ASAIO JournalPub Date : 2025-01-27DOI: 10.1097/MAT.0000000000002353
Nicola Pradegan, Claudia Cattapan, Chiara Tessari, Giuseppe Toscano, Augusto D'Onofrio, Vincenzo Tarzia, Antonio Gambino, Marny Fedrigo, Vladimiro L Vida, Annalisa Angelini, Gino Gerosa
{"title":"Anatomical Aspects and Long-Term Outcomes of Additional Surgical Repair During Heart Transplantation in Adult Congenital Heart Disease.","authors":"Nicola Pradegan, Claudia Cattapan, Chiara Tessari, Giuseppe Toscano, Augusto D'Onofrio, Vincenzo Tarzia, Antonio Gambino, Marny Fedrigo, Vladimiro L Vida, Annalisa Angelini, Gino Gerosa","doi":"10.1097/MAT.0000000000002353","DOIUrl":"10.1097/MAT.0000000000002353","url":null,"abstract":"<p><p>Adult patients with congenital heart disease (ACHD) requiring heart transplantation (HT) usually show complex anatomies, posing surgical challenges. Consequently, we analyzed technical aspects and early and long-term outcomes of additional surgical repairs during HT in ACHD. Forty patients were identified (23 males, median age: 38 years, interquartile range [IQR]: 26-50). Of these, 17 (42.5%) required additional surgical repair (7 systemic veins repair, 13 pulmonary arteries repair). These procedures were more associated with univentricular physiology ( p < 0.001) and prior Fontan palliation ( p < 0.001). Eight (20.0%) experienced 30 day mortality. At a median follow-up of 5.6 (IQR: 2.0-11.9) years, 5 (12.5%) patients died. Additional surgical repair did not affect postoperative 30 day and long-term follow-up mortality ( p = 0.451 and p = 0.330, respectively).</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943690","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}
ASAIO JournalPub Date : 2025-01-22DOI: 10.1097/MAT.0000000000002378
Benjamin Wang, Jimmy Zheng, Madeline D Silva, Zhuo Shi, Jared Fong, Calvin Diep, William Hiesinger, Karim Sallam
{"title":"Alteplase Purge Solution for Impella 5.5 Ventricular Assist Device Purge System Occlusion: Case Report and Review of the Literature.","authors":"Benjamin Wang, Jimmy Zheng, Madeline D Silva, Zhuo Shi, Jared Fong, Calvin Diep, William Hiesinger, Karim Sallam","doi":"10.1097/MAT.0000000000002378","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002378","url":null,"abstract":"<p><p>The use of an alteplase (Activase) purge solution to address Impella ventricular assist device \"thrombosis\" or \"purge system occlusion\" has been mainly documented with earlier generation Impella devices (CP, 2.5, 5.0). Here, we report the use of an alteplase purge solution to manage Impella 5.5 purge system occlusion in a 31-year-old male admitted to the cardiac care unit in cardiogenic shock and listed for a heart transplant. Throughout the purge system occlusion, the patient demonstrated hemodynamic stability and overall pump flow and cardiac output were preserved. Initially, there was a lack of response in purge flow and pressure observed at the lower concentration of alteplase purge solution (0.04 mg/ml), yet after using the alteplase 4 mg/50 ml purge (0.08 mg/ml) solution concentration, a response was seen. No bleeding or hemodynamic complications were observed. In addition, a suggested management workflow and review of the case reports and case series published to date regarding Impella purge system occlusion is included in this article.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031917","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}
ASAIO JournalPub Date : 2025-01-16DOI: 10.1097/MAT.0000000000002381
Kaspar F Bachmann, David Berger
{"title":"Estimation of Cardiac Output Under Venovenous Extracorporeal Membrane Oxygenation: Comparing Thermodilution Methods to 3D Echocardiography.","authors":"Kaspar F Bachmann, David Berger","doi":"10.1097/MAT.0000000000002381","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002381","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999466","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}
ASAIO JournalPub Date : 2025-01-16DOI: 10.1097/MAT.0000000000002376
Jose I Nunez, Mayuko Uehara, Snehal R Patel, Stephen J Forest, Yogita Rochlani, Shivank Madan, Daniel B Sims, Nicholas Mellas, Justin E Ashley, Marjan Rahmanian, Anthony Carlese, Daniel J Goldstein, Ulrich P Jorde, Omar Saeed
{"title":"Changes in Neutrophil-to-Lymphocyte Ratio During Venoarterial Extracorporeal Membrane Oxygenation.","authors":"Jose I Nunez, Mayuko Uehara, Snehal R Patel, Stephen J Forest, Yogita Rochlani, Shivank Madan, Daniel B Sims, Nicholas Mellas, Justin E Ashley, Marjan Rahmanian, Anthony Carlese, Daniel J Goldstein, Ulrich P Jorde, Omar Saeed","doi":"10.1097/MAT.0000000000002376","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002376","url":null,"abstract":"<p><p>Mortality remains elevated during venoarterial extracorporeal membrane oxygenation support (VA-ECMO) for cardiogenic shock and the role of inflammation is uncertain. By using the neutrophil-to-lymphocyte ratio (NLR), we investigated inflammatory dynamics during VA-ECMO and their relation to clinical outcomes. A single-center, retrospective cohort study was conducted. Patients receiving steroids or on-device support for less than 48 hours were excluded. Patients were grouped as those who did and did not have a persistent rise in NLR during the 24-48 hour interval after VA-ECMO placement. Overall, 253 patients comprised the study cohort. In-hospital mortality was 56%. Neutrophil-to-lymphocyte ratio was higher at 24 hours after VA-ECMO placement compared to pre-ECMO (Δ4.36, interquartile range [IQR]: -0.23 to 8.61, p < 0.001). Persistent increase in NLR during the 24-48 hour interval after VA-ECMO placement was associated with higher in-hospital mortality (adjusted hazard ratio [aHR]: 1.51, 95% confidence interval [CI]: 1.02-2.25, p = 0.04). The magnitude of this rise in NLR was incrementally related to greater in-hospital mortality (Δ0-5: 72%, aHR: 1.61, 95% CI: 1.03-2.54, p = 0.039; Δ>5: 79%, aHR: 1.64, 95% CI: 1.03-2.63, p = 0.037) in comparison 52%, for those with a drop in NLR. Venoarterial extracorporeal membrane oxygenation exacerbates inflammation, as evident by a rise in NLR, which is progressively higher in nonsurvivors.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999463","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}
ASAIO JournalPub Date : 2025-01-16DOI: 10.1097/MAT.0000000000002380
Keshava Rajagopal
{"title":"Venting About Left Ventricular Unloading.","authors":"Keshava Rajagopal","doi":"10.1097/MAT.0000000000002380","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002380","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999468","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}
ASAIO JournalPub Date : 2025-01-10DOI: 10.1097/MAT.0000000000002374
Lesley Pepin, HoanVu Nguyen, Stephanie Kilgore, George Sam Wang, John S Kim
{"title":"Venoarterial Extracorporeal Membrane Oxygenation for Support of Vasodilatory Shock in Children Due to Toxicological Ingestions.","authors":"Lesley Pepin, HoanVu Nguyen, Stephanie Kilgore, George Sam Wang, John S Kim","doi":"10.1097/MAT.0000000000002374","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002374","url":null,"abstract":"<p><p>Venoarterial extracorporeal membrane oxygenation (VA ECMO) may provide temporary hemodynamic support for patients with severe vasodilatory shock due to toxicologic ingestion. In a series of 10 cases of children less than 18 years of age who received VA ECMO support for toxicologic-induced vasodilatory shock, there were eight survivors and two nonsurvivors who died of significant neurologic injury. Upon initiation of ECMO support, survivors had decline in Vasoactive-Inotrope Scores (VIS). With the exception of one survivor who had a VIS range of 5-10, the seven remaining survivors had reduction in VIS by half at a median of 5.3 (interquartile range [IQR]: 3.7-12) hours. Nonsurvivors demonstrated no VIS reduction on ECMO before death. Six of 10 patients received continuous renal replacement therapy (CRRT) while on ECMO and potentially had augmentation of toxin clearance or treatment of severe acidosis as a result. Of the eight survivors, four patients had ECMO-related bleeding or thrombotic complications (three patients with stroke and one patient with extremity compartment syndrome). Venoarterial extracorporeal membrane oxygenation, with and without CRRT, may have potential utility and benefit in supporting poisoned patients with vasodilatory shock.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942981","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}
ASAIO JournalPub Date : 2025-01-07DOI: 10.1097/MAT.0000000000002369
Siddharth Pawan Dugar, Ryota Sato, Matthew Charlton, Daisuke Hasegawa, Marta Velia Antonini, Prashant Nasa, Hakeem Yusuff, Marcus J Schultz, Mary Pat Harnegie, Kollengode Ramanathan, Kiran Shekar, Matthieu Schmidt, Vasileios Zochios, Abhijit Duggal
{"title":"Right Ventricular Injury Definition and Management in Veno-Venous Extracorporeal Membrane Oxygenation.","authors":"Siddharth Pawan Dugar, Ryota Sato, Matthew Charlton, Daisuke Hasegawa, Marta Velia Antonini, Prashant Nasa, Hakeem Yusuff, Marcus J Schultz, Mary Pat Harnegie, Kollengode Ramanathan, Kiran Shekar, Matthieu Schmidt, Vasileios Zochios, Abhijit Duggal","doi":"10.1097/MAT.0000000000002369","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002369","url":null,"abstract":"<p><p>Right ventricular injury (RVI) in respiratory failure receiving veno-venous extracorporeal membrane oxygenation (VV ECMO) is associated with significant mortality. A scoping review is necessary to map the current literature and guide future research regarding the definition and management of RVI in patients receiving VV ECMO. We searched for relevant publications on RVI in patients receiving VV ECMO in Medline, EMBASE, and Web of Science. Of 1,868 citations screened, 30 studies reported on RVI (inclusive of right ventricular dilation, right ventricular dysfunction, and right ventricular failure) during VV ECMO. Twenty-three studies reported on the definition of RVI including echocardiographic indices of RV function and dimensions, whereas 13 studies reported on the management of RVI, including veno-pulmonary (VP) ECMO, veno-arterial (VA) ECMO, positive inotropic agents, pulmonary vasodilators, ultra-lung-protective ventilation (Ultra-LPV), and optimization of positive end-expiratory pressure (PEEP). The definitions of RVI in patients receiving VV ECMO used in the literature are heterogeneous. Despite the high incidence of RVI during VV ECMO support and its strong association with mortality, studies investigating therapeutic strategies for RVI are also lacking. To fill the existing knowledge gaps, a consensus on the definition of RVI and research investigating RV-targeted therapies during VV ECMO is urgently warranted.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943015","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}
ASAIO JournalPub Date : 2025-01-03DOI: 10.1097/MAT.0000000000002372
Anju Bhardwaj, Amir Gahremanpour, Siavosh Saatee
{"title":"Global Trends in Ambulation Practices for Patients Supported by Temporary Mechanical Circulatory Support: A Survey-Based Analysis.","authors":"Anju Bhardwaj, Amir Gahremanpour, Siavosh Saatee","doi":"10.1097/MAT.0000000000002372","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002372","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920541","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}