Trials and Tribulations: Neurologic Events on Centrifugal Ventricular Assist Device Support
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Interpreting Comparisons Between Clinical Trials
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Yes or No. Tolvaptan May Be a Potential Alternative to Loop Diuretics in Patients With Left Ventricular Assist Device
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Does Tolvaptan Have Any Therapeutic Roles in Patients With Left Ventricular Assist Device?
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Extracorporeal Carbon Dioxide Removal in the Management of Complex Bilateral Flail Chest Injury
Flail chest is an uncommon consequence of traumatic injury. Medical management includes mechanical ventilation for internal pneumatic stabilization. Control of respiratory drive is necessary to avoid paradoxical movement and impairment of recovery. Traditional approaches include sedation and neuromuscular blockade, but these measures are at odds with current trends of keeping patients awake and implementing active rehabilitation. We hypothesized that extracorporeal carbon dioxide removal (ECCO2R) would suppress the respiratory drive sufficiently to permit synchronous mechanical ventilation, allowing rib fracture healing in...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Case Reports Source Type: research

Acute Pump Thrombosis in the Early Postoperative Period After HeartMate 3 Implantation
We present a case of early thrombosis of the pump and outflow graft, necessitating acute pump and outflow graft replacement. A combination of low-flow episodes and subtherapeutic levels of anticoagulation was the most likely cause. (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Case Reports Source Type: research

Current Use and In-Hospital Outcomes of Mechanical Circulatory Support in HIV-Infected Patients: A Friend or a Foe?
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Brief Communication Source Type: research

QRS Shortens after Left Ventricular Assist Device Implantation
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Brief Communication Source Type: research

Confirming Distal Perfusion Catheter Position by Micro-bubbles in Patients on Peripheral Venoarterial Extracorporeal Membrane Oxygenation
We describe in this article a novel method to use micro-bubble ultrasound enhancing agents, which are commonly used for contrast echocardiography studies, to confirm DPC position at the bedside. The sequential appearance of the micro-bubbles in the popliteal artery and then popliteal vein by ultrasound after injection through the side port of the DPC confirms the proper DPC position. (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: How to do it Article Source Type: research

In Vivo Remodeling of an Extracellular Matrix Cardiac Patch in an Ovine Model
This study investigated the in vivo electrophysiologic, mechanical, and histological properties of an ECM patch used to repair a right-ventricular (RV) wall defect in a growing ovine model. A full-thickness, 2 × 2 cm RV defect was created in 11 juvenile sheep and repaired with an ECM patch. Longitudinal RV three-dimensional-electrical mapping, magnetic resonance imaging (MRI), and histological analysis were performed at 3, 6, 9, and 12 months. Three-dimensional mapping demonstrated consistent conduction across the patch with little to no difference in voltage, but conduction velocity was consiste...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Tissue Engineering/Biomaterials Source Type: research

Hemoadsorption does not Have Influence on Hemolysis During Cardiopulmonary Bypass
Cardiopulmonary bypass (CPB) induces hemolysis, which manifests as plasma free hemoglobin. We investigated in a post hoc analysis of a single-center, blinded, controlled study whether the use of a novel hemoadsorption device (CytoSorb, CytoSorbents Europe GmbH, Berlin, Germany) affects hemolysis during CPB. A total of 35 patients undergoing elective CPB surgery with an expected CPB duration of more than 120 min were included in the analysis. The hemoadsorption device was used in 17 patients (intervention group) and not used in 18 patients (control group). The primary outcome was differences of postoperative free hem...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Renal/Extracorporeal Blood Treatment Source Type: research

Marked Practice Variation in Antithrombotic Care with the Berlin Heart EXCOR Pediatric Ventricular Assist Device
The objective of this study is to characterize antithrombotic practice variation among North American pediatric ventricular assist device programs, in order to guide future research. In this descriptive cross-sectional study, a survey assessing antithrombotic (AT) practices was distributed by Berlin Heart Inc. to centers that implanted ≥1 EXCOR between January 2012 and January 2016. Practices were compared at high- versus low-volume centers. High volume was defined as ≥14 implants in this period. Seventeen of 38 centers (44.7%) participated; 4 were high volume. At half of all centers (9/17), ≤2 clinicians managed ...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research

Improved 6 Minute Walk Distance and Brain-Type Natriuretic Peptide After Continuous-Flow Ventricular Assist Device Placement in Children
Despite increasing continuous-flow ventricular assist device (CF-VAD) use in children, minimal data exist regarding the functional recovery and rehabilitation potential after device placement. We hypothesized that after CF-VAD implantation, children would demonstrate a time-limited improvement in 6 minute walk distance (6MWD) and brain-type natriuretic peptide (BNP). A retrospective cohort study of 27 patients was conducted, those (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research

Increased Stroke Risk in Children and Young Adults on Extracorporeal Life Support with Carotid Cannulation
Patients on extracorporeal life support (ECLS) are at risk for central nervous system (CNS) injury. One potentially modifiable risk factor is site of arterial cannulation in venoarterial (VA) ECLS, as in most cases one can choose the femoral or carotid artery. There is acute alteration in cerebral blood flow with carotid cannulation, potentially increasing the risk of stroke. Children may have lower risk of stroke with carotid cannulation compared with adults because of impaired cerebral circulation with aging. Our objective was to evaluate risk of stroke with carotid versus femoral cannulation and determine whether this d...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research

Trends in Extracorporeal Membrane Oxygenation Growth in the United States, 2011–2014
The use of extracorporeal membrane oxygenation (ECMO) has grown rapidly in recent years. We sought to describe the rate of ECMO use in the United States, regional variation in ECMO use, the hospitals performing ECMO, and the primary payers for ECMO patients. Detailed data were obtained using the Healthcare Cost and Utilization Project (HCUPnet) summaries of State Inpatient Databases from 34 participating states for the years 2011–2014. The ECMO rates over time were modeled, overall and within subcategories of age group, bed size, hospital ownership, teaching status, and payer type. During the study period, the overal...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Clinical Critical Care Source Type: research

Conduction Abnormalities Associated with Tricuspid Annuloplasty in Cardiac Transplantation
Prophylactic DeVega tricuspid annuloplasty (DVA) of the donor heart has been reported to improve tricuspid regurgitation (TR), renal dysfunction, and mortality in cardiac transplant recipients. This is the first study to investigate the electrical, as well as, hemodynamic effects of DVA during orthotopic heart transplantation (OHT). Electrocardiographic, echocardiographic, and hemodynamic data of 76 patients with DVA and 104 patients without DVA who underwent OHT between 2013 and 2017 at Columbia University Medical Center (New York, NY) were studied. Patients with DVA were older (56.5 ± 1.2 vs. 52.4&th...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Clinical Cardiovascular Source Type: research

Virtual Fitting and Hemodynamic Simulation of the EVAHEART 2 Left Ventricular Assist Device and Double-Cuff Tipless Inflow Cannula
Inflow malposition during surgery, postoperative pump migration, inflow obstruction, and right ventricular compression are major contributors to low flow and adverse events in patients with ventricular assist devices (VADs). These position abnormalities can lead to adverse events including ischemic stroke. To address these problems, we conducted a virtual anatomical fitting study and hemodynamic simulation on iterative cannula designs, resulting in the EVAHEART 2 with the novel double-cuff tipless (DCT) inflow cannula and smaller pump design. Anatomical fitting was based on computed tomography scans of six patients with he...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Biomedical Engineering Source Type: research

An Artificial Placenta Protects Against Lung Injury and Promotes Continued Lung Development in Extremely Premature Lambs
An artificial placenta (AP) utilizing extracorporeal life support (ECLS) could protect premature lungs from injury and promote continued development. Preterm lambs at estimated gestational age (EGA) 114–128 days (term = 145) were delivered by Caesarian section and managed in one of three groups: AP, mechanical ventilation (MV), or tissue control (TC). Artificial placenta lambs (114 days EGA, n = 3; 121 days, n = 5) underwent venovenous (VV)-ECLS with jugular drainage and umbilical vein reinfusion for 7 days, with a fluid-filled, occluded airway. Mechanical ventilation lambs (121 days, n = 5; 128 days, n = 5) underwen...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Biohybrid Source Type: research

Management of Antiplatelet Therapy During Continuous-Flow Left Ventricular Assist Device Support After Thrombotic Hemorrhagic Events
Hemorrhagic or thrombotic events are common complications in heart failure patients with continuous-flow left ventricular assist device (CF-LVAD) support. Aim of this study is to investigate the effect of change in antiplatelet therapy after thrombotic or hemorrhagic events in patients with CF-LVAD support. A total of 231 CF-LVAD patients were included in this study. Patients with CF-LVAD were categorized into three groups: (1) high antiplatelet regimen as control group (aspirin [ASA] 325 mg; n = 115), (2) low antiplatelet regimen (ASA 81 mg; n = 82), started after hemorrhagic complications, and (3) double an...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Obesity Is Associated with Driveline Infection of Left Ventricular Assist Devices
In patients with left ventricular assist devices (LVADs), the association of driveline infection (DLI) and body mass index (BMI) remains controversial. The aim of this study was to explore a potential correlation between BMI and DLI in the LVAD patient population. A retrospective, single-center study evaluated patients who underwent LVAD implantation between May 2012 and July 2016. Driveline infection was evaluated per Interagency Registry for Mechanically Assisted Circulatory Support established criteria. Of 222 included patients, 80% were male, the average age was 55 years, and the main underlying heart failure diagnosis...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Large Dual-Lumen Extracorporeal Membrane Oxygenation Cannulas Are Associated with More Intracranial Hemorrhage
Large dual-lumen veno-venous (VV) extracorporeal membrane oxygenation (ECMO) cannulas may increase venous pressure in the brain, contributing to intracranial hemorrhage (ICH). A retrospective cohort study was performed using the extracorporeal life support organization (ELSO) registry. Propensity score matching was used to control for confounding. The rate of ICH and rates of hemolysis, cannula complications, and mortality were compared between patients with a 27 French dual-lumen cannula and patients with a 31 French dual-lumen cannula. Seven hundred forty-four patients were included in the propensity score-matched cohort...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Impact of Change in Body Mass Index on Outcomes After Left Ventricular Assist Device Implantation in Obese Patients
Obesity could be a risk factor portending a poor prognosis after left ventricular assist device (LVAD) implantation. We sought to determine the impact of change in body mass index (BMI) on outcomes in obese patients supported by LVAD. Fifty-nine patients, who received LVAD between January 2010 and June 2015, with BMI ≥30 kg/m2 at the time of LVAD implantation, were retrospectively analyzed. Patients were divided into two groups based upon whether BMI after 6 months of device support decreased when compared with before. Thirty-eight patients who experienced decrease in BMI (group D) were compared with 21 patients ...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Survival and Functional Status After Bridge-to-Transplant with a Left Ventricular Assist Device
The use left ventricular assist devices (LVAD) as a bridge-to-transplant (BTT) has become a common modality to treat end-stage heart failure. We sought to examine the impact of BTT on long-term survival and quality of life after heart transplant. The population was all adult patients undergoing isolated heart transplantation in the United States between 2007 and 2017. Inclusion criteria covered BTT patients with a LVAD (only Heartmate II [HMII] or HeartWare Ventricular Assist System [HVAD]) and compared these with patients undergoing de novo heart transplantation. Our primary end-point was survival at 1, 2, and 5 years. Se...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Passive Leg Raising After Left Ventricular Assist Device Implantation
Left ventricular assist device (LVAD) implantation is a common procedure in patients with end-stage heart failure. Although optimal fluid management is essential for acceptable postoperative treatment, it is critical to identify which patients will benefit from fluid administration. Passive leg raising (PLR) is a validated dynamic method that predicts fluid responsiveness in patients with heart failure by inducing a transient increase in cardiac preload. We performed a prospective study on 20 consecutive patients who underwent PLR maneuvers after LVAD implantation. Left ventricular assist device flow, end-tidal carbon diox...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Anticoagulation Reversal and Risk of Thromboembolic Events Among Heart Transplant Recipients Bridged with Durable Mechanical Circulatory Support Devices
Anticoagulation reversal agents (ARAs) can minimize bleeding complications associated with mechanical circulatory support devices (MCSDs) explantation at the time of heart transplantation (HT); data on thromboembolic (TE) risk associated with ARAs are limited in this patient population. In this single-center study, we retrospectively analyzed 118 consecutive adults who were supported with durable MCSDs and underwent HT between May 2013 and October 2016. Patients were categorized based on intraoperative use of ARAs (recombinant factor VIIa [n=23], 4-factor prothrombin complex concentrate [n=48], or factor IX complex [n=2]) ...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Meet the Authors
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Meet the Authors Source Type: research

Clinical Outcomes of Impella Microaxial Devices Used to Salvage Cardiogenic Shock as a Bridge to Durable Circulatory Support or Cardiac Transplantation
Temporary mechanical circulatory support (MCS) can be a bridge to decision for patients in severe cardiogenic shock who may be eligible for durable support or transplantation. Outcomes with Impella microaxial devices for salvage of severe shock in the end-stage heart failure population are not well described. Patients who underwent Impella placement as a bridge to decision, durable MCS, or transplantation were included. Eighty Impella devices (2.5 [1.3%], CP [53.8%], and 5.0 [45.0%]) were placed in 64 patients. Implant age was 56.2 ± 12.5 years. Mean duration of assisted support was 13.2 ±...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Pediatric Femoral Arterial Cannulations in Extracorporeal Membrane Oxygenation: A Review and Strategies for Optimization
Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is a treatment strategy for pediatric patients with cardiopulmonary failure. Femoral cannulation is a commonly used technique for obtaining central access in children and adolescents despite high rates of vascular complications. Ischemic limb complications remain one of the most common problems facing survivors of femoral VA ECMO. Our aim is to review the literature on femoral cannulation in children and to present a review of techniques for femoral cannula placement, decannulation, and arterial repair to help minimize and ameliorate complications related to cann...
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Review Article Source Type: research

Extracorporeal Life Support and Increased Risk of Stroke with Carotid Cannulation: Maybe, Maybe Not
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - September 1, 2019 Category: Medical Devices Tags: Invited Commentary Source Type: research

Erratum
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Errata Source Type: research

Left Ventricular Ejection Fraction Depends on Loading Conditions
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

The Physiologic Basis of Ejection Fraction
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Left Ventricular Assist Device Outflow Graft Obstruction: A Complication Specific to Polytetrafluoroethylene Covering. A Word of Caution!
Pump thrombosis is an established complication of left ventricular assist devices (LVADs). Outflow graft obstruction has been previously described as one cause of LVAD thrombosis. We identified four cases of outflow graft obstruction that were attributed to a commonly applied polytetrafluoroethylene (PTFE) covering of the outflow graft. In this set of patients, the outflow graft was obstructed by a thrombus which formed between the outflow graft and its external PTFE covering, leading to impingement of the outflow graft. Patients typically presented after a median duration of 26 months (range 23–41 months) of support...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Case Reports Source Type: research

ECMO Flow as a Sign of Intraabdominal Hemorrhage After Prolonged CPR
Although life-saving, cardiopulmonary resuscitation (CPR) has been associated with traumatic injuries in adult patients surviving cardiac arrest. In addition to rib and sternal fractures, intraabdominal injuries have also been shown to occur, particularly after prolonged external cardiac massage. Early detection of these injuries remains difficult and is often masked by concomitant hemodynamic instability and the higher likelihood of other injuries such as retroperitoneal hemorrhage. Accurate diagnosis is further complicated when venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is instituted. As such, it is imp...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Case Reports Source Type: research

Discontinuation of Aspirin in Heartmate 3 Left Ventricular Assist Device
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Brief Communication Source Type: research

Optimal Methods to Secure Extracorporeal Membrane Oxygenation Bicaval Dual-Lumen Cannulae: What Works?
Ambulation while on extracorporeal membrane oxygenation (ECMO) is critical to facilitate native pulmonary recovery for patients with acute respiratory failure and is a prerequisite for listing for lung transplantation to achieve optimal outcomes. The development of a bicaval dual-lumen cannula capable of providing venovenous (VV) ECMO support via the internal jugular vein has greatly facilitated ambulation and rehabilitation programs. But cannula dislodgement is a serious concern with ambulation and rehabilitation, especially when minor cannula migration can significantly impact VV-ECMO flow. We review an optimal technique...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: How to do it Article Source Type: research

Hemostasis and Bone Regeneration Using Chitosan/Gelatin-BCP Bi-layer Composite Material
The aim of the study was to determine the hemostatic activity of a composite bi-layered topical hemostat composed of electrospun gelatin loaded with bi-phasic calcium phosphate and chitosan layer and its effect on bone formation. Morphology of the composite hemostat and its individual components were observed using scanning electron microscopy. In vitro biocompatibility of the topical hemostat tested using preosteoblasts cells (MC3t3-E1) showed no adverse toxicity. Confocal microscopy of seeded cells showed good cell adhesion while 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay indicated 15% incre...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Tissue Engineering/ Biomaterials Source Type: research

Fluid Balance and Recovery of Native Lung Function in Adult Patients Supported by Venovenous Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy
Fluid overload is associated with increased mortality in adult patients with acute respiratory distress syndrome. In patients requiring venovenous extracorporeal membrane oxygenation (VV-ECMO), the effects of fluid removal on survival and lung recovery remain undefined. We assessed the impact of early fluid removal in adult patients supported by VV-ECMO and concomitant continuous renal replacement therapy, in an 18-bed tertiary intensive care unit between 2010 and 2015. Twenty-four patients met inclusion criteria, of these 15 (63%) survived to hospital discharge. In our patient group, a more negative cumulative daily fluid...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Pulmonary Source Type: research

A Proof of Concept Study, Demonstrating Extracorporeal Carbon Dioxide Removal Using Hemodialysis with a Low Bicarbonate Dialysate
Extracorporeal carbon dioxide removal (ECCO2R) devices remove CO2 directly from blood, facilitating ultraprotective ventilation or even providing an alternative to mechanical ventilation. However, ECCO2R is not widely available, whereas dialysis is available in most intensive care units (ICUs). Prior attempts to provide ECCO2R with dialysis, by removing CO2 in the form of bicarbonate, have been plagued by metabolic acidosis. We hypothesized that bicarbonate dialysis is feasible, provided the plasma strong ion difference is maintained. We used a mathematical model to investigate the effects of bicarbonate removal on pH and ...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Pulmonary Source Type: research

Evaluation of 30 Day Readmissions After Index Ventricular Assist Device Implantation in the United States
Ventricular assist device (VAD) implantation has improved quality of life and short-term survival for advanced heart failure patients. There are limited data from single-center studies addressing the characteristics and etiologies of 30 day readmissions after VAD implant. We used the Nationwide Readmissions Database (NRD) 2014 to identify insertion of implantable heart assist system during index admission. Primary and secondary outcomes were 30 day readmissions and leading etiologies, respectively. We analyzed 1,481 patients who received VAD during the primary admission of whom 1,315 patients survived to hospital discharge...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Clinical Cardiovascular Source Type: research

Chronic In Vivo Test of a Right Heart Replacement Blood Pump for Failed Fontan Circulation
This study was the first successful test of a right heart replacement device in a chronic animal study. (Source: ASAIO Journal)
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Impact of Diabetes Mellitus on Survival in Patients Bridged to Transplantation with Left Ventricular Assist Devices in the United States
Diabetes mellitus (DM) is associated with increased mortality in advanced heart failure and in patients undergoing cardiac surgery. However, its impact on outcomes in patients supported with left ventricular assist devices (LVAD) is not well established. We queried the United Network for Organ Sharing (UNOS) for all adults listed for heart transplantation and bridged with continuous-flow LVAD in the United States from 2000 to 2015. We compared the pre- and post-transplant mortality of patients with and without DM. Unadjusted and adjusted time-event analyses were performed. A total of 4,978 patients were included in this an...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

LVAD Pulsatility Assesses Cardiac Contractility: In Vitro: Model Utilizing the Total Artificial Heart and Mock Circulation
In this study, therefore, we develop a translatable and effective predictive model characterizing pulsatility to determine HF status and potential HF recovery using the SynCardia Total Artificial Heart (TAH) in conjunction with a Donovan Mock Circulation System to create a simulation platform for the collection of pulsatility data. We set the simulation platform to patient conditions ranging from critical heart failure to a normal operating condition through the variation preload, afterload, and left ventricular (LV) pumping force or TAH “contractility.” By manipulating these variables, pulsatility was found to...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Impact of Cannula Size on Clinical Outcomes in Peripheral Venoarterial Extracorporeal Membrane Oxygenation
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is an effective mechanical circulatory support for cardiopulmonary failure. Conventionally, an arterial cannula over 15 Fr is inserted for full circulatory support in peripheral VA ECMO. However, limited data are available regarding the impact of cannula size on clinical and procedural outcomes. Between January 2014 and April 2016, 165 patients underwent peripheral VA ECMO with femoral artery cannulation were enrolled in a single-center registry. We classified patients into two groups according to the arterial cannula’s size: “small cannula group”...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Simulated Performance of the Cleveland Clinic Continuous-Flow Total Artificial Heart Using the Virtual Mock Loop
Our new Virtual Mock Loop (VML) is a mathematical model designed to simulate the human cardiovascular system and gauge performance of mechanical circulatory support devices. We aimed to mimic the hemodynamic performance of Cleveland Clinic’s self-regulating continuous-flow total artificial heart (CFTAH) via VML and evaluate VML’s accuracy versus bench data from our standard mock circulatory loop. The VML reproduced 23 hemodynamic conditions. Systemic/pulmonary vascular resistances and pump rotational speed were set for VML from bench test data. We compared outputs (pump flow, left/right pump pressure rise, norm...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Long-Term Continuous-Flow Left Ventricular Assist Device Support After Left Ventricular Outflow Tract Closure
Aortic valve insufficiency can be addressed during continuous-flow left ventricular assist device (CF-LVAD) implantation by performing aortic valve repair or replacement, or patch closure of the left ventricular outflow tract (LVOT). However, few studies have examined the safety of long-term CF-LVAD support after LVOT closure. From November 2003 through March 2016, 16 patients with advanced chronic heart failure underwent CF-LVAD implantation and concomitant LVOT closure for severe aortic insufficiency. We compared their long-term outcomes with those of 510 CF-LVAD recipients without concomitant LVOT closure. Total support...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Valvular Regurgitation in a Biventricular Mock Circulatory Loop
Aortic regurgitation (AR), mitral regurgitation (MR), and tricuspid regurgitation (TR) after continuous-flow left ventricular assist device (LVAD) are common and may increase with prolonged LVAD support. The aim of this study was to simulate severe valvular regurgitation (AR, MR, and TR) within a 4-elemental pulsatile mock circulatory loop (MCL) and observe their impact on isolated LVAD and biventricular assist device (BiVAD) with HeartWare HVAD. Aortic regurgitation, MR, and TR were achieved via the removal of one leaflet from bileaflet mechanical valve from the appropriate valves of the left or right ventricles. The impa...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Meet the Authors
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Meet the Authors Source Type: research

The Impact of Infection and Elevated INR in LVAD-Associated Intracranial Hemorrhage: A Case-Crossover Study
Despite the common occurrence left ventricular assist device (LVAD)–associated intracranial hemorrhage, the etiology of intracranial hemorrhage is uncertain. We aim to explore the impact of infection and international normalized ratio (INR) on intracranial hemorrhage in a case-crossover study. We reviewed consecutive patients with intracranial hemorrhage in a prospectively collected data of LVAD patients from a single, tertiary center from October 2004 to December 2016. Information on infection and INR values were collected at the time and 1 month before the intracranial hemorrhage as controls. Of 477 persons with LV...
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Highlights from the Extracorporeal Life Support Organization Registry: 2006–2017
This report provides a brief summary of 16 peer-reviewed articles that have advanced the knowledge and treatment of neonates, children, and adults supported with ECMO using data from the ELSO registry. (Source: ASAIO Journal)
Source: ASAIO Journal - July 30, 2019 Category: Medical Devices Tags: Review Article Source Type: research