The VAD journal : the journal of mechanical assisted circulation and heart failure最新文献_第2页

Restoration Of Left Ventricular Function Following LVAD Implantation – Remission Or Recovery? A Case series 左室辅助装置植入后左心室功能的恢复-缓解还是恢复?案例系列

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-11-03 DOI: 10.14434/VAD.V4I0.28050

S. Joshi, Mariah Barlow, M. Guglin

引用次数: 0

De-airing method of an axial flow left ventricular assist device influences post-operative lactate dehydrogenase levels: a possible explanation for some episodes of pump thrombosis 轴流左心室辅助装置的脱气方法影响术后乳酸脱氢酶水平:一些泵血栓发作的可能解释

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-09-22 DOI: 10.14434/VAD.V4I0.28045

D. Tanaka, S. Rizvi, A. Boyle, J. Entwistle

{"title":"De-airing method of an axial flow left ventricular assist device influences post-operative lactate dehydrogenase levels: a possible explanation for some episodes of pump thrombosis","authors":"D. Tanaka, S. Rizvi, A. Boyle, J. Entwistle","doi":"10.14434/VAD.V4I0.28045","DOIUrl":"https://doi.org/10.14434/VAD.V4I0.28045","url":null,"abstract":"Background \u0000Pump thrombosis (PT) is a relatively uncommon but serious complication of a left ventricular assist device (LVAD). We believe that de-airing of the HeartMate II (HMII) with the pump turned on and a clamp across the outflow graft may lead to early thrombus formation due to heat generation on the bearings. \u0000Methods \u0000Patients who underwent HMII implantation from November 2012 to February 2016 were retrospectively reviewed. Patients were separated into two groups depending on the timing of removing the clamp from the outflow graft. Patients in Group 1 underwent de-airing by turning on the pump with the vascular clamp on the outflow graft and patients in Group 2 were completely de-aired with the pump off and the pump was only activated after removing the clamp. \u0000Results \u0000There were 45 patients in Group 1 (“clamp on”) and 33 patients in Group 2 (“clamp off”). Five patients had PT in Group 1 but none in Group 2 (p=0.07). Average LDH levels in the early postoperative period were similar (404±168 IU/L vs 425±267 IU/L; p=0.71). However, average LDH levels in the late postoperative period were significantly higher in Group 1 (388±214 IU/L vs 313±73 IU/L; p=0.045). \u0000Conclusion \u0000De-airing a running HMII with the outflow graft clamped increases LDH levels, suggesting that the bearings may act as a nidus for early thrombus formation caused by the lack of heat dissipation. Delaying pump activation until removal of the clamp on the outflow graft may affect the incidence of PT after HMII implantation. This may have potential importance in any VAD where there are mechanical bearings or other areas susceptible to heat generation.","PeriodicalId":91822,"journal":{"name":"The VAD journal : the journal of mechanical assisted circulation and heart failure","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89011387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Modified Access Technique of Impella 5.0 Axillary Artery Insertion 改良的Impella 5.0腋窝动脉插入入路技术

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-09-07 DOI: 10.14434/vad.v4i0.28049

A. Alameddine, Brian Binnall, Eric DiBiasio-White, Khaled O. Alameddine

{"title":"A Modified Access Technique of Impella 5.0 Axillary Artery Insertion","authors":"A. Alameddine, Brian Binnall, Eric DiBiasio-White, Khaled O. Alameddine","doi":"10.14434/vad.v4i0.28049","DOIUrl":"https://doi.org/10.14434/vad.v4i0.28049","url":null,"abstract":"The conventional method for the axillary artery insertion of Impella 5.0 is a nontunneling route of the side-graft. We present an alternative technique in order to facilitate device insertion and to ensure protection from potential wound contamination. The technique consists of exiting the graft separately and away from the main incision with an intact skin and subcutaneous fat between the two sites. By proper isolation of the main wound, the risk of infection can thus be largely mitigated. Furthermore, this technique allows a better landing entry angle of graft insertion; the resulting smoother curve trajectory leads to facile device insertion, while the risk of kinking after resumption of flow is readily avoided. A further possible advantage would be a less likely to produce thrombosis at the anastomosis. Differences of this technique have already been reported for insertions of extracorporeal membrane oxygenation (ECMO), and for aortic dissections and aneurysms. Our experience in 8 cases suggests the applicability of our method to access the axillary artery for Impella 5.0 insertion.","PeriodicalId":91822,"journal":{"name":"The VAD journal : the journal of mechanical assisted circulation and heart failure","volume":"358 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82624615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Beta Blockers and ACE Inhibitors after Left Ventricular Assist Device Implantation 受体阻滞剂和ACE抑制剂对左心室辅助装置植入后的影响

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-09-07 DOI: 10.14434/VAD.V4I0.28044

G. Vaidya, E. Birks, J. Pillarella, Benjamin C. Salgado, R. Vijayakrishnan, A. Lenneman, M. Slaughter, D. Abramov

{"title":"Effects of Beta Blockers and ACE Inhibitors after Left Ventricular Assist Device Implantation","authors":"G. Vaidya, E. Birks, J. Pillarella, Benjamin C. Salgado, R. Vijayakrishnan, A. Lenneman, M. Slaughter, D. Abramov","doi":"10.14434/VAD.V4I0.28044","DOIUrl":"https://doi.org/10.14434/VAD.V4I0.28044","url":null,"abstract":"Background \u0000While Beta blockers(BB) and Angiotensin system blockers(ACEinh/ARB) are important components in advanced heart failure therapy, their use after left ventricular assist device (LVAD) implantation remains controversial. Concern has been raised about possible adverse effects of BB on right ventricular(RV) function while tolerance and efficacy/outcome data for ACEinh are lacking. This study aimed to characterize the use of medical therapy post-LVAD implantation and to evaluate its safety and efficacy. \u0000Methods \u0000Demographic, clinical and echocardiographic variables of patients implanted with a continuous-flow LVAD between 2012 and 2015 at a single center were retrospectively reviewed. Mortality and heart failure(CHF) hospitalizations were followed from 6-18 months’ post-implant. \u0000Results \u0000Of a total of 98 patients, the mean age was 57 years, 81% were men and 61% had ischemic disease. While the use of diuretics decreased considerably post LVAD, over 50% continued to require diuretics. At 6th month post-implantation, 73% of patients were on BB, and these patients had significantly lower proBNP at 6 and 12 months follow up. Despite significant prevalence of RV dysfunction in the cohort (>75% at 6 months), there was no significant difference in CHF hospitalizations based on BB use (14% vs 15%) and instead a trend towards less deaths in those on BB (6% vs 15%). ACEinh/ARB use was likewise common at 6 month (61%) and these patients had lower proBNP at 6 and 12 months, lower right atrial(RA) pressures (9 vs 12 mmHg, p=0.03), and a significantly lower mortality—a finding which remained on multivariate analysis. \u0000Conclusion \u0000The use of ACEinh/ARB appeared to be associated with subsequent improved survival, lower proBNP and RA pressures. The use of BB post-LVAD appears safe and was associated with a lower proBNP, even in a patient population with a significant prevalence of RV dysfunction.","PeriodicalId":91822,"journal":{"name":"The VAD journal : the journal of mechanical assisted circulation and heart failure","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74896224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Electrocardiographic characteristics, antiarrhythmic utilization, and outcomes in patients with left ventricular assist devices 左心室辅助装置患者的心电图特征、抗心律失常的应用和结果

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-08-19 DOI: 10.14434/VAD.V4I0.28039

S. Lundgren, E. Lyden, D. Stoller, M. Hyden, A. Burdorf, R. Zolty, J. Um, B. Lowes

{"title":"Electrocardiographic characteristics, antiarrhythmic utilization, and outcomes in patients with left ventricular assist devices","authors":"S. Lundgren, E. Lyden, D. Stoller, M. Hyden, A. Burdorf, R. Zolty, J. Um, B. Lowes","doi":"10.14434/VAD.V4I0.28039","DOIUrl":"https://doi.org/10.14434/VAD.V4I0.28039","url":null,"abstract":"Background \u0000Left ventricular assist devices (LVAD) are an increasingly used therapy for patients with advanced heart failure. Arrhythmias are common complications following LVAD implantation requiring admission, initiation, and escalation of medical therapy. Despite their frequent use in the treatment of arrhythmias, little has been reported regarding electrocardiographic changes, antiarrhythmic utilization, and outcomes post-LVAD. \u0000Methods \u0000A total of 309 patients who received a LVAD underwent retrospective chart review pre- and post-LVAD. Kaplan-Meier curves were calculated and compared using the log-rank test. Cox regression model was used for univariate analysis and those with a p \u0000Results \u0000There was a significant reduction in both the QRS interval (p=0.0001) and QTc interval (p=0.0074) following LVAD implantation. Ventricular tachycardia is common following LVAD implant at 31.1%. Amiodarone use was frequent prior to LVAD (52.1%) and on discharge (68.6%). Amiodarone use (p=0.019, HR 1.7, 95% CI 1.1-2.6), age at implant (p \u0000Conclusion \u0000Amiodarone is a commonly used antiarrhythmic in advanced heart failure and its use prior to LVAD implantation may increase the risk of long-term mortality. Amiodarone's efficacy needs to be weighed against its long-term side effects and implant on clinical outcomes","PeriodicalId":91822,"journal":{"name":"The VAD journal : the journal of mechanical assisted circulation and heart failure","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81541084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Safety and Efficacy of Routine Bridging Anticoagulation for Subtherapeutic Anticoagulation in Outpatients with a Left Ventricular Assist Device 常规桥接抗凝对门诊左心室辅助装置患者亚治疗性抗凝的安全性和有效性

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-08-01 DOI: 10.14434/vad.v4i0.28038

D. Shisler, G. Vaidya, L. Muncy, R. Vijayakrishnan, M. Slaughter, E. Birks, D. Abramov

{"title":"Safety and Efficacy of Routine Bridging Anticoagulation for Subtherapeutic Anticoagulation in Outpatients with a Left Ventricular Assist Device","authors":"D. Shisler, G. Vaidya, L. Muncy, R. Vijayakrishnan, M. Slaughter, E. Birks, D. Abramov","doi":"10.14434/vad.v4i0.28038","DOIUrl":"https://doi.org/10.14434/vad.v4i0.28038","url":null,"abstract":"Background \u0000Anticoagulation with vitamin K antagonists is vital to prevent pump thrombosis in patients with left ventricular assist devices (LVADs). However, the safety and efficacy of bridging anticoagulation for the routine management of subtherapeutic international normalized ratio (INR) in stable outpatients remains poorly characterized. \u0000 Methods \u0000In this retrospective study, a total of 60 LVAD outpatients had 110 episodes of subtherapeutic INR noted on routine testing. 34 of these episodes were managed with parenteral bridging anticoagulation and 76 were managed with only an adjusted dose of warfarin. The rates of bleeding and thromboembolic adverse events following these episodes of subtherapeutic INR were measured to evaluate the safety and efficacy of bridging anticoagulation in this population. \u0000Results \u0000Ischemic cerebrovascular events occurred following 2 bridged episodes compared to 4 non-bridged episodes (6% vs. 5%, p=0.895). Hemolysis occurred following 1 bridged episode compared to 3 non-bridged episodes (3% vs. 4%, p=0.794). Bleeding events occurred after 4 bridged episodes compared to 13 non-bridged episodes (12% vs. 17%, p=0.474). In a subgroup of patients with either a CHA2DS2-VASc score > 3 or a history of atrial fibrillation, thromboembolic events occurred only in those who did not receive bridging anticoagulation although this result was not statistically significant. \u0000Conclusions \u0000There was no benefit associated with the routine use of bridging anticoagulation in a general population of stable LVAD outpatients with subtherapeutic INR. A trend towards benefit was seen in a subset of patients with a CHA2DS2-VASc score of > 3 or a history of atrial fibrillation.","PeriodicalId":91822,"journal":{"name":"The VAD journal : the journal of mechanical assisted circulation and heart failure","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77385505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Exploring the “Weekend Effect” on the Care of Patients with Left Ventricular Assist Devices 探讨“周末效应”对左心室辅助装置患者护理的影响

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-07-02 DOI: 10.14434/VAD.V4I0.27988

Gbolahan O. Ogunbayo, L. Ha, N. Misumida, A. Elbadawi, Q. Ahmad, Remi T. Okwechime, D. Akanya, A. Kolodziej, C. Elayi, M. Guglin

{"title":"Exploring the “Weekend Effect” on the Care of Patients with Left Ventricular Assist Devices","authors":"Gbolahan O. Ogunbayo, L. Ha, N. Misumida, A. Elbadawi, Q. Ahmad, Remi T. Okwechime, D. Akanya, A. Kolodziej, C. Elayi, M. Guglin","doi":"10.14434/VAD.V4I0.27988","DOIUrl":"https://doi.org/10.14434/VAD.V4I0.27988","url":null,"abstract":"\u0000 \u0000 \u0000Background \u0000Many studies have described differences in in-hospital outcomes and length of stay between patients treated for major cardiac conditions on weekdays versus weekends.1 Our study aimed to explore the “weekend effect” on in-hospital care among patients with left ventricular assist devices. \u0000Methods \u0000Using data from the National Inpatient Sample (NIS) database, with a weighted estimate of more than 35 million admissions per year.2 We identified patients 18 years or older with an ICD code signifying presence of a LVAD. Characteristics, comorbidities and clinical outcomes were compared between patients admitted on a weekend versus patients admitted on a weekday. The outcomes of interest were in-hospital all-cause mortality and length of hospital stay (LOS). \u0000 \u0000 \u0000 \u0000Results \u0000Patients admitted on weekend days were younger, otherwise both groups were similar with respect to comorbidities. Patients admitted on weekend days were more likely to have cardiogenic shock, septic shock and respiratory failure. They were also more likely to require mechanical ventilation and undergo cardiac transplantation. Patients admitted on a weekend day however had a shorter hospital median hospital stay. This remained significant after multivariate analysis (OR .81 95% CI .72-.91, p<0.01). \u0000Our data analysis from this large database demonstrates no effect of weekend admission on all-cause mortality among patients with LVADs, although patients admitted on weekend days were more likely to have shorter hospital stay. \u0000 \u0000 \u0000 \u0000 \u0000 \u0000","PeriodicalId":91822,"journal":{"name":"The VAD journal : the journal of mechanical assisted circulation and heart failure","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73846613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reversal of fixed pulmonary hypertension with transcatheter valve replacement for aortic insufficiency on ventricular assist device support 在心室辅助装置支持下，经导管瓣膜置换术治疗主动脉不全逆转固定肺动脉高压

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2018-06-17 DOI: 10.14434/vad.v4i0.28048

F. Ahmad, M. Ricciardi, L. Davidson, A. Anderson, K. Ghafourian, I. Okwuosa, E. Vorovich, J. Wilcox, D. Holloway, D. Pham, J. Rich

{"title":"Reversal of fixed pulmonary hypertension with transcatheter valve replacement for aortic insufficiency on ventricular assist device support","authors":"F. Ahmad, M. Ricciardi, L. Davidson, A. Anderson, K. Ghafourian, I. Okwuosa, E. Vorovich, J. Wilcox, D. Holloway, D. Pham, J. Rich","doi":"10.14434/vad.v4i0.28048","DOIUrl":"https://doi.org/10.14434/vad.v4i0.28048","url":null,"abstract":"We present a 43-year-old woman with a nonischemic cardiomyopathy implanted with a ventricular assist device (VAD) as bridge to transplant due to severe, “fixed” pulmonary hypertension (PH). Within three months of VAD implant, her “fixed” PH had resolved entirely. Nearly two years later, still supported with a VAD because of severe HLA allosensitization, she developed dyspnea and “moderate” aortic insufficiency (AI) by standard criteria. Invasive hemodynamics revealed recurrence of severe PH in the setting of elevated left-sided filling pressures. We concluded the AI was indeed severe and the cause of her symptoms and recurrent PH. Despite her noncalcified aortic valve and small body habitus, after a thorough assessment, including meticulous annular measurements and appropriate valve sizing, she underwent a transcatheter aortic valve replacement (TAVR) with complete resolution of both her AI and recurrent, severe PH. This case highlights, in a single patient, reversal of “fixed” PH with adequate left ventricular unloading, that “moderate” AI by standard criteria is often “severe” and must be considered in a VAD patient with recurrent PH, and the need for meticulous pre-procedural planning for TAVR in patients with VADs, including accurate measurements of the aortic annulus to ensure adequate oversizing of the valve.","PeriodicalId":91822,"journal":{"name":"The VAD journal : the journal of mechanical assisted circulation and heart failure","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88952864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Protocol for Collecting Human Cardiac Tissue for Research 收集人类心脏组织用于研究的规程

The VAD journal : the journal of mechanical assisted circulation and heart failure Pub Date : 2016-06-03 DOI: 10.13023/VAD.2016.12

Cheavar A. Blair, Premi Haynes, S. Campbell, C. Chung, Mihail I Mitov, D. Dennis, M. Bonnell, C. Hoopes, M. Guglin, K. Campbell

引用次数: 20