Pre-Operative Intracardiac Thrombus is Associated with Increased Risk of Stroke and Death in CF-LVAD Patients

Advanced heart failure predisposes patients to intracardiac thrombus (ICT) formation. There is a paucity of evidence examining the impact of pre-existing left atrial (LA) or left ventricular (LV) thrombi on post-operative outcomes in patients undergoing durable LVAD implantation.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (349) Source Type: research

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Left ventricular assist devices (LVAD) are widely used as a support strategy for advanced heart failure. Complications such as thrombosis and bleeding have been linked to LVAD. We observed that LVAD implantation was followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE) and apoptotic cells. Nabs have been implicated in inflammatory reactions related to atherosclerosis, ischemic stroke and primary graft dysfunction following heart transplantation.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (1211) Source Type: research
Small children with end-stage heart failure who require left ventricular assist device (LVAD) support to heart transplant have limited device options leading to high morbidity and mortality and chronic hospitalization until transplant.1,2 The only FDA-approved durable LVAD for children is a paracorporeal pulsatile device that carries a high stroke risk and lacks portability precluding hospital discharge.1 Temporary paracorporeal continuous flow (CF) devices have also been used off-label for bridge-to-transplant but carry higher mortality, require lengthy paracorporeal cannulas prone to circuit thrombus, and typically requi...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
AT1R antibodies (Abs) are known to occur in patients (pts) with heart failure. It has been reported that when AT1R Abs are detected at high levels in mechanical circulatory support (MCS) pts, MCS mortality is increased. AT1R has been associated with the development of an inflammatory state inciting thrombosis. It may be that AT1R Abs are associated with pump thrombosis or even possibly thrombotic stroke. Furthermore, it is not clear whether these pts with MCS and AT1R Abs are at increased risk for post-heart transplant complications such as primary graft dysfunction (PGD) due to the recipients ’ highly inflamed state...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 502 Source Type: research
Left ventricular assist devices (LVAD) are widely used as a bridge to heart transplantation or destination therapy for advanced heart failure. However, hemocompatibility-related complications such as pump thrombosis, stroke and bleeding remain frequent. We previously reported that LVAD implantation is followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE). Nabs have been implicated in inflammatory reactions related to atherosclerosis, ischemic stroke and primary graft dysfunction following heart transplantation.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 606 Source Type: research
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke and GI bleeding are amongst the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort and reduced quality of life. Device miniaturization is one design trend that has enabled device implantation in patients with a broader range of body sizes, and...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke, and gastrointesinal bleeding are among the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort, and reduced quality of life.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke and GI bleeding are amongst the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort and reduced quality of life. Device miniaturization is one design trend that has enabled device implantation in patients with a broader range of body sizes, and...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Mechanical circulatory support for class III heart failure will be acceptable if it is devoid of any adverse events associated with current LVAD devices. Long blood paths, lack of regular maintainence in a pump bathed in blood and tethered operation may account for some of the adverse events witnessed in current LVADs such as stroke, pump thrombosis and infections. An intra-cardiac device with ability to isolate and clean the interior of the pump, powered without driveline is presented.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
In conclusion, the analyses do not permit us to predict the trajectory that maximum lifespans will follow in the future, and hence provide no support for their central claim that the maximum lifespan of humans is "fixed and subject to natural constraints". This is largely a product of the limited data available for analysis, owing to the challenges inherent in collecting and verifying the lifespans of extremely long-lived individuals. A reply from Jan Vijg's research group The authors of the accompanying comment disagree with our finding of a limit to human lifespan. Although we thank them for a...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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