ASAIO Journal最新文献

Left Ventricular Assist Device Implantation in Dextrocardia: Lessons From a Complex Redo Case. 右心左室辅助装置植入：一个复杂的重做病例的经验教训。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-19 DOI: 10.1097/MAT.0000000000002875

Jun Fu, Zhixiang Gu, Jinpeng Li, Dongsi Shuang, Bao Sun, Yiliyasi Yimingjiang, Lin Chen

{"title":"Left Ventricular Assist Device Implantation in Dextrocardia: Lessons From a Complex Redo Case.","authors":"Jun Fu, Zhixiang Gu, Jinpeng Li, Dongsi Shuang, Bao Sun, Yiliyasi Yimingjiang, Lin Chen","doi":"10.1097/MAT.0000000000002875","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002875","url":null,"abstract":"Dextrocardia with situs solitus poses significant surgical challenges for left ventricular assist device (LVAD) implantation, particularly in patients with prior sternotomy and complex valvular disease. We report on a 60 year old man with dextrocardia, advanced heart failure, prior mechanical mitral valve replacement, and bicuspid aortic valve disease who underwent successful Corheart 6 LVAD implantation during redo sternotomy with concomitant bioprosthetic aortic and mitral valve replacement. Intraoperative findings included extensive pannus/thrombus on the mechanical mitral prosthesis (causing relative stenosis) and an unsuspected 10 g left atrial thrombus, both of which were removed. Total cardiopulmonary bypass time was 330 minutes, and aortic cross‑clamp time was 233 minutes. Postoperative acute kidney injury requiring dialysis resolved, and the patient was discharged after 137 days. At 1 year follow-up, the left ventricular end-diastolic diameter decreased from 69 to 66 mm, left ventricular ejection fraction (LVEF) remained stable (28-25%), New York Heart Association (NYHA) class improved from IIIb‑IV to II, and estimated glomerular filtration rate (eGFR) recovered from 32 ml/min at 9 months to 51 ml/min at 1 year.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223268","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

When Human Tissue Meets the Driveline: Implications of Tissue Integration to Combat Driveline Infections. 当人体组织与传动系统相遇：组织整合对抗传动系统感染的意义。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-19 DOI: 10.1097/MAT.0000000000002878

Wei Qiu, David McGiffin, David M Kaye, Anton Y Peleg, Yue Qu

{"title":"When Human Tissue Meets the Driveline: Implications of Tissue Integration to Combat Driveline Infections.","authors":"Wei Qiu, David McGiffin, David M Kaye, Anton Y Peleg, Yue Qu","doi":"10.1097/MAT.0000000000002878","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002878","url":null,"abstract":"Driveline infection remains a common complication of ventricular assist device (VAD) therapy. These infections often progress from the exit site through the subcutaneous tract to the deeper tunnel and, in severe cases, the pocket, underscoring the vulnerability of the driveline-tissue interface. In this review, we examine the biological and mechanical factors governing tissue-driveline interactions and their implications for tissue integration of the implanted driveline. Dysregulated inflammation, impaired vascular maturation, abnormal extracellular matrix remodeling, repetitive micromotion and traction, and biomaterial-tissue mismatch may all compromise optimal tissue ingrowth of the driveline. Insufficient tissue integration can lead to the formation of microgaps within the driveline tunnel, providing a potential niche for microbial colonization and biofilm formation, thereby contributing to persistent driveline infections. Recognizing the potential association between inadequate tissue integration and the occurrence of driveline infection shifts the focus from microbial eradication alone toward optimizing driveline-tissue interactions across different segments of the driveline. Such an approach may help reduce the incidence of driveline infections in patients requiring long-term VAD support. Finally, strategies to promote tissue integration and long-term driveline stability, including driveline surface engineering, modulation of physicochemical properties, and optimization of surgical techniques, are discussed.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223272","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

Obesity and Mortality in V-V ECMO: Patient Heterogeneity Explains the Conflicting Findings. V-V ECMO的肥胖和死亡率：患者异质性解释了相互矛盾的发现。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-16 DOI: 10.1097/MAT.0000000000002891

Wincy Ng, Ka-Chun Leung, Rex Wan-Hin Hui, Pauline Yeung Ng, Chun-Wai Ngai, Simon Wai-Ching Sin

引用次数: 0

Response to the Letter to the Editor: Obesity and Mortality in V-V ECMO: Patient Heterogeneity Explains the Conflicting Findings. 致编辑的回复：V-V ECMO中的肥胖和死亡率：患者异质性解释了相互矛盾的发现。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-16 DOI: 10.1097/MAT.0000000000002890

Juan G Ripoll

引用次数: 0

Immobilized Neuroglobin Scavenges Carbon Monoxide From Circulating Carboxyhemoglobin. 固定的神经球蛋白清除循环中的碳氧血红蛋白中的一氧化碳。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-15 DOI: 10.1097/MAT.0000000000002882

Madison Butler, XueYin N Huang, Ryan A Orizondo, Jason J Rose, Mark T Gladwin, Nahmah Kim-Campbell, William J Federspiel, Jesús Tejero

{"title":"Immobilized Neuroglobin Scavenges Carbon Monoxide From Circulating Carboxyhemoglobin.","authors":"Madison Butler, XueYin N Huang, Ryan A Orizondo, Jason J Rose, Mark T Gladwin, Nahmah Kim-Campbell, William J Federspiel, Jesús Tejero","doi":"10.1097/MAT.0000000000002882","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002882","url":null,"abstract":"Carbon monoxide (CO) poisoning is responsible for around 50,000 emergency department visits per year in the United States alone. Currently, there is no available antidote for CO poisoning. We have previously developed an antidotal therapy based on an engineered hemeprotein, human neuroglobin (Ngb-H64Q-CCC). Intravenous infusion of Ngb-H64Q-CCC removes CO from circulating red blood cells and improves survival in a lethal CO poisoning mouse model. However, the infusion of heme-containing proteins has inherent heme toxicity risks that may limit the dose that can be used safely without liver or kidney toxicity. To overcome these problems, we have investigated the development of immobilized Ngb in a solid matrix. This approach allows for the development of a CO removal system using an extracorporeal blood-circulating system coupled with a stationary matrix with immobilized Ngb-H64Q-CCC. Such a system avoids drug infusion and possible organ injury, allows for antidote recycling, and provides advantages for storage and handling of the antidote. Here we have developed Ngb-H64Q-CCC covalently bound to N-hydroxysuccinimide agarose. The immobilized protein shows preserved heme redox activity and retains its CO removal capacity after successive regeneration cycles. We expect that this novel approach will advance the development of new scavenger-based therapies for CO poisoning.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191215","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

Microcirculatory Hemodynamic Changes on Full Support Microaxial Flow Pump in Cardiogenic Shock. 全支撑型微轴流泵在心源性休克中的微循环血流动力学变化。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-15 DOI: 10.1097/MAT.0000000000002879

James W Schurr, Jacob Niculcea, Tayyab Shah, Aditya Parikh, Mauer Biscotti, Marisa Cevasco, Alyson Brown, John C Greenwood, Joyce W Wald

{"title":"Microcirculatory Hemodynamic Changes on Full Support Microaxial Flow Pump in Cardiogenic Shock.","authors":"James W Schurr, Jacob Niculcea, Tayyab Shah, Aditya Parikh, Mauer Biscotti, Marisa Cevasco, Alyson Brown, John C Greenwood, Joyce W Wald","doi":"10.1097/MAT.0000000000002879","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002879","url":null,"abstract":"Impaired microcirculation predicts mortality in cardiogenic shock independent of systemic hemodynamics, yet current treatment strategies focus primarily on restoring macrocirculatory markers. We studied whether full-support microaxial flow pump (mAFP) therapy improves sublingual microcirculation in cardiogenic shock. A prospective, single-arm, observational study of serial sublingual microcirculation imaging via incident darkfield handheld videomicroscopy was performed in 18 cardiogenic shock patients undergoing Impella 5.5 (mAFP) placement. Microvascular flow index (MFI), microvascular heterogeneity index (MHI), proportion of perfused vessels (PPV), and perfused vessel density (PVD) were measured. Eighteen patients were enrolled. Microvascular flow index (p = 0.004), MHI (p = 0.055), PPV (p = 0.003), and PVD (p = 0.067) improved immediately on support, including when adjusted for vasoactive-inotropic score. Improvement in MFI, MHI, PPV, or PVD was most pronounced in those with impaired baseline microcirculatory hemodynamics (all p < 0.05), whereas those with preserved baseline values demonstrated no change. Improved agreement between systemic and microcirculatory hemodynamics was observed in association with mAFP support, and none experienced worsening microcirculatory function. These exploratory findings suggest full-support mAFPs may improve impaired microcirculation during cardiogenic shock, although device-specific effects cannot be isolated from overall clinical improvement; validation in larger studies is warranted. Although agreement between systemic and microcirculatory hemodynamic markers improved, no macrohemodynamic marker proved sufficient to ensure adequate microcirculatory perfusion.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191228","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

Aspirin Omission in CH-VAD Support: The Importance of Exposure Timing and Anticoagulation Assessment. CH-VAD支持中阿司匹林遗漏：暴露时间和抗凝评估的重要性。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-14 DOI: 10.1097/MAT.0000000000002885

Teruhiko Imamura

引用次数: 0

Response to: "Aspirin Omission in CH-VAD Support: The Importance of Exposure Timing and Anticoagulation Assessment". 对“CH-VAD支持中阿司匹林遗漏：暴露时间和抗凝评估的重要性”的回应。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-14 DOI: 10.1097/MAT.0000000000002884

Zelin Yin, Xianqiang Wang

引用次数: 0

Computed Tomography-Derived Psoas Muscle Quantity, Attenuation, and 1 Year Mortality in Venovenous Extracorporeal Membrane Oxygenation. 经计算机断层扫描得出的腰大肌数量、衰减和静脉-静脉体外膜氧合1年死亡率。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-14 DOI: 10.1097/MAT.0000000000002883

Jin Ho Jang, Eunjeong Choi, Woo Hyun Cho, Doosoo Jeon, Yun Seong Kim, Hye Ju Yeo

{"title":"Computed Tomography-Derived Psoas Muscle Quantity, Attenuation, and 1 Year Mortality in Venovenous Extracorporeal Membrane Oxygenation.","authors":"Jin Ho Jang, Eunjeong Choi, Woo Hyun Cho, Doosoo Jeon, Yun Seong Kim, Hye Ju Yeo","doi":"10.1097/MAT.0000000000002883","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002883","url":null,"abstract":"Computed tomography (CT)-derived skeletal muscle characteristics may provide prognostic information in patients receiving venovenous extracorporeal membrane oxygenation (VV ECMO), but the relative contributions of muscle quantity and attenuation remain uncertain. We retrospectively studied adults who received VV ECMO for severe respiratory failure between 2014 and 2023 and underwent abdominal CT within 48 h before ECMO initiation. Psoas muscle index (PMI) and attenuation were measured using an artificial intelligence-based pipeline, and combined PMI-attenuation phenotypes were evaluated for 1 year mortality. Among 92 patients, 53 (57.6%) died within 1 year. In Cox proportional hazards models adjusted for age, sex, and initial Sequential Organ Failure Assessment score and stratified by bridge-to-transplantation status, higher PMI (adjusted hazard ratio [aHR] per standard deviation increase, 0.58; 95% confidence interval [CI], 0.41-0.82) and higher attenuation (aHR per 5 Hounsfield unit increase, 0.87; 95% CI, 0.77-0.97) were associated with lower 1 year mortality. When modeled simultaneously, PMI remained significant, whereas attenuation did not. The low PMI/low attenuation phenotype had the highest mortality risk (aHR, 5.30; 95% CI, 2.10-13.34). PMI showed a more robust association with 1 year mortality, while combined PMI-attenuation phenotyping may identify a particularly high-risk subgroup.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179376","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

Forty-Eight Hour Lactate Normalization Predicts Favorable Neurologic Recovery and Survival in Venoarterial ECMO for Cardiogenic Shock. 48小时乳酸正常化预示着心源性休克的静脉ECMO有利的神经恢复和生存。

IF 2.2 3区医学

ASAIO Journal Pub Date : 2026-10-13 DOI: 10.1097/MAT.0000000000002869

Gyu Tae Park, Ik Hyun Park, Jeong Hoon Yang, Hyeon-Cheol Gwon, Min Chul Kim, Min-Seok Kim, Woo Jin Jang

{"title":"Forty-Eight Hour Lactate Normalization Predicts Favorable Neurologic Recovery and Survival in Venoarterial ECMO for Cardiogenic Shock.","authors":"Gyu Tae Park, Ik Hyun Park, Jeong Hoon Yang, Hyeon-Cheol Gwon, Min Chul Kim, Min-Seok Kim, Woo Jin Jang","doi":"10.1097/MAT.0000000000002869","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002869","url":null,"abstract":"Extracorporeal membrane oxygenation (ECMO) for cardiogenic shock (CS) is associated with high mortality and poor neurological outcomes. Dynamic assessment of metabolic recovery, reflected by lactate normalization, may offer additional prognostic value compared with static severity indices. We retrospectively analyzed 662 consecutive patients from the multicenter RESCUE II registry who remained on venoarterial ECMO for at least 48 hours. Patients were stratified by 48 hour lactate level: 48 hour lactate normalization group (< 2.0 mmol/L, n = 371) and persistent lactate elevation group (≥ 2.0 mmol/L, n = 291). The primary outcome was favorable neurologic discharge (FND), defined as discharge with a Cerebral Performance Category score of 1 or 2. The persistent lactate elevation group had a higher SOFA score (9.8 ± 3.2 vs. 8.5 ± 3.4, p < 0.001) and initial serum lactate (7.9 ± 4.8 mmol/L vs. 6.0 ± 4.3 mmol/L, p < 0.001). Lactate normalization was associated with a higher rate of FND (71.4% vs. 41.9%, p < 0.001), remained an independent predictor of FND (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.21-4.41, p < 0.001), and was associated with lower risks of all-cause death (hazard ratio [HR]: 0.49, 95% CI: 0.38-0.64, p < 0.001) at 12 months. In conclusion, lactate normalization within 48 hours of ECMO initiation is associated with favorable neurologic status and 12 month survival.","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164492","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