National Trends in Utilization, Mortality, Complications, and Cost of Care After Left Ventricular Assist Device Implantation From 2005 to 2011.

National Trends in Utilization, Mortality, Complications, and Cost of Care After Left Ventricular Assist Device Implantation From 2005 to 2011. Ann Thorac Surg. 2015 Nov 14; Authors: Shah N, Agarwal V, Patel N, Deshmukh A, Chothani A, Garg J, Badheka A, Martinez M, Islam N, Freudenberger R Abstract BACKGROUND: Left ventricular assist devices (LVADs) have shown survival benefit in end-stage heart failure patients. LVAD technology has evolved considerably with the development of continuous-flow devices. METHODS: The Nationwide Inpatient Sample was queried from 2005 to 2011 using International Classification of Diseases, 9th Edition procedure code 37.66, Insertion of Implantable Heart System, in any procedure field. Patients with primary diagnosis of orthotopic heart transplant or use of temporary mechanical circulatory support devices were excluded. Procedural complications were identified using International Classification of Diseases, 9th Edition codes and patient safety indicators. Cochran-Armitage and Cuzick tests for trend were used to identify time trends for categorical and continuous variables, respectively. RESULTS: There were 2,038 LVAD implantations from 2005 to 2011. LVAD use increased from 127 procedures in 2005 to 506 procedures in 2011, and in-hospital mortality declined from 47.2% to 12.7% (p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research

Related Links:

ConclusionsVADs are an important staple in the treatment of patients with refractory HF. Log files provide a treasure-trove of information and knowledge that can be utilised for clinical benefit. Furthermore, log files provide an excellent tool for conducting research into device functionality. Current literature on the clinical utility of log files is sparse with much untapped potential.
Source: Indian Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Authors: Leebeek FWG, Muslem R Abstract Chronic heart failure (HF) is a growing health problem, and it is associated with high morbidity and mortality. Left ventricular assist devices (LVADs) are nowadays an important treatment option for patients with end-stage HF not only as a bridging tool to heart transplantation but also, as a permanent therapy for end-stage HF (destination therapy). The use of LVAD is associated with a high risk for bleeding complications and thromboembolic events, including pump thrombosis and ischemic stroke. Bleeding is the most frequent complication, occurring in 30% to 60% of patients, b...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Left ventricular assist devices (LVADs) offer live-saving therapy to transplant-ineligible heart failure patients. A major limitation of the technology includes pump thrombosis, bleeding, and recurrent infection that prove difficult to predict from in vivo animal testing. Shear stress introduced by the LVAD affects more than just haemolysis since platelets, leukocytes, and plasma proteins all contribute to the propensity for complications. It is important to assess overall damage by a new device against a base line as early as possible in the development process so that design iterations can be made if required.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
Authors: Eisen HJ Abstract Congestive heart failure is a major cause of morbidity and mortality as well as a major health care cost in the developed world. Despite the introduction of highly effective heart failure medical therapies and simple devices such as cardiac resynchronization therapy that reduce mortality, improve cardiac function and quality of life, there remains a large number of patients who do not respond to these therapies or whose heart failure progresses despite optimal therapy. For these patients, cardiac transplantation is an option but is limited by donor availability as well as co-morbidities w...
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J 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
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
There is little data outlining the use of outpatient inotropic medications in patients with existing left ventricular assist devices (LVADs). This case series explores this patient population and seeks to define the indications, complications, and safety of dual support. A retrospective chart review was conducted for all patients on LVAD and then subsequently started on home inotropes post device implant. Eight patients met inclusion criteria. The indications for inotropes were right ventricular failure, aortic insufficiency with biventricular failure, LVAD thrombosis with contraindication to device exchange, and cannula m...
Source: ASAIO Journal - Category: Medical Devices Tags: Case Reports Source Type: research
Background: While novel agents have allowed for successful outpatient treatment of patients with multiple myeloma (MM), multi-agent infusional chemotherapy regimens continue to have a role, particularly in high burden disease states. However, the use of platinum-based regimens is limited in patients with renal insufficiency and renal failure. We have been using a modified hyperCVAD regimen, termed HyperCD (Table 1), with omission of vincristine, and inclusion of a proteasome inhibitor (PI, either bortezomib or carfilzomib) in these aggressive clinical presentations for rapid tumor reduction. Here we present our experience ...
Source: Blood - Category: Hematology Authors: Tags: 653. Myeloma: Therapy, excluding Transplantation: Poster II Source Type: research
BECAUSE OF the donor organ shortage, an increasing number of patients with advanced heart failure are receiving ventricular assist devices (VADs) as a bridge to transplantation or as a destination therapy.1 Patients with advanced heart failure who receive a VAD have significantly greater survival rates compared with those who are treated with only medication.2 However, short- and long-term complications of VADs still are a major concern.3 There are perioperative risks attributed to patient comorbidities; risks of surgery and anesthesia; and postoperative risks such as bleeding, thrombosis, stroke, infection, right ventricu...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
Publication date: July 2018Source: Anaesthesia &Intensive Care Medicine, Volume 19, Issue 7Author(s): Guarang Vaidya, Barbora Parizkova, Emma J BirksAbstractMechanical support of the heart can be offered to patients who are refractory to pharmacological treatment, therapy for coronary or valvular disease or resynchronization therapy. Ventricular assist devices enable end-organ perfusion in the setting of heart failure. This can be temporary (as a bridge to recovery or transplantation) or permanent (destination therapy). Devices can be extracorporeal or implanted, and generated flows can be pulsatile or non-pulsatile. I...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
More News: Bleeding | Cardiology | Cardiovascular & Thoracic Surgery | Heart | Heart Failure | Heart Transplant | Thrombosis | Transplant Surgery | Transplants