ASAIO Journal最新文献

New Right Ventricular Dysfunction in Pediatric Acute Respiratory Distress Syndrome on Venovenous Extracorporeal Membrane Oxygenation. 静脉体外膜氧合治疗小儿急性呼吸窘迫综合征的新右心室功能障碍。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-06-19 DOI: 10.1097/MAT.0000000000002257

Caroline Holton, Sanket Shah, Jenna O Miller

{"title":"New Right Ventricular Dysfunction in Pediatric Acute Respiratory Distress Syndrome on Venovenous Extracorporeal Membrane Oxygenation.","authors":"Caroline Holton, Sanket Shah, Jenna O Miller","doi":"10.1097/MAT.0000000000002257","DOIUrl":"10.1097/MAT.0000000000002257","url":null,"abstract":"The development of new right ventricular (RV) dysfunction after cannulation to venovenous (VV) extracorporeal membrane oxygenation (ECMO) and its association with worse outcomes is increasingly recognized in adult patients, however, no studies have evaluated this phenomenon in pediatric patients. We report results of a single-center retrospective cohort study at a large academic children's hospital. New RV systolic dysfunction was present in 48% (12/25) of pediatric patients on VV ECMO for acute respiratory distress syndrome (ARDS). There was no statistically significant difference in survival, duration of mechanical ventilation, or hospital length of stay between those with and without RV dysfunction. Over half (5/9, 56%) of survivors with RV dysfunction on ECMO had RV dilation or RV hypertrophy on post-ECMO echocardiograms, and in two patients the RV dysfunction persisted for months following decannulation. Cardiac catheterization and autopsy reports suggested that echocardiographic assessment of RV systolic function alone may not be sufficient to diagnose clinically relevant RV injury. This is the first study to report the prevalence of RV dysfunction on VV ECMO for pediatric ARDS. Future multicenter collaboration is needed to create a clinically relevant definition of pediatric \"RV injury\" and to further evaluate risk factors and outcomes of RV dysfunction.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426246","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}

引用次数: 0

Three-Dimensional Bio-Printed Tubular Tissue Using Dermal Fibroblast Cells as a New Tissue-Engineered Vascular Graft for Venous Replacement. 利用真皮成纤维细胞的三维生物打印管状组织作为用于静脉置换的新型组织工程血管移植物

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-03 DOI: 10.1097/MAT.0000000000002224

Makoto Hayasaka, Takashi Kokudo, Junichi Kaneko, Takehiro Chiyoda, Anna Nakamura, Manabu Itoh, Kazuhiro Endo, Koichi Nakayama, Kiyoshi Hasegawa

{"title":"Three-Dimensional Bio-Printed Tubular Tissue Using Dermal Fibroblast Cells as a New Tissue-Engineered Vascular Graft for Venous Replacement.","authors":"Makoto Hayasaka, Takashi Kokudo, Junichi Kaneko, Takehiro Chiyoda, Anna Nakamura, Manabu Itoh, Kazuhiro Endo, Koichi Nakayama, Kiyoshi Hasegawa","doi":"10.1097/MAT.0000000000002224","DOIUrl":"10.1097/MAT.0000000000002224","url":null,"abstract":"The current study was a preliminary evaluation of the feasibility and biologic features of three-dimensionally bio-printed tissue-engineered (3D bio-printed) vascular grafts comprising dermal fibroblast spheroids for venous replacement in rats and swine. The scaffold-free tubular tissue was made by the 3D bio-printer with normal human dermal fibroblasts. The tubular tissues were implanted into the infrarenal inferior vena cava of 4 male F344-rnu/rnu athymic nude rats and the short-term patency and histologic features were analyzed. A larger 3D bio-printed swine dermal fibroblast-derived prototype of tubular tissue was implanted into the right jugular vein of a swine and patency was evaluated at 4 weeks. The short-term patency rate was 100%. Immunohistochemistry analysis showed von Willebrand factor positivity on day 2, with more limited positivity observed on the luminal surface on day 5. Although the cross-sectional area of the wall differed significantly between preimplantation and days 2 and 5, suggesting swelling of the tubular tissue wall (both p < 0.01), the luminal diameter of the tubular tissues was not significantly altered during this period. The 3D bio-printed scaffold-free tubular tissues using human dermal or swine fibroblast spheroids may produce better tissue-engineered vascular grafts for venous replacement in rats or swine.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854234","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}

引用次数: 0

Volume Displacement Pulsatile Veno-Arterial Extracorporeal Membrane Oxygenation: Preliminary Data From In Vitro Tests. 体积置换脉动性静脉-动脉体外膜氧合：体外试验的初步数据。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-03-29 DOI: 10.1097/MAT.0000000000002207

Silver Heinsar, Clayton Semenzin, Samia M Farah, John F Fraser

引用次数: 0

Meet the Authors. 与作者见面

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-10-25 DOI: 10.1097/01.mat.0001081416.36880.1e

引用次数: 0

Omission of Antiplatelet Therapy in Patients With HeartMate 3 Left Ventricular Assist Devices: A Systematic Review and Meta-Analysis. 使用 HeartMate 3 左心室辅助装置的患者放弃抗血小板治疗：系统综述与元分析》。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-10 DOI: 10.1097/MAT.0000000000002225

Maximilian Tscharre, David Mutschlechner, Thomas Schlöglhofer, Dominik Wiedemann, Daniel Zimpfer, Thomas Gremmel

{"title":"Omission of Antiplatelet Therapy in Patients With HeartMate 3 Left Ventricular Assist Devices: A Systematic Review and Meta-Analysis.","authors":"Maximilian Tscharre, David Mutschlechner, Thomas Schlöglhofer, Dominik Wiedemann, Daniel Zimpfer, Thomas Gremmel","doi":"10.1097/MAT.0000000000002225","DOIUrl":"10.1097/MAT.0000000000002225","url":null,"abstract":"The HeartMate 3 (HM3) left ventricular assist device has decreased thromboembolic events and minimized the risk of pump thrombosis. However, bleeding complications due to combined antithrombotic therapy with a vitamin K antagonist (VKA) and aspirin remain high. Only limited data on the safety of VKA monotherapy in HM3 patients are available. A systematic search on the main databases was performed. Observational data and randomized trials were eligible for this analysis. As primary endpoint, we analyzed hemocompatibility-related adverse events (HRAE). As secondary endpoints, we investigated the individual components of the primary endpoint. The analysis was carried out using the odds ratio (OR) as outcome measure. A random-effects model was fitted to the data. Five manuscripts fulfilled the inclusion criteria. These trials included 785 patients (381 on VKA monotherapy, 404 on VKA and aspirin). VKA monotherapy significantly reduced HRAE (OR: 0.11 [95% confidence interval {CI}: 0.02-0.59], p = 0.01, I2 = 87%). The reduction was driven by a decrease in bleeding complications (OR: 0.12 [95% CI: 0.02-0.62], p = 0.01, I2 = 86%) without increasing the rates of thromboembolic events (OR: 0.69 [95% CI: 0.26-1.81], p = 0.45, I = 0%). Vitamin K antagonist monotherapy is associated with a significant reduction of bleeding events without increasing the risk of thromboembolic complications in HM3 patients.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903534","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}

引用次数: 0

ECMO Alone Versus ECPELLA in Patients Affected by Cardiogenic Shock: The Multicenter EVACS Study. 心源性休克患者单用 ECMO 与 ECPELLA 的对比：多中心 EVACS 研究。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-03 DOI: 10.1097/MAT.0000000000002219

Antonio Piperata, Jef Van den Eynde, Charles-Henri David, Ahmet Ruchan Akar, Masazumi Watanabe, Ilias Doulamis, Pierre-Guillaume Piriou, Mehmet Cahit Saricaoğlu, Hiroki Ikenaga, Thomas Gouttenegre, Mickael Vourc'h, Shinya Takahashi, Alexandre Ouattara, Louis Labrousse, Giacomo Frati, Mathieu Pernot

{"title":"ECMO Alone Versus ECPELLA in Patients Affected by Cardiogenic Shock: The Multicenter EVACS Study.","authors":"Antonio Piperata, Jef Van den Eynde, Charles-Henri David, Ahmet Ruchan Akar, Masazumi Watanabe, Ilias Doulamis, Pierre-Guillaume Piriou, Mehmet Cahit Saricaoğlu, Hiroki Ikenaga, Thomas Gouttenegre, Mickael Vourc'h, Shinya Takahashi, Alexandre Ouattara, Louis Labrousse, Giacomo Frati, Mathieu Pernot","doi":"10.1097/MAT.0000000000002219","DOIUrl":"10.1097/MAT.0000000000002219","url":null,"abstract":"The objective was to investigate the outcomes of concomitant venoarterial extracorporeal membrane oxygenation (ECMO) and left ventricular unloading with Impella (ECPELLA) compared with ECMO alone to treat patients affected by cardiogenic shock. Data from patients needing mechanical circulatory support from 4 international centers were analyzed. Of 438 patients included, ECMO alone and ECPELLA were adopted in 319 (72.8%) and 119 (27.2%) patients, respectively. Propensity score matching analysis identified 95 pairs. In the matched cohort, 30-day mortality rates in the ECMO and ECPELLA were 49.5% and 43.2% ( P = 0.467). The incidences of complications did not differ significantly between groups ( P = 0.877, P = 0.629, P = 1.000, respectively). After a median follow-up of 0.18 years (interquartile range 0.02-2.55), the use of ECPELLA was associated with similar mortality compared with ECMO alone (hazard ratio 0.81, 95% confidence interval 0.54-1.20, P = 0.285), with 1-year overall survival rates of 51.3% and 46.6%, for ECPELLA and ECMO alone, respectively. ECMO alone and ECPELLA are both effective strategies in patients needing mechanical circulatory support for cardiogenic shock, showing similar rates of early and mid-term survival.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847704","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}

引用次数: 0

Changes in Donor Utilization and Outcomes for Patients Bridged With Durable Left Ventricular Assist Device. 使用耐用左心室辅助装置进行桥接的患者使用捐赠者和治疗效果的变化。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-10 DOI: 10.1097/MAT.0000000000002228

Armaan F Akbar, Dianela Perdomo, Benjamin L Shou, Alice L Zhou, Jessica M Ruck, Ahmet Kilic

{"title":"Changes in Donor Utilization and Outcomes for Patients Bridged With Durable Left Ventricular Assist Device.","authors":"Armaan F Akbar, Dianela Perdomo, Benjamin L Shou, Alice L Zhou, Jessica M Ruck, Ahmet Kilic","doi":"10.1097/MAT.0000000000002228","DOIUrl":"10.1097/MAT.0000000000002228","url":null,"abstract":"We studied the impact of the 2018 heart allocation policy change on donor characteristics and posttransplant outcomes of left ventricular assist device (LVAD)-bridged heart transplant (HT) recipients. Left ventricular assist device-bridged adult HT recipients from October 2014 to October 2022 in the United Network for Organ Sharing database were categorized into old allocation policy (OAP) and new allocation policy (NAP) cohorts. Baseline characteristics, posttransplant outcomes, and subgroup analyses of unstable and stable LVAD-bridged recipients were assessed. The study included 7,384 HT recipients; 4,345 (58.8%) were transplanted in the OAP era and 3,039 (41.2%) in the NAP era. Old allocation policy recipients were most frequently status 1A at transplantation (71.1%), whereas NAP recipients were most frequently status 3 (40.0%), and status 4 (31.9%). Median donor sequence number (DSN) was higher in the NAP versus OAP era (9 vs. 3, p < 0.001). On multivariable analysis, NAP recipients had 20% higher 1 year mortality compared to OAP (adjusted hazard ratio [aHR] = 1.20 [95% confidence interval {CI}: 1.04-1.40], p = 0.01). Status 1 or 2 recipients had 28% higher 1 year mortality compared to status 1A (aHR = 1.28 [95% CI: 1.01-1.63], p = 0.04). Status 1 and 2 LVAD-supported recipients had higher mortality following the 2018 allocation change, indicating the need for closer surveillance of LVAD-bridged patients who may decompensate on the waitlist.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903443","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}

引用次数: 0

Extracorporeal Membrane Oxygenation-Supported Patient Outcome Undergoing Transcatheter Aortic Valve Replacement. 接受经导管主动脉瓣置换术的体外膜氧合患者的预后。

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-08-30 DOI: 10.1097/MAT.0000000000002305

Akshat Banga, Vikas Bansal, Harsha Pattnaik, Tanya Amal, Anjali Agarwal, Pramod K Guru

{"title":"Extracorporeal Membrane Oxygenation-Supported Patient Outcome Undergoing Transcatheter Aortic Valve Replacement.","authors":"Akshat Banga, Vikas Bansal, Harsha Pattnaik, Tanya Amal, Anjali Agarwal, Pramod K Guru","doi":"10.1097/MAT.0000000000002305","DOIUrl":"10.1097/MAT.0000000000002305","url":null,"abstract":"The efficacy and safety of extracorporeal membrane oxygenation (ECMO) support during transcatheter aortic valve replacement (TAVR) remains unknown. We conducted a meta-analysis to compare benefit and risk of ECMO in TAVR patients. Bibliographic databases were searched from inception to January 1, 2024. Included studies involved patients ≥18 years old undergoing TAVR and using ECMO emergently or prophylactically. Mortality and procedure success were primary outcomes. Peri- or postoperative complications were the secondary outcomes. We identified 11 observational studies, including 2,275 participants (415 ECMO and 1,860 non-ECMO). The unadjusted mortality risk in ECMO-supported patient was higher than non-ECMO patients (odds ratio [OR] 1.73). The mortality unadjusted risk remained high (OR 3.89) and statistically significant for prophylactic ECMO. Prophylactic ECMO had lower mortality risk compared with emergent ECMO (OR 0.17). Extracorporeal membrane oxygenation-supported patients had lower procedural success rate (OR 0.10). Extracorporeal membrane oxygenation patients undergoing TAVR had significantly increased risk of bleeding (OR 3.32), renal failure (OR 2.38), postoperative myocardial infarction (OR 1.89), and stroke (OR 2.32) compared with non-ECMO patients. Clinical results are not improved by ECMO support in patients with high-risk TAVR. Prophylactic ECMO outperforms emergent. Overall, ECMO support increases mortality and postoperative complications. Transcatheter aortic valve replacement outcomes may improve with prophylactic ECMO in high-risk situations.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103971","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}

引用次数: 0

Hemocompatibility Evaluation of a Novel Ambulatory Pulmonary Assist System Using a Lightweight Axial-Flow Pump. 使用轻型轴流泵的新型非卧床肺辅助系统的血液兼容性评估

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-10 DOI: 10.1097/MAT.0000000000002227

Yeahwa Hong, Suji Shin, Umar Nasim, Kalliope G Roberts, Alexander S Potchernikov, Kimberly Y Liu, Keith A Dufendach, David J Skoog, Matthew Bacchetta, Keith E Cook

{"title":"Hemocompatibility Evaluation of a Novel Ambulatory Pulmonary Assist System Using a Lightweight Axial-Flow Pump.","authors":"Yeahwa Hong, Suji Shin, Umar Nasim, Kalliope G Roberts, Alexander S Potchernikov, Kimberly Y Liu, Keith A Dufendach, David J Skoog, Matthew Bacchetta, Keith E Cook","doi":"10.1097/MAT.0000000000002227","DOIUrl":"10.1097/MAT.0000000000002227","url":null,"abstract":"The Pulmonary Assist System (PAS) is currently under development as a wearable respiratory assist system. In this study, the hemocompatibility of the PAS's axial-flow mechanical pump (AFP) was compared to other contemporary mechanical pumps in an acute ovine model. The PAS was attached to a normal sheep in a venovenous configuration using one of three pumps: 1) AFP, 2) ReliantHeart HeartAssist 5 (control), or 3) Abbott Pedimag (control) (n = 5 each). Each sheep was supported on the PAS for 12 hours with two L/minute of blood flow and four L/minute of sweep gas. Hemolysis, coagulation, inflammation, and platelet activation and loss were compared among the groups. In this study, the plasma-free hemoglobin (pfHb) was less than 10 mg/dl in all groups. The pfHb was significantly lower in the AFP group compared to other groups. There was no significant clot formation in the pumps and oxygenators in all groups. Furthermore, no significant differences in coagulation (oxygenator resistance, fibrinopeptide A), inflammation (white blood cell counts, IL-8), and platelet activation and loss (p-selectin, platelet counts) were observed among the groups (all, p > 0.05). This study demonstrates equivalent hemocompatibility of the PAS's AFP to other contemporary mechanical pumps with a reduced level of hemolysis on startup.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903568","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}

引用次数: 0

ECPELLA in Advanced Cardiogenic Shock: Venting for Anyone? ECPELLA 在晚期心源性休克中的应用：为谁通气？

IF 3.1 3区医学

ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-10-25 DOI: 10.1097/MAT.0000000000002332

Peter S Natov, Muhammad Saad, Navin K Kapur

引用次数: 0