ASAIO Journal最新文献

{"title":"Impact of Thoracotomy-Based Left Ventricular Assist Device Implantation on Right Ventricular Functional Preservation.","authors":"Seda Tanyeri Üzel, Murat Karaçam, Ayhan Güneş, Barkin Kültürsay, Azmican Kaya, Süleyman Çağan Efe, Gülümser Sevgin Halil, Cem Doğan, Emre Gürcü, Mehmet Kaan Kirali, Rezzan Deniz Acar","doi":"10.1097/MAT.0000000000002877","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002877","url":null,"abstract":"<p><p>Right ventricular (RV) dysfunction remains a critical determinant of outcomes following left ventricular assist device (LVAD) implantation. We used a doubly robust inverse probability weighting based on propensity scores to evaluate the association between surgical approach and clinical outcomes in 187 consecutive patients (thoracotomy: n = 55; sternotomy: n = 132). The primary endpoint was RV systolic function in the early postoperative period, assessed by tricuspid annular plane systolic excursion (TAPSE). Despite comparable baseline RV performance and hemodynamics, the thoracotomy-based approach was associated with superior preservation of postoperative RV systolic function compared to median sternotomy (TAPSE: 12.0 vs. 11.0 mm, p = 0.001). In weighted regression models, median sternotomy was associated with a significant reduction in postoperative TAPSE (β = -0.085, p = 0.036) and a 35% relative increase in hospital length of stay (p = 0.015). Furthermore, accounting for heart transplantation as a competing risk, median sternotomy was associated with a significantly higher hazard of long-term mortality (subdistribution hazard ratio [sHR]: 1.78, 95% confidence interval [CI]: 1.07-3.00, p = 0.027). These findings suggest that the clinical benefits of sternal-sparing techniques extend beyond acute functional protection. This surgical strategy supports the use of less invasive approaches to optimize both early recovery and long-term outcomes in the LVAD population.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163893","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":"Acute Effects of Impella 5.5 on Biventricular Filling and Pressure-Volume Area in Patients With Heart Failure Associated Cardiogenic Shock.","authors":"Kay D Everett, Pankaj Jain, Aaron Lee, Satoshi Miyashita, Michele Esposito, Lara Reyelt, Christian Said, Katherine Barland, Vincent Picone, Anthony Faugno, Haval Chweich, Amanda R Vest, Michael Kiernan, Edward Hong, Ethan Brovman, John Fox, Masashi Kawabori, Navin K Kapur","doi":"10.1097/MAT.0000000000002876","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002876","url":null,"abstract":"<p><p>Use of Impella 5.5 in patients with decompensated heart failure-associated cardiogenic shock (ADHF-CS) is increasing as a bridge to advanced therapies. The effects of maximal trans-valvular unloading on biventricular filling and pressure-volume area (PVA) in ADHF-CS are poorly understood. Nine patients with medically refractory ADHF-CS underwent Impella 5.5 placement with simultaneous invasive arterial, venous, and biventricular pressure-volume loop analysis. Acutely after Impella 5.5 activation, cardiac output (3.4 ± 0.5 vs. 5.0 ± 0.7 L/min, p = 0.0011), diastolic (67.2 ± 8.0 vs. 80.7 ± 9.7 mm Hg, p = 0.0044) and mean arterial pressures (77.9 ± 7.1 vs. 86.9 ± 10.4 mm Hg, p = 0.029) increased, compared to baseline. Left ventricular end-diastolic pressure (24.1 ± 6.7 vs. 16.8 ± 5.4 mm Hg, p = 0.0027), volume (262.1 ± 103.9 vs. 231.5 ± 104.3 ml, p = 0.0036), and PVA (21,913 ± 7,055 vs. 18,357 ± 7,758 mmHg·ml, p = 0.013) decreased. Right ventricular end-diastolic (12.4 ± 4.6 vs. 9.1 ± 3.8 mm Hg, p = 3.8E-5) and end-systolic pressure (42.1 ± 11.9 vs. 34.4 ± 11.1 mm Hg, p = 0.030) and PVA (6,303 ± 3,851 vs. 4,437 ± 2,473 mm Hg·ml, p = 0.027) also decreased. These findings suggest that maximal left ventricular unloading can acutely reduce biventricular filling pressures and PVA in patients with ADHF-CS.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164092","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":"Letter to the Editor: Cardiopulmonary Outcomes After Venovenous Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome.","authors":"Chaofan Song, Xiaoxu Ren, Guoying Wang","doi":"10.1097/MAT.0000000000002870","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002870","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103594","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":"Response to Letter to the Editor: Cardiopulmonary Outcomes After Venovenous Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome.","authors":"Dawid L Staudacher, Viviane Zotzmann","doi":"10.1097/MAT.0000000000002871","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002871","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103558","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":"Pulmonary Arterial Compliance Determines Hemodynamic and Prognostic Value of Pulmonary Artery Pulsatility Index After LVAD Implantation.","authors":"Toshihide Izumida, Eisuke Amiya, Masaru Hatano, Junichi Ishida, Masahiko Ando, Minoru Ono, Koichiro Kinugawa, Norihiko Takeda","doi":"10.1097/MAT.0000000000002872","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002872","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103560","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":"Inferior Vena Cava Resection Using Modified Veno-Venous Bypass With Renal Vein Drainage: Case Report Adapted From Liver Transplant Practice.","authors":"Guido Fallani, Alice Assirelli, Matteo Ravaioli, Pietro Piazza, Riccardo Schiavina","doi":"10.1097/MAT.0000000000002654","DOIUrl":"10.1097/MAT.0000000000002654","url":null,"abstract":"<p><p>We describe an innovative application of a modified three-arm veno-venous bypass (VVB) in the management of a complex case of recurrent renal cell carcinoma (RCC) invading the inferior vena cava (IVC) and left renal vein confluence. The patient, with a solitary kidney following right nephrectomy, underwent radical tumor resection and IVC reconstruction. To preserve renal function and minimize ischemic injury, we employed an extracorporeal circuit traditionally used in liver transplantation, adapting it to include an additional cannula in the left renal vein. This configuration allowed continuous renal venous drainage during IVC clamping, limiting kidney warm ischemia to only 14 minutes. The extracorporeal circuit included jugular and femoral venous drainage limbs connected to a centrifugal pump and a third limb providing direct renal outflow, effectively maintaining hemodynamic stability and renal perfusion. Postoperative recovery was uneventful, with transient minimal creatinine elevation and no acute kidney injury. This case demonstrates the versatility of extracorporeal venous bypass circuits in complex onco-vascular surgery and highlights the potential for broader applications of organ support technologies in preserving organ function during major vascular reconstruction. The proposed configuration represents a valuable adjunct in surgeries involving solitary kidneys and prolonged caval occlusion, bridging concepts from transplant and extracorporeal support domains.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e321-e324"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040362","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":"Neighborhood-Level Social Determinants of Health, Mortality, and Hospital Length of Stay in Patients Treated With Venoarterial Extracorporeal Membrane Oxygenation: A Retrospective Single-Center Study.","authors":"Leon Fan, Ernesto Marin, Mingfeng Cao, Medha Majety, Winnie Liu, Hyun Yi Jacqualine Woo, Glenn J R Whitman, Sung-Min Cho","doi":"10.1097/MAT.0000000000002719","DOIUrl":"10.1097/MAT.0000000000002719","url":null,"abstract":"<p><p>Social determinants of health (SDOH) are increasingly recognized as drivers of critical care outcomes but remain understudied in venoarterial extracorporeal membrane oxygenation (VA ECMO). We examined whether neighborhood-level SDOH were associated with 30 day post-discharge survival and prolonged length of stay (LOS) among VA ECMO patients. We retrospectively analyzed VA ECMO patients treated at Johns Hopkins Hospital, linking geocoded addresses to 12-digit Federal Information Processing Standards (FIPS) codes, 2022 American Community Survey data, 2023 Area Deprivation Index (ADI), and PolicyMap metrics. The primary outcome was 30 day mortality from discharge; secondary outcome was prolonged LOS (> 38 days, median among survivors). Multivariable logistic regression adjusted for preselected variables. Among 266 VA ECMO patients (median age: 59.50, 59% male), the median ADI percentile was 31.00, and LOS was 20.50 days. At 30 days, non-survivors (n = 133) were older (62 vs . 55 years, p = 0.002) and had higher body mass index (34.7 vs . 25.2, p < 0.001). Prolonged LOS was associated with longer ECMO duration, higher neighborhood insurance coverage, and greater commuting by car. In adjusted models, SDOH were not associated with mortality, but higher insurance coverage remained associated with prolonged LOS. Clinical factors influenced short-term survival, whereas neighborhood-level SDOH may affect discharge. Future studies should evaluate SDOH in long-term recovery.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"848-855"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760804","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":"Post-Cardiotomy Extracorporeal Life Support Following Aortic Surgery.","authors":"Gabor Bari, Silvia Mariani, Bas C T van Bussel, Michele Di Mauro, Luca Conci, Diyar Saeed, Matteo Pozzi, Antonio Loforte, Udo Boeken, Robertas Samalavicius, Karl Bounader, Xiaotong Hou, Jeroen J H Bunge, Hergen Buscher, Leonardo Salazar, Bart Meyns, Michael Mazzeffi, Sacha Matteucci, Sandro Sponga, Vitaly Sorokin, Claudio Russo, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Daniele Camboni, Giuseppe Maria Raffa, Rodrigo Diaz, I-Wen Wang, Jae-Seung Jung, Jan Belohlavek, Vin Pellegrino, Giacomo Bianchi, Matteo Pettinari, Alessandro Barbone, José P Garcia, Kiran Shekar, Glenn Whitman, Roberto Lorusso","doi":"10.1097/MAT.0000000000002619","DOIUrl":"10.1097/MAT.0000000000002619","url":null,"abstract":"<p><p>Aortic surgery carries high risks and complication rates, particularly when extracorporeal life support (ECLS) is required. We compared outcomes of patients receiving post-cardiotomy ECLS after surgeries involving or not involving the thoracic aorta, with a focus on emergency operations. This retrospective multicenter study included adults requiring veno-arterial (V-A) ECLS for post-cardiotomy shock. In-hospital outcomes and long-term survival were analyzed. Among 2,058 patients, 382 (18.6%) underwent aortic and 1,676 (81.4%) non-aortic surgery. Patients undergoing aortic operations were younger (63.0, interquartile range [IQR]: 54.4-70 years; non-aortic: 65.0, IQR: 55-72 years; p = 0.020), with more emergencies (n = 126, 33.1%; non-aortic: n = 402, 24.3%; p < 0.001), longer cross-clamp times (148, IQR: 101-203 mins; non-aortic: 90, IQR: 59-133 mins; p < 0.001) and more postoperative bleeding events (n = 234, 62.4%; non-aortic: n = 922, 56.0%; p = 0.024). Stroke was more frequent after aortic surgery (n = 60, 15.8%; non-aortic: n = 157, 9.4%; p < 0.001), especially in emergency cases (n = 27, 21.6%; p = 0.034). In-hospital mortality was greater after aortic surgery (n = 258, 67.5%; non-aortic: n = 986, 58.8%; p = 0.002), with 49.9% (n = 189) on-ECLS mortality. Neurological injury caused death in 8.9% (n = 22) of patients undergoing aortic and 4.0% (n = 36) non-aortic operations. Post-discharge survival was similar ( p = 0.32), and emergency status did not affect mortality in the aortic group ( p = 0.643). Veno-arterial extracorporeal life support after aortic surgery is associated with higher bleeding, stroke, and in-hospital mortality compared with non-aortic surgery, independent of emergency status.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e306-e314"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773292","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":"Left Ventricular Assist Device Implantation and Concomitant Tricuspid Valve Surgery: A Systematic Review and Meta-Analysis of Reconstructed Time-to-Event Data.","authors":"Florinda Mastro, Marco Gemelli, Michele Gallo, Alberto Bortolato, Enrico G Italiano, Roberto Lorusso, Vincenzo Tarzia, Mark Slaughter, Gino Gerosa","doi":"10.1097/MAT.0000000000002618","DOIUrl":"10.1097/MAT.0000000000002618","url":null,"abstract":"<p><p>Patients who undergo left ventricular assist device (LVAD) implantation may present with severe tricuspid regurgitation (TR), revealing underlying right heart failure. This study aims to evaluate the impact of concurrent tricuspid valve surgery (TVS) on LVAD implantation outcomes. Online electronic databases were systematically reviewed for studies including patients with advanced heart failure and TR treated by isolated LVAD implantation versus concomitant TVS and LVAD implantation. In-hospital outcomes were analyzed, and Kaplan-Meier (KM) curves presenting late survival by reconstruction of individual patient data. Sixteen studies were identified, comprising 2,206 patients who underwent either isolated LVAD or LVAD implant with concomitant TVS. There was no significant difference in early mortality between the two groups (odds ratio [OR]: 1.18, 95% confidence interval [CI]: 0.85-1.65, p = 0.3, I2 : 0%). The odds of right ventricular assist device (RVAD) implant were significantly higher in the LVAD + TVS group: (OR: 1.36 [95% CI: 1.0-1.86], p = 0.05). Analysis of late all-cause mortality showed a significantly higher risk of mortality in the LVAD + TVS group, hazard ratio (HR): 0.82 (0.69-0.98, p = 0.032) at each time-point. Tricuspid valve surgery at the same time as LVAD implant showed no difference in early operative mortality but jeopardized long-term survival. Future studies should aim to identify distinct patient subsets that could significantly benefit from TVS during the implantation of LVAD.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e296-e305"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809137","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":"Association of Serum KL-6 With Mortality in Patients With Acute Respiratory Distress Syndrome Requiring Extracorporeal Membrane Oxygenation: A Multicenter Retrospective Cohort Study.","authors":"Kenshiro Wada, Naofumi Bunya, Hirofumi Ohnishi, Ryuichi Nakayama, Yoshihiro Hagiwara, Mitsuaki Nishikimi, Shinichiro Ohshimo, Nobuaki Shime, Eichi Narimatsu","doi":"10.1097/MAT.0000000000002679","DOIUrl":"10.1097/MAT.0000000000002679","url":null,"abstract":"<p><p>Identifying reliable biomarkers associated with clinical outcomes in patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) is essential. Elevated serum Krebs von den Lungen-6 (KL-6) has been linked to increased mortality in ARDS; however, its prognostic utility in ECMO remains unclear. This multicenter retrospective cohort study analyzed adult patients with severe ARDS who received veno-venous ECMO in 24 Japanese hospitals between 2012 and 2022. Serum KL-6 was measured within 3 days before or after ECMO initiation. The primary outcome was 90 day in-hospital mortality, and the secondary outcome was successful ECMO liberation. Among 373 patients, 265 (71.0%) survived, and 108 (29.0%) died. In multivariable Cox proportional hazards models using restricted cubic splines, higher KL-6 levels were significantly associated with increased 90 day mortality ( p = 0.004), whereas lower KL-6 levels were significantly associated with successful liberation from ECMO ( p < 0.001). These findings suggest that serum KL-6 measured around the time of ECMO initiation is associated with mortality and liberation outcomes in patients with, supporting its potential as a biomarker of disease severity.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"865-870"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163922","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}