Ischemic Stroke and Intracranial Hemorrhages during Percutaneous Left Ventricular Assist Device Cardiac Support
Mechanical circulatory support systems for cardiogenic shock and heart failure are associated with ischemic strokes and intracranial hemorrhages. Impella is a percutaneously placed, ventricular assist device for short-term cardiac support. We aimed to study the prevalence of acute neurologic complications during short-term support with Impella.
Publication date: Available online 24 May 2020Source: Annals of Physical and Rehabilitation MedicineAuthor(s): Maira Jaqueline da Cunha, Katia Daniele Rech, Ana Paula Salazar, Aline Souza Pagnussat
ConclusionsThe e-ASPECTS software generates robust values for e-ASPECTS and acute infarct volumes when using ST ≤ 4 mm with ST = 1 mm yielding the best performance for predicting baseline stroke severity and clinical outcome after 90 days.Key Points•Clinical utility of automatically derived ASPECTS from computed tomography scans was shown in patients with acute ischemic stroke and treatment with mechanical thrombectomy.•Thin slices (= 1 mm) had the highest clinical utility in comparison with thicker slices (2–10 mm) by having the strongest correlation...
Psychologists say anxiety and uncertainty prompt irrational decisions — like turning down a transplant when an organ becomes available.
This study, for instance, attributes a patient’s waitlist/transplant outcome to the very last dialysis facility the patient was associated with. In epidemiology speak, this means the causal inference authors are trying to draw between for-profit status and good transplant outcomes is subject to time-varying confounding. As an example, if one is seeking an association between testosterone levels and risk of a heart attack, using the last testosterone level available would be a poor way of doing this study because testosterone levels are known to vary over time. The same applies to dialysis facilities. Patie...
Authors: Alsadat N, Hyun K, D'Souza M, Chew D, Weaver J, Juergens C, Kritharides L, Hammett C, Brieger D Abstract BACKGROUND: Approximately 50% of patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) have multivessel coronary disease (MVD). Evidence on the best PCI approach for these patients is conflicting. The aim of this study is to examine Australian data from the CONCORDANCE registry to describe the practice and outcomes of patients receiving multivessel vs culprit-only PCI. METHODS: Two cohorts were constructed from MVD-STEMI patients undergoi...
ConclusionsECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation.
CONCLUSIONS: ECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation. PMID: 30236527 [PubMed - as supplied by publisher]
We report the first case of mechanical circulatory supported with Impella CP on the left and Impella RP on the right (Abiomed Inc., Danvers, MA) for acute biventricular failure due to suspected acute myocarditis in the context of thrombolytic therapy for ischaemic stroke.
Conclusions The tobacco paradox is a finding that could be explained by other prognostic factors. Smoking cessation prior to hospitalization for acute coronary syndrome is associated with a better prognosis.
CONCLUSIONS: The POLCAS heart assist system is an effective method of treatment as a bridge to transplantation or recovery in patients with end-stage heart failure. Early survival after the treatment remains at a satisfactory level. The main problem is the large number of complications related to the therapy. PMID: 26702278 [PubMed]