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138 papers 25 to 100 followers
A Montalto, V Piazza, F Albi, R Gherlia, C Contento, A Palermo, F Musumeci
BACKGROUND: Pump speed optimization in patients implanted with a ventricular assist device represents a major challenge during the follow-up period. We present our findings on whether combined invasive hemodynamic ramp tests and cardiopulmonary exercise testing (CPX) can help optimize patient management. METHODS: Eighteen patients implanted with a HeartMate 3 (HM3) device underwent ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP], and blood pressure) and echocardiography...
June 30, 2018: Transplantation Proceedings
Colleen K McIlvennan, Kathleen L Grady, Daniel D Matlock, Laura J Helmkamp, Martha Abshire, Larry A Allen
BACKGROUND: Trial and registry data have reported mortality rates and causes of death in patients with left ventricular assist devices (LVADs); however, a more granular description is needed of end of life, including location of death and quality of life (QOL), to better guide expectations and care. METHODS: To identify where patients with an LVAD died, characterize QOL before death, and cause of death over time, we evaluated patients in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) implanted with a continuous-flow LVAD...
December 15, 2018: Journal of Heart and Lung Transplantation
A Montalto, A Palermo, R Gherli, A Cammardella, C Contento, V Piazza, F Musumeci
INTRODUCTION: The measurement of blood pressure (BP) and the management of hypertension in patients with continuous-flow ventricular assist devices (CF-VADs) can present unique challenges. Patients with CF-VADs often do not have a palpable pulse, and therefore traditional blood pressure measurement by auscultation or automated cuff is less reliable. We tested the efficacy of blood pressure estimation using sphygmomanometry combined with finger pulse oximetry only after a hemodynamic optimization was effected to make the values estimated approximately similar to mean arterial pressure...
June 30, 2018: Transplantation Proceedings
Rene Schramm, Michiel Morshuis, Michael Schoenbrodt, Jochen Boergermann, Kavous Hakim-Meibodi, Masatoshi Hata, Jan F Gummert
Mechanical circulatory support gained a significant value in the armamentarium of heart failure therapy because of the increased awareness of the prevalence of heart failure and the tremendous advances in the field of mechanical circulatory support during the last decades. Current device technologies already complement a heart transplant as the gold standard of treatment for patients with end-stage heart failure refractory to conservative medical therapy. This article reviews important aspects of mechanical circulatory support therapy and focuses on currently debated issues...
January 4, 2019: European Journal of Cardio-thoracic Surgery
George Batsides, Joe Massaro, Anson Cheung, Edward Soltesz, Danny Ramzy, Mark B Anderson
OBJECTIVE: The aim of the study was to comprehensively summarize the survival outcomes and complications of Impella 5.0 (Abiomed Inc, Danvers, MA USA) use in patients with cardiogenic shock (CS). METHODS: We performed a literature review for relevant studies by searching in Medline, Medline In-Process, EMBASE, and the CENTRAL bibliographic databases on April 30, 2017. Nonoverlapping studies with 10 patients or more supported for cardiogenic shock with Impella 5...
July 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Rashad Zayat, Ares K Menon, Andreas Goetzenich, Gereon Schaelte, Ruediger Autschbach, Christian Stoppe, Tim-Philipp Simon, Lachmandath Tewarie, Ajay Moza
BACKGROUND: The use of left ventricular assist devices (LVADs) has gained significant importance for treatment of end-stage heart failure. Fast-track procedures are well established in cardiac surgery, whereas knowledge of their benefits after LVAD implantation is sparse. We hypothesized that ultra-fast-track anesthesia (UFTA) with in-theater extubation or at a maximum of 4 h. after surgery is feasible in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 3 and 4 patients and might prevent postoperative complications...
February 8, 2017: Journal of Cardiothoracic Surgery
Kristen M Tecson, Brian Lima, Andy Y Lee, Fayez S Raza, Grace Ching, Cheng-Han Lee, Joost Felius, Ronald D Baxter, Sasha Still, Justin D G Collier, Shelley A Hall, Susan M Joseph
BACKGROUND: Vasoplegia is associated with adverse outcomes following cardiac surgery; however, its impact following left ventricular assist device implantation is largely unexplored. METHODS AND RESULTS: In 252 consecutive patients receiving a left ventricular assist device, vasoplegia was defined as the occurrence of normal cardiac function and index but with the need for intravenous vasopressors within 48 hours following surgery for >24 hours to maintain a mean arterial pressure >70 mm Hg...
May 17, 2018: Journal of the American Heart Association
Marc Stone, Joseph Hinchey, Christopher Sattler, Adam Evans
In our institution, the vast majority of patients presenting for noncardiac surgery (NCS) while supported by a left ventricular assist device (LVAD) are now cared for by noncardiac-trained anesthesiologists as the result of a decade of educational intervention to effect this transition. This represents a significant departure from the published experiences of other institutions. With institutional review board approval, we queried the database of our anesthesia record keeping system (CompuRecord) to determine various aspects of the perioperative management of these patients from July 1, 2003, through June 30, 2013, during which time 271 NCS procedures were performed on adult patients supported by LVADs...
September 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Charlotta Lindvall, Brooks Udelsman, Devvrat Malhotra, Ethan Y Brovman, Richard D Urman, David A D'Alessandro, James A Tulsky
OBJECTIVES: To assess baseline patient characteristics and identify factors associated with in-hospital mortality after ventricular assist device (VAD) placement. METHODS: Cross-sectional study using the National Inpatient Sample database from January 2010 to December 2014. Analyses were performed with sample weights provided by the National Inpatient Sample, which are reported ± the standard error of the mean. RESULTS: Weighted samples yielded 15,021 ± 1111 patients who received a VAD...
November 15, 2018: Journal of Thoracic and Cardiovascular Surgery
Maziar Khorsandi, Jacob Schroder, Mani Daneshmand, Muath Bishawi, Omar Bouamra, Patrick Winterton, Ashley Y Choi, Chetan Patel, Joseph Rogers, J Mauricio Del Rio, Carmelo Milano
BACKGROUND: Right heart failure occurs in 9-44% of left ventricular assist device (LVAD) implants of which less than 10% require a right ventricular assist device (RVAD) support either concurrently with the LVAD or staged, as a delayed procedure. We have reported our outcomes based on whether the RVAD was placed concurrently or staged. METHODS: Clinical data were obtained from the Duke University Medical Center database. The study focused on all consecutive adult patients who received continuous flow LVAD - with either "concurrent" or "staged" (within 7 days) extracorporeal, temporary RVAD, between October 2007 and October 2017...
December 21, 2018: Annals of Thoracic Surgery
Leona T Yarboro
No abstract text is available yet for this article.
December 19, 2018: Annals of Thoracic Surgery
Anton Vonk Noordegraaf, Kelly Marie Chin, François Haddad, Paul M Hassoun, Anna R Hemnes, Susan Roberta Hopkins, Steven Mark Kawut, David Langleben, Joost Lumens, Robert Naeije
The function of the right ventricle determines the fate of patients with pulmonary hypertension. Since right heart failure is the consequence of increased afterload, a full physiological description of the cardiopulmonary unit consisting of both the right ventricle and pulmonary vascular system is required to interpret clinical data correctly. Here, we provide such a description of the unit and its components, including the functional interactions between the right ventricle and its load. This physiological description is used to provide a framework for the interpretation of right heart catheterisation data as well as imaging data of the right ventricle obtained by echocardiography or magnetic resonance imaging...
December 13, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Nader Moazami, Alex Reyentovich
No abstract text is available yet for this article.
November 22, 2018: Journal of Heart and Lung Transplantation
Dmytro Tsyganenko, Tom Wolfgang Gromann, Felix Schoenrath, Marcus Mueller, Johanna Mulzer, Christoph Starck, Thomas Krabatsch, Julia Stein, Volkmar Falk, Evgenij Potapov
OBJECTIVES: Extracorporeal life support (ECLS) can be applied as a bridge to diagnosis and decision-making for further treatment with long-term left ventricular assist devices (LVADs). METHODS: From January 2012 to January 2018, 714 adult patients were treated with ECLS in our institution. During the same period, 618 patients received an LVAD for long-term support. Of them, 100 patients were further supported with a long-term LVAD. We retrospectively analysed the datasets of these 100 consecutive patients with the goal of developing an algorithm to predict outcomes for a rational use of long-term ventricular assist device therapy in this setting...
November 15, 2018: European Journal of Cardio-thoracic Surgery
Rashad Zayat, Ajay Moza, Oliver Grottke, Tim Grzanna, Tamara Fechter, Tadashi Motomura, Christian Schmidt-Mewes, Thomas Breuer, Rüdiger Autschbach, Rolf Rossaint, Andreas Goetzenich, Christian Bleilevens
OBJECTIVES: Shear stress from left ventricular assist devices induces von Willebrand factor degradation and platelet dysfunction, leading to nonsurgical bleeding. We characterized the hemostatic changes induced by 2 centrifugal left ventricular assist devices, the HeartMate 3 (Abbott Inc, Chicago, Ill) and the EVAHEART (Evaheart Inc, Houston, Tex), for comparison. METHODS: Whole blood from 8 healthy volunteers was used ex vivo. Blood from the same donor was used for 6 hours of circulation in a miniature mock-loop system consisting of 2 identical extracorporeal circuits to compare the following experimental settings: (1) optimal revolutions per minute (rpm) for the HeartMate 3 (n = 4; 5000 rpm) and the EVAHEART (n = 4; 2500 rpm) and (2) equal rpm (3000 rpm for the HeartMate 3 and EVAHEART, n = 4 vs n = 4)...
August 6, 2018: Journal of Thoracic and Cardiovascular Surgery
Amrish Deshmukh, Ankit Bhatia, Gabriel T Sayer, Gene Kim, Jayant Raikhelkar, Teruhiko Imamura, Cevher Ozcan, Takeyoshi Ota, Valluvan Jeevanandam, Nir Uriel
BACKGROUND: Thromboembolic events (TEs) are common adverse events with continuous flow left ventricular assist devices (LVADs). Left atrial appendage occlusion (LAAO) is commonly performed at time of cardiac surgery. The effect of LAAO on TEs in LVAD patients remains unknown. METHODS: All patients receiving first LVAD implantation between 1/2013-1/2014 were reviewed. TEs included device thrombosis (DT) and ischemic cerebrovascular accidents (CVA). The incidence of TEs with respect to LAAO was evaluated using Kaplan Meier and Cox proportional hazards analyses...
October 23, 2018: Annals of Thoracic Surgery
Yu Xia, Stephen Forest, Patricia Friedmann, Lin-Chiang Chou, Snehal Patel, Ulrich Jorde, Daniel Goldstein
BACKGROUND: Limited data exist on factors predicting prolonged survival in left ventricular assist device (LVAD) recipients. We sought to identify patient characteristics and complications associated with prolonged survival. METHODS: We conducted retrospective review of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database, including primary continuous-flow LVAD recipients, between May 2012 and March 2013. Patients were identified as having survived with a device in place after 3 years or not, conditional on having initially survived 6 months...
February 2019: Annals of Thoracic Surgery
Jens Garbade, Finn Gustafsson, Steven Shaw, Jacob Lavee, Diyar Saeed, Yuriy Pya, Thomas Krabatsch, Jan D Schmitto, Michiel Morshuis, Joyce Chuang, Daniel Zimpfer
BACKGROUND: The HeartMate 3 left ventricular assist device (Abbott, Chicago, IL) is designed to provide circulatory support with enhanced hemocompatibility for patients with advanced heart failure. The purpose of this study was to compare the surgical outcomes between patients treated during the European Conformity Mark (CE Mark [CEM]) clinical trial and those treated in the postmarket era. METHODS: The prospective, observational, multinational ELEVATE (Evaluating the HeartMate 3 with Full MagLev Technology in a Post-Market Approval Setting) registry includes patients receiving the HeartMate 3 following CEM approval...
January 2019: Annals of Thoracic Surgery
Ibrahim Sultan, Arman Kilic, Ahmet Kilic
Severe right ventricular (RV) failure is a significant cause of morbidity and mortality, with an in-hospital mortality rate up to 70% to 75%. Medical management is employed and is successful for most of these patients. However, a small percentage of patients will continue to have persistent RV failure, for which mechanical support is used for management.
October 2018: Heart Failure Clinics
Mandeep R Mehra, Christopher Salerno, Yoshifumi Naka, Nir Uriel, Joseph C Cleveland, Douglas Horstmanshof, Daniel J Goldstein
No abstract text is available yet for this article.
November 2018: Journal of Heart and Lung Transplantation
2018-09-29 05:55:33
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