WATCH: Artificial 'biobag' womb for extremely premature newborns in testing
Infants born extremely prematurely face a host of health issues from underdeveloped lungs that can cause chronic lung damage to fragile blood vessels that can cause bleeding in the brain.
CardioMEMS heart sensor is a wireless implantable hemodynamic monitoring system that can guide the management of heart failure (HF). Its role in HF patients with left-ventricular assist device (LVAD) is undetermined. Gastrointestinal (GI) bleeding is a common complication in the LVAD population. Severe GI bleeding can lead to a hypovolemic state which results in decreased pulmonary artery pressure (PAP). In this case, we report the changes in PAP recorded by CardioMEMS in an LVAD patient with recurrent GI bleeding.
This study aims to evaluate the impact of omega-3 on angiogenesis.
Our prior work demonstrated Bleeding and thrombosis events (BTEs) are common in adult patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) but risk factors for these complications are not well understood.
This report describes baseline AC data from ACTION centers, including agents used and aggregate levels of performance, to inform development of specific interventions.
Postoperative delayed chest closure (DCC) in LVAD patients, is often required in cases of bleeding due to coagulopathy or right heart distention. Despite the absence of data about the increased risk of infection, this bias limits the use of DCC in most centers. We retrospectively analyzed patients with left ventricular assist devices (LVADs) who underwent DCC in our center and evaluated the impact of this approach on postoperative infection rates.
In the normal, pulsatile circulation, the hemodynamic pattern of the middle cerebral artery (MCA) differs from the central retinal artery (CRA). Whether continuous flow from a left ventricular assist device (LVAD) alters this relationship is not known. Since serious adverse events in different end-organs, such as stroke and GI bleeding, are frequent in LVAD patients, comparing hemodynamics in different arterial beds may enhance our understanding of the specific pathophysiology of these complications.
The HeartMate 3 Left Ventricular Assist System has demonstrated absence of confirmed de-novo pump thrombosis and reduction in stroke. However, bleeding related adverse events persist under standard anticoagulation targeting a INR range of 2.0-3.0. In an initial experience we demonstrated safety of transition to low intensity anticoagulation (INR target 1.5-1.9, n=15, follow up of at least 6 months). Whether complete cessation of anticoagulation maintains “thromboresistance” in the HeartMate 3 pump remains unknown.
In patients supported by left ventricular assist devices (LVADs), half of all non-gastrointestinal bleeding (GIB)-related anemias are related to iron-deficiency (IDA). The clinical benefits of intravenous (IV) iron replacement in heart failure are well described, but there is a paucity of data regarding the treatment of IDA in LVAD patients. This pilot study aimed to determine the impact of IV ferric carboxymaltose (FCM) on anemia, blood transfusion requirements, readmissions,&functional capacity in the LVAD population.
Gastrointestinal bleeding (GIB) in patients supported by Continuous-Flow Left Ventricular Assist Devices (CF-LVAD) is most commonly caused by gastrointestinal angiodysplasia (GIAD). It has been postulated that the abnormal hemodynamic profile in CF-LVAD patients can cause splanchnic submucosal hypoperfusion and activate a Hypoxia Inducible Factor (HIF)1-alpha /Angiopoietins (Ang) signaling cascade that triggers pathological neoangiogenesis. Specifically, it has been established in CF-LVAD recipients that the increased levels of Ang-2, decreased Ang-1 and resultant increase in the ratio of Ang-2/Ang-1, presents angiogenic s...
Gastrointestinal bleeding (GIB) from angiodysplasia is the most frequent cause of readmission in LVAD patients. Angiogenesis, inflammation and coagulopathy as well as venous congestion (VC) are hypothesized to contribute to GIB pathophysiology. We used an established experimental model of peripheral VC to investigate whether increased venous pressure alters plasma levels of angiopoietin-2 (Ang-2) tumor necrosis factor- α (TNF-α) and vonWillebrand factor (vWF).