a bridge to transplantation from July 2009 to April 2019. Of these patients, 94(70...
August 31, 2020: Annals of Thoracic Surgery
Gaik Nersesian, Carsten Tschöpe, Frank Spillmann, Tom Gromann, Luise Roehrich, Marcus Mueller, Johanna Mulzer, Christoph Starck, Volkmar Falk, Felix Schoenrath, Evgenij Potapov
OBJECTIVES: Short-term mechanical circulatory support is a life-saving treatment for acute cardiogenic shock (CS). This multicentre study investigates the preoperative predictors of 30-day mortality in CS patients treated with Impella 5.0 and 5.5 short-term left ventricular assist devices. METHODS: Data of patients in CS (n = 70) treated with the Impella 5 (n = 63) and 5.5 (n = 7) in 2 centres in Berlin between October 2016 and October 2019 were collected retrospectively...
September 3, 2020: Interactive Cardiovascular and Thoracic Surgery
Arka Chatterjee, Neal J Miller, Marc G Cribbs, Amrita Mukherjee, Mark A Law
BACKGROUND: Treatment of congenitally corrected transposition of great arteries (cc-TGA) with anatomic repair strategy has been considered superior due to restoration of the morphologic left ventricle in the systemic circulation. However, data on long term outcomes are limited to single center reports and include small sample sizes. AIM: To perform a systematic review and meta-analysis for observational studies reporting outcomes on anatomic repair for cc-TGA. METHODS: MEDLINE and Scopus databases were queried using predefined criteria for reports published till December 31, 2017...
August 26, 2020: World Journal of Cardiology
Gustavo Luiz Gouvêa de Almeida Junior, João Mansur Filho, Denilson Campos de Albuquerque, Sergio Salles Xavier, Álvaro Pontes, Elias Pimentel Gouvêa, Alexandre Bahia Barreiras Martins, Nágela S V Nunes, Lilian Vieira Carestiato, João Luiz Fernandes Petriz, Armando Márcio Gonçalves Santos, Bruno Santana Bandeira, Bárbara Elaine de Jesus Abufaiad, Luciana da Camara Pacheco, Maurício Sales de Oliveira, Paulo Eduardo Campana Ribeiro Filho, Pedro Paulo Nogueres Sampaio, Gustavo Salgado Duque, Luiz Felipe Camillis, André Casarsa Marques, Francisco Carlos Lourenço, José Ricardo Palazzo, Cláudio Ramos da Costa, Bibiana Almeida da Silva, Cleverson Neves Zukowski, Romulo Ribeiro Garcia, Fernanda de Carvalho Zonis, Suzana Andressa Morais de Paula, Carolina Gravano Ferraz Ferrari, Bruno Soares da Silva Rangel, Roberto Muniz Ferreira, Bárbara Ferreira da Silva Mendes, Isabela Ribeiro Carvalho de Castro, Leonardo Giglio Gonçalves de Souza, Luiz Henrique Dos Santos Araújo, Alexandre Giani
BACKGROUND: Takotsubo syndrome (TTS) is an acquired form of cardiomyopathy. National Brazilian data on this condition are scarce. The Takotsubo Multicenter Registry (REMUTA) is the first to include multicenter data on this condition in Brazil. OBJECTIVE: To describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up. METHODS: This is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition...
August 28, 2020: Arquivos Brasileiros de Cardiologia
Sandeep Dayanand, Jasmin M Martinez, Vincent M Figueredo, Shuchita Gupta
A number of devices can now provide mechanical circulatory support (MCS) to patients with acute cardiogenic shock (CS) and chronic end-stage heart failure (HF). Women differ from men in pathophysiology and natural history of CS and HF, and are usually sicker at admission. Current evidence suggests that women benefit as much as men, if not more, from both temporary and durable MCS for appropriate indications. Yet, women have been under-represented in clinical trials of MCS devices. Limited evidence suggests that women benefit more from temporary MCS in CS associated with acute myocardial infarction...
August 29, 2020: Journal of Cardiology
Omar Chehab, Rami Z Morsi, Amjad Kanj, Rayan Jo Rachwan, Mohit Pahuja, Shareef Mansour, Hussam Tabaja, Usman Ahmad, Said El Zein, Mohammad Raad, Ali Saker, Paulino Alvarez, Alexandros Briasoulis
OBJECTIVES: This study addresses the incidence, trends, and impact of nosocomial infections (NI) on the outcomes of patients admitted with ST-segment elevation myocardial infarction (STEMI) and cardiogenic shock (STEMI-CS) using the United States National Inpatient Sample (NIS) database. METHODS: We analyzed data from 105,184 STEMI-CS patients using the NIS database from the years 2005-2014. NI was defined as infections of more than or equal to three days, comprising of central line-associated bloodstream infection (CLABSI), urinary tract infection (UTI), hospital-acquired pneumonia (HAP), Clostridium difficile infection (CDI), bacteremia, and skin related infections...
August 28, 2020: Heart & Lung: the Journal of Critical Care
Catalin Toma, Sameer Khandhar, Adrian M Zalewski, Stephen J D'Auria, Thomas M Tu, Wissam A Jaber
OBJECTIVE: Examine FlowTriever thrombectomy feasibility in high-risk PE patients. BACKGROUND: The FlowTriever thrombectomy system (Inari Medical, Irvine, CA) can reduce right ventricle (RV) strain in acute submassive pulmonary embolism (PE) patients. This technology has not been studied in higher risk PE patients. METHODS: This multicenter retrospective analysis included patients treated with FlowTriever between 2017 and 2019 if they met at least one of the following: vasopressor dependence, PE induced respiratory failure, or decreased cardiac index (CI) measured by right heart catheterization...
August 31, 2020: Catheterization and Cardiovascular Interventions
Swati Garekar, Talha Meeran, Vinay Patel, Sachin Patil, Shyam Dhake, Shivaji Mali, Amit Mhatre, Dilip Bind, Ashish Gaur, Sandeep Sinha, Vijay Shetty, Kirtis Sabnis, Bharat Soni, Dhananjay Malankar, Anvay Mulay
Background: Pediatric heart transplantation is a now a well-established and standard treatment option for end stage heart failure for various conditions in children. Due to logistic issues, it is not an option for in most pediatric cardiac centres in the third world. Aim: We sought to describe our early experience in the current era in India. Methods: This is a short term retrospective chart review of pediatric patients who underwent heart transplantation at our centre...
July 2020: Annals of Pediatric Cardiology
Saraschandra Vallabhajosyula, Saarwaani Vallabhajosyula, Shannon M Dunlay, Sharonne N Hayes, Patricia J M Best, Jorge A Brenes-Salazar, Amir Lerman, Bernard J Gersh, Allan S Jaffe, Malcolm R Bell, David R Holmes, Gregory W Barsness
OBJECTIVE: To evaluate outcomes by sex in older adults with cardiogenic shock complicating acute myocardial infarction (AMI-CS). MATERIALS AND METHODS: A retrospective cohort of older (≥75 years) AMI-CS admissions during January 1, 2000, to December 31, 2014, was identified using the National Inpatient Sample. Interhospital transfers were excluded. Use of angiography, percutaneous coronary intervention (PCI), mechanical circulatory support (MCS), and noncardiac interventions was identified...
September 2020: Mayo Clinic Proceedings
Sandro Sponga, A Dave Nagpal, Igor Vendramin, Veronica Ferrara, Andrea Lechiancole, Massimo Maiani, Chiara Nalli, Concetta Di Nora, Giorgio Guzzi, Nunzio D De Manna, Uberto Bortolotti, Ugolino Livi
AIMS: We aimed to describe how treatment of patients in cardiogenic shock bridged to heart transplantation with mechanical circulatory support, using either biventricular assist devices (BVADs) or extracorporeal life support (ECLS), has evolved in the last 20 years in our centre. METHODS: Since 1998, 72 patients with refractory heart failure and indication for heart transplantation have received mechanical circulatory support: 40 had an ECLS system and 32 a BVAD...
August 26, 2020: Journal of Cardiovascular Medicine
Maximilian Vondran, Mahmoud S Wehbe, Christian Etz, Tamer Ghazy, Ardawan J Rastan, Michael A Borger, Thomas Schroeter
BACKGROUND: Post-infarction ventricular septal defect (pVSD) due to acute myocardial infarction complicated by cardiogenic shock (CS) is associated with high mortality. The aim of this study was to determine the outcome of primary surgical repair of pVSD in patients with CS and examine whether it is influenced by the use of mechanical circulatory support (MCS) devices. METHODS: Between 10/1994 and 04/2016, primary surgical repair of pVSD complicated by CS was performed in 53 patients...
August 28, 2020: Artificial Organs
Jae Hong Lim, Jae Gun Kwak, Jooncheol Min, Hye Won Kwon, Mi Kyung Song, Gi Beom Kim, Eun Jung Bae, Woong-Han Kim, Jeong Ryul Lee
Though ventricular assist devices (VADs) are an important treatment option for acute heart failure, an extracorporeal membrane oxygenator (ECMO) is usually used in pediatric patients for several reasons. However, a temporary centrifugal pump-based Bi-VAD might have clinical advantages versus ECMO or implantable VADs. From January 2000 to July 2018, we retrospectively reviewed 36 pediatric patients who required mechanical circulatory support (MCS) for acute heart failure. Cases with postoperative MCS were excluded...
August 27, 2020: Pediatric Cardiology
Nirmal Guragai, Upamanyu Rampal, Rahul Vasudev, Pragya Bhandari, Atul Prakash, Hartaj Virk, Mahesh Bikkina, Shamoon Fayez
Radiofrequency ablation is one of the alternative treatment strategies in patients with atrial fibrillation. With the increasing number of such ablation procedures being performed it is important for the physicians to be aware of the associated complications. We present a very rare case of severe triple coronary vessel spasm during radiofrequency catheter ablation. The procedure was complicated by cardiac arrest secondary to ventricular fibrillation and cardiogenic shock requiring subsequent management with a temporary mechanical circulatory support device...
August 2, 2020: Journal of Community Hospital Internal Medicine Perspectives
Enrique Pérez de la Sota, Andrea Eixerés-Esteve
Providing complex therapies such as extracorporeal membrane oxygenation (ECMO) during outbreaks of infectious diseases has singular challenges. The impact of the SARS-CoV-2 pandemic has implied a mentality change by force of circumstances, and cardiac surgery has not been stranger to this trend. The need to treat critically ill patients with an unknown evolution has compelled cardiovascular surgeons to decide whether or not to implant an ECMO system, despite the limited scientific evidence available in the context of COVID-19...
August 26, 2020: Journal of Cardiac Surgery
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