Effect of Socioeconomic Status on Patients Supported with Contemporary Left Ventricular Assist Devices

Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly used in advanced heart failure patients. Recent studies suggest that low socioeconomic status (SES) predicts worst survival after heart transplantation. Both individual-level and neighborhood-level SES (nSES) have been linked to cardiovascular health; however, the impact of SES in CF-LVAD patients remains unknown. We hypothesized that SES is a major determinant of CF-LVAD candidacy and postimplantation outcomes. A retrospective chart review was conducted on 362 patients between February 2009 and May 2016. Neighborhood-level SES was measured using the American Community Survey data and the Agency for Healthcare Research and Quality SES index score. Individual-level SES was self reported. Kaplan–Meier survival analysis and multivariable Cox proportional hazards regression determined survival statistics. Patients in the highest SES tertile were older (58 ± 13 vs. 53 ± 14; p
Source: ASAIO Journal - Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Related Links:

Ventricular assist devices (VADs) are an increasingly common therapy for end-stage heart failure across all ages as a bridge to recovery or transplant and more recently as destination therapy. With increasing experience and difficulties with establishing therapeutic heparin levels, we have begun to explore the effectiveness of direct thrombin inhibitors in this patient population. This is a retrospective review of all long-term VAD patients, both adult and pediatric, who were anticoagulated with bivalirudin between January 2009 and January 2016. The starting dose was 0.3 mg/kg/hr, and dose was titrated for a goal pa...
Source: ASAIO Journal - Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research
AbstractPurpose of ReviewWith the growing need for donor hearts and longer transplant waiting lists, there is a growing interest in expanding the donor pool by reconsidering previously excluded donor candidates. There has been an increase in solid organ availability due to drug overdose deaths in the setting of the recent opioid epidemic. However, these donors often have transmissible infections such as hepatitis C. In this review, we discuss the challenges associated with heart transplantation from hepatitis C –infected donors as well as the recent advancements that are making the use of these organs possible.Recent...
Source: Current Heart Failure Reports - Category: Cardiology Source Type: research
Medtronic is recalling its HeartWare HVAD pump outflow graft and outflow graft strain relief because of the risk of breaks and tears during the pre-implant pump assembly process. FDA has identified this as a Class I recall. The Dublin-based company said it has received 92 complaints. The recalled products according to FDA’s release are: HeartWare HVAD Pump Outflow Graft and Outflow Graft Strain Relief Model Numbers:HVAD Pump Outflow Graft: 1125 HVAD Pump Implant Kit: 1103 HVAD Implant Accessories Kit: 1153 Distribution Dates: March 1, 2018 to April 1, 2020   Medtronic said the use of the affe...
Source: MDDI - Category: Medical Devices Tags: Cardiovascular Regulatory and Compliance Source Type: news
AbstractAdvances in surgery and pediatric care over the past decades have achieved improved survival for children born with congenital heart disease (CHD) and have produced a large, growing population of patients with adult congenital heart disease (ACHD). Heart failure has emerged as the leading cause of death and a major cause of morbidity among the ACHD population, while as little evidence supports the efficacy of guideline-directed medical therapies in this population. It is increasingly important that clinicians caring for these patients understand how to utilize mechanical circulatory support (MCS) in ACHD. In this r...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
CONCLUSIONS: This novel extracorporeal VAD system with a hydrodynamically levitated centrifugal pump can safely and successfully bridge patients with advanced heart failure to subsequent therapeutic stages. PMID: 32461539 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Abstract Rescuing patients with the development of acute respiratory distress syndrome and right heart failure after left ventricular assist device placement remains a challenge in patients with congenital heart disease. TandemLife Protek Duo (TandemLife, Pittsburg, PA) is a double-lumen cannula introduced via the internal jugular vein that can provide veno-venous extra-corporeal membrane oxygenation and right heart support. To our knowledge, we report the first case of successfully using the TandemLife Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricle support in an...
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Authors: den Exter PL, Beeres SLMA, Eikenboom J, Klok FA, Huisman MV Abstract INTRODUCTION: The treatment options for advanced heart failure patients drastically changed with the introduction of left ventricular assist devices (LVADs), either as bridge to transplant or as destination therapy for patients ineligible for transplant. Despite major benefits in terms of survival, functional status and quality of life, managing patients with LVADs comes with several challenges. The most significant challenge is balancing between the risks of thrombotic and bleeding complications. AREAS COVERED: The present review des...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
Implantable mechanical circulatory support (MCS) devices are used in patients with progressive heart failure either as destination therapy or a bridge-to-transplant. Left ventricular assist devices (LVAD) have become commonplace with development of continuous flow platforms. LVADs are effective in selected patients and improve quality of life and reduce mortality.1 However, patients with severe biventricular dysfunction or anatomical contraindications such as small or non-dilated ventricles (i.e.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
AbstractPercutaneous biventricular assist devices (BiVAD) are a recently developed treatment option for severe cardiogenic shock. This systematic review sought to identify indications and outcomes of patients placed on percutaneous BiVAD support. An electronic search was performed to identify all appropriate studies utilizing a percutaneous BiVAD configuration. Fifteen studies comprising of 20 patients were identified. Individual patient survival and outcomes data were combined for statistical analysis. All 20 patients were supported with a microaxial LVAD, 12/20 (60%) of those patients were supported with a microaxial (RM...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
AbstractBackgroundContemporary survival trends of Dilated Cardiomyopathy (DCM) patients are largely unknown. The aims of this study are to describe clinical descriptors, survival trends and the prognostic impact of etiological characterization in DCM patients.MethodsDCM patients were consecutively enrolled and divided into 4 groups according to the period of enrolment: 1st: 1978 ‐1984; 2nd: 1985 ‐1994; 3rd: 1995 ‐2004; 4th: 2005 ‐2015. A cohort of patients with DCM with specific etiology, enrolled from 2005 to 2015, was also analyzed.ResultsOver a mean follow ‐up of 12±8 years, 1284 DCM patients (52...
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
More News: Agency for Healthcare Research and Quality (AHRQ) | Cardiology | Cardiovascular | Heart | Heart Failure | Heart Transplant | Medical Devices | Statistics | Study | Transplants