Artificial organs最新文献

{"title":"Extracorporeal Photopheresis in Heart Transplantation: Mechanisms, Clinical Integration, and the Experience of the Azienda Ospedaliera Universitaria Senese.","authors":"Luca Martini, Francesca Maria Righini, Adelina Selimi, Sonia Bernazzali, Sandro Sponga, Serafina Valente, Massimo Maccherini","doi":"10.1111/aor.70232","DOIUrl":"https://doi.org/10.1111/aor.70232","url":null,"abstract":"<p><strong>Backgrounds: </strong>Extracorporeal photopheresis (ECP) is a promising immunomodulatory strategy for complex rejection in heart transplant (HTx) recipients. By combining leukapheresis, 8-methoxypsoralen photoactivation, and UVA irradiation, ECP induces leukocyte apoptosis and promotes immune tolerance through dendritic-cell modulation, regulatory T-cell expansion, and cytokine reprogramming. Clinical evidence supports its use in steroid-refractory acute cellular rejection (ACR) and selected antibody-mediated rejection (AMR). This study reviews the mechanistic rationale and clinical evidence for ECP and reports the real-world experience of the Azienda Ospedaliera Universitaria Senese (AOU Senese).</p><p><strong>Methods: </strong>We retrospectively analyzed a single-centre cohort of 19 heart transplant recipients treated with extracorporeal photopheresis at AOU Senese between March 2010 and November 2024. Clinical, histological, immunological, echocardiographic, biomarker, immunosuppressive-treatment, and safety data were extracted at baseline and at dataset-defined 3-, 6-, 12-, and 24-month assessments. Analyses were descriptive and used variable-specific denominators because follow-up and laboratory data were incomplete at later time points.</p><p><strong>Results: </strong>Biopsy data for cellular-mediated rejection (CMR) were available in 19 patients through 12 months and in 11 patients at 24 months. The proportion with ≥ 1R CMR decreased from 11/19 (57.9%) at baseline to 4/19 (21.1%) at 3 months, 3/19 (15.8%) at 6 months, 2/19 (10.5%) at 12 months, and 0/11 at 24 months. pAMR1 was present in 6/18 (33.3%) patients with available baseline AMR data, absent at 3 months, present in 1/19 (5.3%) at 6 months, and absent among patients with available biopsies at 12 and 24 months. In contrast, Class II DSA positivity did not show a consistent decline (12/19 [63.2%] at baseline and 8/10 [80.0%] at 24 months). Left ventricular systolic function remained broadly preserved among available observations, and corticosteroid dose decreased over time. Seven deaths occurred during the available overall follow-up, four of which were recorded as reasons for ECP discontinuation.</p><p><strong>Conclusions: </strong>In this small, retrospective, uncontrolled, and clinically heterogeneous cohort, ECP use was temporally associated with a lower biopsy-documented rejection burden and reduced corticosteroid exposure. The study does not establish a causal effect of ECP on rejection, antibody burden, or safety, and the antibody data do not support a uniform reduction in DSA. Prospective multicentre studies with standardized treatment protocols, assay definitions, and complete longitudinal follow-up are required.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporary Mechanical Circulatory Support in High-Risk Cardiac Surgery: Contemporary Practice and Insights From U.S. Transplant Centers.","authors":"Suguru Ohira, Philip J Spencer, Sooyun Caroline Tavolacci, Yasir Abu Omar","doi":"10.1111/aor.70227","DOIUrl":"https://doi.org/10.1111/aor.70227","url":null,"abstract":"<p><strong>Background: </strong>To date, evidence regarding the role of temporary mechanical circulatory support (tMCS) for high-risk cardiac surgery (HRCS) is limited and continues to evolve. We aimed to appraise current evidence and characterize contemporary use of tMCS in HRCS across selected U.S. Transplant Centers.</p><p><strong>Methods: </strong>The authors have conducted a cross-sectional survey for tMCS use for HRCS. This survey was conducted using the RedCap system evaluating the timing of support, device selection, and technical considerations. The response rate was 74%.</p><p><strong>Results: </strong>For isolated coronary artery bypass grafting (CABG) patients with left ventricular ejection fraction (LVEF) 25%-35%, no-tMCS and intra-aortic balloon pump were the common approaches. In isolated CABG patients with LVEF less than 25%, more surgeons consider tMCS use including Impella 5.5. For CABG with mitral repair or replacement, more surgeons consider the use of tMCS. The annual volume of Impella 5.5 use for HRCS cases was ≤ 10 cases annually. For arterial access for Impella 5.5, the rate of trans-aortic and trans-axillary approach were equal. For HRCS, the simultaneous approach was more predominant, and most surgeons advance Impella to the left ventricle after the cross-clamp is off. Most surgeons leave Impella 5.5 for 72 h to 1 week. For patients with severe aortic insufficiency, one-fourth of surgeons have performed Impella 5.5 insertion.</p><p><strong>Conclusions: </strong>Contemporary practice demonstrates increasing adoption of tMCS use in HRCS with a trend toward preemptive implementation of support. Given limited high-quality evidence and variability in practice, careful patient selection, technical expertise, and institutional experience remain critical to achieving optimal results.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"276 Days of Support by a Micro-Axial Left Ventricular Assist Device as a Bridge to Heart Transplant.","authors":"Junichi Shimamura, Avi Levine, Stephen Pan, Gregg M Lanier, Chhaya Aggarwal, Alan Gass, David Spielvogel","doi":"10.1111/aor.70225","DOIUrl":"https://doi.org/10.1111/aor.70225","url":null,"abstract":"<p><p>The Impella 5.5 is a surgically implanted micro-axial left ventricular assist device (LVAD) increasingly utilized for mechanical circulatory support (MCS) in cardiogenic shock. While typically used for acute support up to FDA-approved 14 days, reports of prolonged utilization remain limited. We present the case of a 69-year-old male who presented with severe biventricular failure and cardiogenic shock who was bridged to heart transplantation (HT) utilizing a single Impella 5.5 for a total of 276 days. His prolonged support course was managed through a multidisciplinary approach addressing recurrent ventricular arrhythmias, renal failure, heparin-induced thrombocytopenia, and device management (suction alarms and purge flow limitations). Following successful HT, the explanted device demonstrated no mechanical injury or thrombus, and pathologic examination revealed no significant device-related structural heart damage. The patient was discharged without major complications and continued to do well at 5-month follow-up.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geometry-Related Technical Complications After LVAD Implantation: Impact on Device Dysfunction and Clinical Outcomes.","authors":"Ali Saad Merzah, Ezin Deniz, Sara Knigge, Jasmin Hanke, Alina Zubarevich, Mohamad Dia, Chaikovska Sofia, Todurov Borys, Saeed Torabi, Bastian Schmack, Alexander Weymann, Zurab Darbaidze, Josephina Haunschild, Christian D Etz, Max Biewer, Arjang Ruhparwar, Jan D Schmitto, Günes Dogan","doi":"10.1111/aor.70204","DOIUrl":"https://doi.org/10.1111/aor.70204","url":null,"abstract":"<p><strong>Background: </strong>Geometry of LVAD implantation is a determinant of pump performance and hemocompatibility. Despite technically successful operations, avoidable geometric errors may produce characteristic imaging patterns and clinically relevant device dysfunction.</p><p><strong>Objectives: </strong>To determine the frequency, diagnostic pathway, and clinical impact of preventable geometry-related failure modes after HeartMate 3 implantation in a single-center referral cohort, specifically inflow cannula malposition, outflow graft kinking/excessive length, and aortic anastomotic stenosis.</p><p><strong>Methods: </strong>Retrospective, single-center analysis of 21 consecutive HeartMate 3 recipients implanted between 2016 and 2025 at external centers and subsequently evaluated in our department. All patients underwent CT/CTA when device dysfunction was suspected. Failure modes were predefined and adjudicated using standardized imaging criteria. CT/CTA was the primary modality used to confirm geometric failure modes following triggers such as low-flow alarms, hemolysis, and abnormal chest radiography.</p><p><strong>Results: </strong>Among 21 HeartMate 3 recipients, inflow cannula malposition was identified in 7 patients, outflow graft kinking/excessive length in 12, and aortic anastomotic stenosis in 2.</p><p><strong>Conclusions: </strong>In this single-center referral cohort, geometric failure modes were identified in 15 of 21 patients (71.4%) after HeartMate 3 implantation and showed reproducible CT/CTA signatures. A standardized imaging-driven diagnostic pathway may improve recognition of correctable geometric problems in patients referred for suspected device dysfunction; given the referral-based design, these frequencies should not be interpreted as the true incidence in an unselected HeartMate 3 population.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Complete Revascularization Before Left Ventricular Assist Device Implantation in Patients With Severe Ischemic Cardiomyopathy.","authors":"David Hong, Ah-Ram Kim, Minjung Bak, Kitae Kim, Junho Hyun, Darae Kim, Sang Eun Lee, Yang Hyun Cho, Sung-Ho Jung, Jin-Oh Choi, Jeong Hoon Yang, Min-Seok Kim","doi":"10.1111/aor.70221","DOIUrl":"10.1111/aor.70221","url":null,"abstract":"<p><strong>Background: </strong>Limited information exists regarding whether coronary revascularization by percutaneous coronary intervention (PCI) prior to left ventricular assist device (LVAD) implantation improves outcomes. This study aimed to investigate the clinical impact of complete revascularization (CR) by PCI before LVAD implantation in patients with severe ischemic cardiomyopathy (ICM).</p><p><strong>Methods: </strong>From July 2013 to August 2024, data were retrospectively collected from all patients who underwent LVAD implantation at two tertiary referral hospitals. ICM patients were selected, and those who did not undergo coronary evaluation before LVAD implantation or who received a coronary artery bypass graft within one year were excluded from the analysis. Primary outcome was all-cause mortality at 2 years following LVAD implantation according to CR status.</p><p><strong>Results: </strong>Among the 118 patients included in the study, 42 (35.6%) patients underwent CR by PCI within 1 year before LVAD implantation. All-cause death occurred in 18.3% of the patients in the CR group and 22.8% in the incomplete revascularization group (hazard ratio, 0.76; 95% confidence interval, 0.31-1.86; p = 0.554). There was also no significant difference in hospitalization for heart failure, ventricular arrhythmias, progressive right ventricular failure, or heart transplantation between patients in the CR group and those in the incomplete revascularization group. No acute coronary syndrome occurred during LVAD support regardless of CR status.</p><p><strong>Conclusion: </strong>CR by PCI before LVAD implantation in patients with severe ICM did not improve clinical outcomes following LVAD therapy. These findings suggest that revascularization should be carefully considered on a case-by-case basis, weighing potential risks and benefits.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Experience With the Aeson Total Artificial Heart in Patients With Ventricular Septal Defect After Acute Myocardial Infarction.","authors":"Michal Nozdrzykowski, Olivier Bouchot, Andre Vincentelli, Bernd Panholzer, Saed Jazayeri, Mouhamed Moussa, Christian Latremouille, Assad Haneya, Michael A Borger, Alexey Dashkevich","doi":"10.1111/aor.70218","DOIUrl":"10.1111/aor.70218","url":null,"abstract":"<p><strong>Background: </strong>Post-myocardial infarction ventricular septal defect (VSD) is a rare but highly lethal complication of acute myocardial infarction. In cases of extensive septal destruction, surgical reconstruction is often not feasible. We report the first clinical experience with implantation of the Aeson total artificial heart (TAH) in patients with irreparable post-infarction VSD.</p><p><strong>Methods: </strong>This multicenter retrospective analysis included 10 male patients with severe cardiogenic shock who underwent Aeson TAH implantation at four centers in Germany and France between November 2022 and March 2025. All patients required temporary mechanical circulatory support before implantation. Previous surgical VSD repair had failed in four patients, while six were considered unsuitable for surgical reconstruction because of extensive basal septal defects involving the atrioventricular valve apparatus.</p><p><strong>Results: </strong>Following TAH implantation, early extubation was achieved in most patients, whereas three required temporary veno-venous extracorporeal membrane oxygenation support. No cases of permanent renal failure, irreversible hepatic dysfunction, or neurological complications such as stroke were observed. Eight patients (80%) were successfully bridged to heart transplantation after a median support duration of 167 days, while one patient remains on ongoing device support. During a median follow-up of 351 days (interquartile range, 202-470 days), four patients died. Overall survival was 80% at 6 months and 60% at 1 year after implantation.</p><p><strong>Conclusions: </strong>Aeson TAH implantation appears to be a feasible bridge-to-transplant strategy for selected patients with irreparable post-myocardial infarction VSD. The procedure provided hemodynamic stabilization, facilitated recovery of end-organ function, and resulted in favorable short- to mid-term outcomes in an otherwise fatal clinical condition.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Organ Preservation and Perfusion: Introducing the International Society of Organ Preservation and Perfusion Therapy (ISOPPT)","authors":"Narendra R. Battula,&nbsp;Renato Romagnoli,&nbsp;Damiano Patrono,&nbsp;Shaf Keshavjee,&nbsp;Davide Ghinolfi,&nbsp;Stefan Tullius,&nbsp;Amelia Hessheimer,&nbsp;James Guarrera,&nbsp;Valeria Mas,&nbsp;Gabriel Oniscu,&nbsp;Mihai Oltean,&nbsp;Vakhtang Tchantchaleishvili,&nbsp;Qinggong Tang,&nbsp;Pierre A. Clavien,&nbsp;Paulo N. Martins","doi":"10.1111/aor.70179","DOIUrl":"10.1111/aor.70179","url":null,"abstract":"&lt;p&gt;Over the past decade, ex-situ organ machine perfusion has undergone one of the most remarkable expansions in modern transplant medicine. What began as a niche preservation strategy, an experimental adjunct meant to mitigate ischemic injury during organ storage, has now blossomed into a powerful, multifunctional biological platform. It is becoming increasingly clear that machine perfusion is not merely an extension of static cold storage but a fundamental technological advancement that is altering how we preserve, evaluate, repair, and ultimately understand human organs [&lt;span&gt;1, 2&lt;/span&gt;]. The emergence of dedicated organ repair and regeneration centers marks an important inflection point in transplantation. What was once a field centered on preservation is evolving towards an active intervention where organs can be assessed, treated, and optimized prior to implantation. As preservation and perfusion technologies continue to mature, the long-held aspiration of more predictable, on-demand organ availability is beginning to feel within reach.&lt;/p&gt;&lt;p&gt;Paradoxically, this rapid scientific and clinical progress has unfolded within a fragmented and disjointed landscape. Innovation is being propelled by experts spanning transplant surgery, bioengineering, critical care, regenerative medicine, pharmacology, and device development. Each brings essential competencies, yet they are largely operating in parallel tracks. This lack of integration has created a widening gap: while science has moved rapidly, the organizational, regulatory, and ethical frameworks needed to support and govern it have lagged behind. If left unaddressed, this misalignment risks constraining the very progress it helped create, slowing the advancement of one of the most transformative fields in organ medicine.&lt;/p&gt;&lt;p&gt;The time has come to acknowledge a simple truth: machine perfusion has outgrown transplantation. The breadth of its impact demands a dedicated international society to guide its future and create a unified home for scientists, engineers, surgeons, ethicists, regulators, industry, and innovators working across the entire organ perfusion ecosystem.&lt;/p&gt;&lt;p&gt;In the clinical transplant arena, perfusion has already established itself as a transformative force. Normothermic and hypothermic liver perfusion have improved early graft function and reduced non-utilization rates. In liver transplantation, hypothermic oxygenated and normothermic perfusion have lowered the incidence of post-transplant cholangiopathy and helped expand the donor pool in ways cold storage alone could never achieve [&lt;span&gt;3-7&lt;/span&gt;]. Continuous hypothermic kidney perfusion has consistently reduced delayed graft function, even in the highest-risk donors [&lt;span&gt;7, 8&lt;/span&gt;]. For thoracic organs, perfusion has extended safe transport times, facilitated distant procurement, and enabled the recovery of organs that previously would not have been utilized [&lt;span&gt;9-11&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Organs once deemed unsuitable for","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 8","pages":"1098-1100"},"PeriodicalIF":2.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.70179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short Inter-Treatment Interval Treatment With Artificial Liver Support System Reduces 90-Day Transplant-Free Mortality in Patients With Hepatitis B Virus–Related Acute-On-Chronic Liver Failure: A Retrospective Observational Study","authors":"Jingjie Fu,&nbsp;Fang Chen,&nbsp;Wenfeng Yang,&nbsp;Ting Chen,&nbsp;Jian Xu","doi":"10.1111/aor.70186","DOIUrl":"10.1111/aor.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This retrospective observational study aimed to compare the effects of short inter-treatment interval treatment (SIIT) versus long inter-treatment interval treatment (LIIT) using the artificial liver support system (ALSS) on liver function recovery and 90-day transplant-free mortality in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 149 HBV-ACLF patients selected from 166 patients who received comprehensive internal medicine therapy combined with ALSS. Patients were categorized into the SIIT group and the LIIT group. Laboratory test data were recorded both before ALSS treatment and the seventh day after the last ALSS treatment. The 90-day transplant-free mortality was compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Biochemical indicators reflecting patient's liver function including alanine aminotransferase, aspartate aminotransferase, serum total bilirubin (TBIL), direct bilirubin (DBIL), total bile acid, and coagulation function (prothrombin time activity, PTA) were significantly improved at posttreatment than pretreatment in both groups (<i>p</i> &lt; 0.05). At Day 7 after the last ALSS treatment, TBIL and DBIL levels were significantly lower in the SIIT group than in the LIIT group (<i>p</i> &lt; 0.01). The 90-day transplant-free mortality in the SIIT group and LIIT group was 12.8% and 29.6%, respectively (<i>p</i> &lt; 0.001). Higher baseline MELD score was associated with increased 90-day transplant-free mortality (OR = 1.815, 95% CI: 1.466–2.247, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with HBV-ACLF, SIIT with ALSS was associated with reduced 90-day transplant-free mortality compared with LIIT, although prospective studies are required to confirm causality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 8","pages":"1145-1152"},"PeriodicalIF":2.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.70186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upcoming Meetings","authors":"","doi":"10.1111/aor.70193","DOIUrl":"https://doi.org/10.1111/aor.70193","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 8","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148695768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Intraoperative Doppler Flow Measurements and Algorithmic Flow Estimations in Patients Undergoing Durable Left Ventricular Assist Device Implantation","authors":"Gaik Nersesian,&nbsp;Anna Stegmann,&nbsp;Daniel Lewin,&nbsp;Yuriy Hrytsyna,&nbsp;Leonard Pitts,&nbsp;Julius Kaemmel,&nbsp;Marian Kukucka,&nbsp;Alexander Mladenow,&nbsp;Lisa Garczarek,&nbsp;Julia Stein,&nbsp;Friedrich Kaufmann,&nbsp;Volkmar Falk,&nbsp;Evgenij Potapov,&nbsp;Pia Lanmueller","doi":"10.1111/aor.70150","DOIUrl":"10.1111/aor.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Left ventricular assist devices (LVAD) have become an established therapy for end-stage heart failure over the last three decades. In currently available devices, the blood flow is estimated using a power consumption algorithm. In this study, intraoperative direct LVAD flow measurement with an ultrasonic flow probe was analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>As part of our routine evaluation of optimal LVAD flow, intraoperative direct flow measurement at the outflow graft was performed using a 14-mm ultrasonic flow probe. Direct LVAD flow measurements were performed at different speed levels: 4400 rpm, 4800 rpm, 5200 rpm, and the optimal flow setting before chest closure. In twenty consecutive patients who underwent a durable LVAD implantation via median sternotomy in our institution between January and April 2025, direct flow measurement was compared with the estimated flow provided by the device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median age was 63 [60;68] years, 17 (85%) were male, 8 (40%) had a history of acute myocardial infarction. Temporary mechanical circulatory support with a microaxial flow pump was necessary in 8 (40%) patients prior to durable LVAD implantation. Destination therapy was indicated in 12 (60%) cases. Mean flows at 4400 rpm were 2.9 ± 0.3 and 3.4 ± 0.4 L/min calculated by the pump and measured by the probe, respectively. Mean difference between the measurements was 0.56 L/min (95% CI [0.40, 0.70], <i>p</i> &lt; 0.001). Mean flows at 4800 rpm were 3.5 ± 0.3 and 4.1 ± 0.5 L/min, respectively. Mean difference between the measurements was 0.55 L/min (95% CI [0.33, 0.77], <i>p</i> &lt; 0.001). Mean flows at 5200 rpm were 4.2 ± 0.3 and 4.7 ± 0.5 L/min, respectively. Mean difference between the measurements was 0.53 L/min (95% CI [0.40, 0.70], <i>p</i> = 0.001). Mean optimal speed for patients was 5400 rpm, mean difference between the measurements was 0.49 L/min (95% CI [0.23, 0.74], <i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LVAD flow measured with an ultrasonic flow probe shows significantly higher results (approximately +0.5 L/min) compared to the flow estimated by the device. The difference remains constant at different LVAD speed modes. Intraoperative flow measurement employing an ultrasonic flow probe is a valuable tool for hemodynamic evaluation during implantation of a durable LVAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 8","pages":"1164-1169"},"PeriodicalIF":2.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}