The Impact of Moderate Aortic Insufficiency on Exercise Capacity and Right Heart Failure During Left Ventricular Assist Device Supports
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Prolonged Organ Perfusion
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Hypothermic Ex Vivo Perfusion: Protecting the Donor Heart and the Recipient
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Extracorporeal Membrane Oxygenation as Salvage Therapy in the Peripartum Period: A Case Series
We report the successful use of extracorporeal membrane oxygenation in three cases of severe peripartum morbidity. The first case describes spontaneous coronary artery dissection supported with veno-arterial extracorporeal membrane oxygenation for refractory cardiogenic shock after out-of-hospital cardiac arrest. The second is a case of severe pregnancy-related liver disease bridged to emergency liver transplantation with veno-venous extracorporeal membrane oxygenation. Finally, we report the use of extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest in a postpartum patient. Peripartum extracorporeal...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Case Reports Source Type: research

Achieving Osmotic Stability in the Context of Critical Illness and Acute Kidney Injury During Continuous Renal Replacement Therapy
We report an illustrative case of a previously healthy 22 year old male presenting after prolonged ventricular fibrillation with 75 minutes of resuscitative efforts before regaining spontaneous perfusing rhythm. Central nervous system protecting hypothermia protocol and veno-arterious (VA) extracorporeal membrane oxygenator (ECMO) therapy were initiated at hospital admission due to refractory hypoxemia. Cardiovascular imaging procedures described global hypokinesis. Due to the combination of anuria, mixed acidosis and hemodynamic instability, we started continuous renal replacement therapy (CRRT) in continuous veno-venous ...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Case Reports Source Type: research

Comparison of Noninvasive and Invasive Blood Pressure Measurements in Patients with Intra-Aortic Balloon Pumps
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Brief Communication Source Type: research

Quantifying the Effect of Plasma Viscosity on In Vivo Dialyzer Performance
Dialyzer manufacturers characterize performance of their devices based on measurements of clearance using crystalloid solutions. Typically, in vitro dialyzer mass transfer area coefficients for urea (K0A) are substantially higher than values measured in vivo. The reason for this reduction has not been clearly determined. We hypothesized that the known effect of viscosity on reducing solute diffusivity might partially or fully account for this reduction. In vitro dialyzer clearances of urea, glucose, and lactate were measured using crystalloid solutions as well as bovine blood with varying hematocrit and plasma viscosity un...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Renal/Extracorporeal Blood Treatment Source Type: research

Predicting Survival of Adult Respiratory Failure Patients Receiving Prolonged (≥14 Days) Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO) for adult respiratory failure has significantly increased, with longer duration ECMO support required in severe hypoxemia. We sought to examine independent predictors of survival of adult respiratory failure patients requiring prolonged (≥14 days) ECMO. We reviewed Extracorporeal Life Support Organization Registry data on all adult (≥18 years) patients who required P- ECMO (n = 4,361) over 10 years (2009–2018). Hospital survival was 51.3%, increased from 45.4% in our prior report of 974 patients (1989–2013). Univariate analysis confirmed factors associated with d...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Pulmonary Source Type: research

Nitric Oxide Attenuates the Inflammatory Effects of Air During Extracorporeal Circulation
Cardiopulmonary bypass causes a systemic inflammatory response reaction that may contribute to postoperative complications. One cause relates to the air/blood interface from the extracorporeal circuit. The modulatory effects of blending nitric oxide (NO) gas into the ventilation/sweep gas of the membrane lung was studied in a porcine model of air-induced inflammation in which NO gas was added and compared with controls with or without an air/blood interface. Healthy swine were supported on partial bypass under four different test conditions. Group 1: no air exposure, group 2: air alone, group 3: air plus 50 ppm NO, ...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Pulmonary Source Type: research

Heparin-Free Extracorporeal Life Support Using Tethered Liquid Perfluorocarbon: A Feasibility and Efficacy Study
Coagulation management is the leading challenge during extracorporeal life support (ECLS) due to shear stress and foreign-surface–induced coagulation disturbance during circulation. A nonadhesive, liquid-infused coating called tethered liquid perfluorocarbon (TLP) was developed to prevent adhesion of blood on medical materials. We investigated the novel application of TLP to commercial ECLS circuits compared with standard heparin-coated circuits in vivo in anesthetized swine for 6 hours veno-venous ECLS (1 L/min blood flow) without systemic anticoagulation (n = 3/group). We hypothesized that TLP coating permit...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Pulmonary Source Type: research

The Effect of Additional Stepwise Venous Inflow on Differential Hypoxia of Veno-Arterial Extracorporeal Membrane Oxygenation
In conclusion, femoral-femoral VA ECMO can produce suboptimal coronary oxygenation in patients unable to tolerate one-lung ventilation. A left-to-right shunt using VAV ECMO can alleviate the differential hypoxia. (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Pulmonary Source Type: research

Tidal Flow Perfusion for the Artificial Placenta: A Paradigm Shift
The modalities of vascular access for the extracorporeal artificial placenta (AP) have undergone many iterations over the past decade. We hypothesized that single lumen cannulation (SLC) of the jugular vein using tidal flow extracorporeal life (ECLS) support is a feasible alternative to venovenous (VV) umbilical–jugular cannulation and double lumen cannulation (DLC) and can maintain fetal circulation, stable hemodynamics, and adequate gas exchange for 24 hours. After in vitro evaluation of the tidal flow system, six preterm lambs at estimated gestational age 118–124 days (term 145 days) were delivered and under...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research

Optimizing Postcardiac Transplantation Outcomes in Children with Ventricular Assist Devices: How Long Should the Bridge Be?
Ventricular assist devices (VADs) decrease waitlist mortality and improve end-organ function. Therefore, we sought to determine the duration of VAD support that could allow for optimal posttransplant outcomes. Pediatric transplant recipients were identified from the United Network for Organ Sharing database. Inflection points were determined using hazard of mortality associated with support time fitted by cubic spline method. Of 685 patients, those supported for>2 months had a significant decrease in inotrope use and mechanical ventilation and an increase in functional status compared with those supported for (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research

Meet the Authors
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Meet the Authors Source Type: research

Moderate Aortic Insufficiency with a Left Ventricular Assist Device Portends a Worse Long-Term Survival
In conclusion, moderate AI at 6 months post-LVAD implant is associated with worse long-term mortality. More aggressive management strategies targeting AI development in long-term LVAD patients may be warranted. (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Clinical Cardiovascular Source Type: research

Effect of Blood Group on Heart Transplant Waitlist Mortality in the Ventricular Assist Device Era
The effect of blood group on heart transplant list mortality in the era of continuous flow left ventricular assist devices (VADs) is unknown. We sought to examine mortality from the United Network for Organ Sharing (UNOS) database, with focus on mortality among VAD versus non-VAD recipients according to blood group. The UNOS database from 2007 to 2015 was evaluated to compare the rates of waitlist mortality or delisting for clinical worsening at 1-year postlisting among various blood types based on the presence or absence of durable continuous VAD. Patients with pulsatile VAD, temporary VAD, or with incomplete data were ex...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Left Ventricular Assist Device Inflow Cannula Insertion Depth Influences Thrombosis Risk
Left ventricular assist device (LVAD) use has continued to grow. Despite recent advances in technology, LVAD patients continue to suffer from devastating complications, including stroke and device thrombosis. Among several variables affecting thrombogenicity, we hypothesize that insertion depth of the inflow cannula into the left ventricle (LV) influences hemodynamics and thrombosis risk. Blood flow patterns were studied in a patient-derived computational model of the LV, mitral valve (MV), and LVAD inflow cannula using unsteady computational fluid dynamics (CFD). Hundreds of thousands of platelets were tracked individuall...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Clinical Significance of Early Hospital Readmission in Continuous-Flow Left Ventricular Assist Device Patients
Data on the clinical significance of early hospital readmission within 90 days following left ventricular assist device (LVAD) implantation in patients with continuous-flow LVAD are limited. We aimed to assess the incidence, predictors, and outcomes of 90-day readmission in LVAD patients. Hospital readmission or death was assessed within 90 days after hospital discharge in 177 patients with HeartMate II LVADs implanted between May 2008 and June 2014. Predictors of early readmission and risk of death were evaluated using multivariable Cox models following adjustment for clinical covariates. Hospital readmission or death rat...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Ex Vivo Heart Perfusion for 72 Hours Using Plasma Cross Circulation
Preservation of a donor heart for transplantation is limited to 6–8 hours. Based on our demonstration of 12 hour perfusion with plasma cross circulation, this study aimed to evaluate ex vivo heart perfusion (EVHP) for up to 72 hours using cross plasma circulation (XC-plasma) from a live, awake paracorporeal sheep (PCS). Six ovine hearts were perfused for 72 hours using plasma cross circulation at a rate of 1 L/min with a live, awake PCS. Controls were seven perfused hearts without cross circulation. Experiments were electively ended at 72 hours, and epinephrine (0.1 mg) was delivered to demonstrate horm...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

New Surgical Circulatory Support System Outcomes
We report the first U.S. experience of the recently approved micro-axial surgical heart pump for the treatment of ongoing cardiogenic shock following acute myocardial infarction (AMICGS), postcardiotomy cardiogenic shock (PCCS), cardiomyopathy including myocarditis, high-risk percutaneous coronary intervention (HRPCI), and coronary artery bypass surgery (HRCABG). Demographic, procedural, hemodynamic, and outcome data were obtained from the manufacturer’s quality database of all Impella 5.5 implants at three centers. Fifty-five patients underwent an Impella 5.5 implant for cardiomyopathy (45%), AMICGS (29%), PCCS (13%...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Food and Drug Administration Malfunction Recalls of Left Ventricular Assist Devices
Left ventricular assist devices (LVADs) are being increasingly implanted given the increasing prevalence of patients with advanced heart failure stages. However, they are not exempt from device malfunctions. A PubMed search for the key words (left ventricular assist device malfunction) (ventricular assist system malfunction) was performed. We identified 28 publications in the US Food and Drug Administration (FDA) website database that addressed LVAD malfunction. Twenty-nine FDA recalls were identified regarding LVAD malfunctions: 17 regarding HeartWare ventricular assist device, six for HeartMate II, three for HeartMate 3,...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Review Article Source Type: research

Veno-venous Extracorporeal Membrane Oxygenation Support in COVID-19 Respiratory Distress Syndrome: Initial Experience
We report on our preliminary institutional experience with COVID-19 patients receiving venovenous ECMO support. (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

Toward Precision Delivery of ECMO in COVID-19 Cardiorespiratory Failure
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

Extracorporeal Membrane Oxygenation in the Treatment of Severe Pulmonary and Cardiac Compromise in Coronavirus Disease 2019: Experience with 32 Patients
As coronavirus disease 2019 (COVID-19) cases surge worldwide, an urgent need exists to enhance our understanding of the role of extracorporeal membrane oxygenation (ECMO) in the management of severely ill patients with COVID-19 who develop acute respiratory and cardiac compromise refractory to conventional therapy. The purpose of this manuscript is to review our initial clinical experience in 32 patients with confirmed COVID-19 treated with ECMO. A multi-institutional registry and database was created and utilized to assess all patients who were supported with ECMO provided by SpecialtyCare. Data captured included patient ...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers
Disclaimer: The Extracorporeal Life Support Organization (ELSO) Coronavirus Disease 2019 (COVID-19) Guidelines have been developed to assist existing extracorporeal membrane oxygenation (ECMO) centers to prepare and plan provision of ECMO during the ongoing pandemic. The recommendations have been put together by a team of interdisciplinary ECMO providers from around the world. Recommendations are based on available evidence, existing best practice guidelines, ethical principles, and expert opinion. This is a living document and will be regularly updated when new information becomes available. ELSO is not liable for the acc...
Source: ASAIO Journal - June 27, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

Management of Aortic Insufficiency Using Transcatheter Aortic Valve Replacement in Patients with Left Ventricular Assist Device Support
We present three cases that developed moderate to severe AI while on HeartMate II (Abbott Laboratories, Chicago, IL) LVAD support; hence, TAVR procedure was performed. Patients A and B (74 year old and 38 year old) developed severe AI and patient C (67 year old) developed moderate AI with cardiogenic shock, after 368, 1,288, and 342 days on LVAD support, respectively. Their aortic valve annulus sizes were 24.2, 24.6, and 23.3 mm, respectively. Oversized Edwards SAPIEN 3 valves (Edwards, Lifesciences, Irvine, CA) were implanted via a transfemoral approach. The patients were hemodynamically stable after the procedure ...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Case Report Source Type: research

Cardiac Arrest Prior to Initiation of Veno-Venous Extracorporeal Membrane Oxygenation Is Not Associated with Increased In-Hospital Mortality
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Brief Communication Source Type: research

Removal of Urea, β2-Microglobulin, and Indoxyl Sulfate Assessed by Absorbance and Fluorescence in the Spent Dialysate During Hemodialysis
In this study, simultaneous removal assessment of marker molecules from three uremic toxin groups was performed during different hemodialysis treatment modalities using optical characteristics of spent dialysate. Results from optical measurements were compared with the results from chemical laboratory. Ten chronic dialysis patients, mean age 59 ± 15 years, were included in the study during 40 hemodialysis sessions. Low-flux hemodialysis (HD), high-flux hemodialysis (HF), and postdilutional online hemodiafiltration (HDF) with different settings were used. The reduction ratio (RR) and total removed solut...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Renal/Extracorporeal Blood Treatment Source Type: research

Practical Clinical Application of an Extracorporeal Carbon Dioxide Removal System in Acute Respiratory Distress Syndrome and Acute on Chronic Respiratory Failure
We retrospectively reviewed the medical records of 11 patients supported with a veno-venous low-flow extracorporeal carbon dioxide (CO2) removal (ECCO2R) device featuring a large gas exchange surface membrane lung (ML) (i.e., 1.8 m2). Seven patients suffered from exacerbation of a chronic pulmonary disease, while four subjects were affected by acute respiratory distress syndrome (ARDS). Twenty-four hours of ECCO2R treatment reduced arterial PCO2 from 63 ± 12 to 54 ± 11 mm Hg (p (Source: ASAIO Journal)
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Pulmonary Source Type: research

How Computational Modeling can Help to Predict Gas Transfer in Artificial Lungs Early in the Design Process
In this study, we applied our previously introduced micro-scale CFD model to the full fiber bundle of a small oxygenator for gas transfer prediction. Three randomized geometries as well as a staggered and in-line configuration were modeled and simulated with Ansys CFX. Three small laboratory oxygenator prototypes were built by stacking fiber segments unidirectionally with spacers between consecutive segments. The devices were tested in vitro for gas transfer with porcine blood in accordance with ISO 7199. The error of the predicted averaged CFD oxygen saturations of the random 1, 2, and 3 configurations relative to the ave...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Pulmonary Source Type: research

Bivalirudin Experience in a Heterogeneous Ventricular Assist Device Population
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 - May 30, 2020 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research

The Effects of Nitric Oxide in Oxygenator Sweep Gas During Extracorporeal Circulation in a Neonatal Ovine Model
In this study, we investigated the effects of nitric oxide (NO) added to the sweep gas of an extracorporeal circuit in a neonatal ovine model. Eight lambs (age 9.6 ± 1.9 days) were cannulated via the neck vessels and maintained on a pumpless arteriovenous extracorporeal membrane oxygenation circuit with blood flow restricted to 100 ml/min for 72 hours. All animals were heparinized, and a subset (n = 4) also received NO in the sweep gas at a concentration of 200 ppm. We observed no adverse effects from NO administration, and methemoglobin levels remained unchanged. Platelet counts signific...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Pediatric Circulatory Support Source Type: research

Time-Course of Physiologic Variables During Extracorporeal Membrane Oxygenation and Outcome of Severe Acute Respiratory Distress Syndrome
In patients undergoing extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS), it is unknown which clinical physiologic variables should be monitored to follow the evolution of lung injury and extrapulmonary organ dysfunction and to differentiate patients according to their course. We analyzed the time-course of prospectively collected clinical physiologic variables in 83 consecutive ARDS patients undergoing ECMO at a single referral center. Selected variables—including ventilator settings, respiratory system compliance, intrapulmonary shunt, arterial blood gases, central hemodynami...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Clinical Critical Care Source Type: research

Left Ventricular Assist Device Outflow Graft Obstruction: A Case Series
Dysfunction of different components within continuous-flow (CF) left ventricular assist device (LVAD) systems may cause adverse cardiovascular and end-organ sequelae. Outflow graft obstruction is a recognized type of LVAD component dysfunction. Ten patients were admitted and treated for LVAD outflow graft obstruction. Two of these patients subsequently developed recurrent outflow graft obstruction requiring reintervention; however, each reoccurrence was at a different site than the original obstruction. Thus, a total of 12 cases of obstruction were analyzed. The most common reasons for hospital admission were low flow LVAD...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Tracheostomy Is Safe During Extracorporeal Membrane Oxygenation Support
We report our experience with performing open and percutaneous tracheostomies on patients supported on ECMO from August 2009 to December 2017. Of the 127 patients who underwent tracheostomy during ECMO support, the median age was 42 years (interquartile range [IQR], 29–54), 99 (78%) patients had venovenous (VV) cannulation, 22 (17%) patients had venoarterial (VA) cannulation, and six (5%) patients had hybrid configurations. Percutaneous tracheostomy was performed in 110 (87%) patients. Median-activated partial thromboplastin time (aPTT) at the time of tracheostomy was 47.5 seconds (IQR, 41–57.6 seconds). The me...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Thalidomide Use Reduces Risk of Refractory Gastrointestinal Bleeding in Patients with Continuous Flow Left Ventricular Assist Devices
We report on 24 patients with recurrent AVM-associated GI bleeding who met criteria for and received thalidomide therapy, of which 17 had sufficient follow-up to be ultimately included for final analysis. We found the risk of rebleeding was significantly reduced in those on thalidomide therapy versus off (hazard ratio = 0.23, p = 0.022). The median number of GI bleeds per year was reduced from 4.6 to 0.4 (p = 0.0008) and the PRBC requirement was lower (36.1 vs. 0.9 units per year, p = 0.004) in those on thalidomide therapy. The adverse event rate with thalidomide was 59%, with symptoms resolution in most following dose red...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

In Vitro Hemocompatibility Evaluation of Modified Rotary Left to Right Ventricular Assist Devices in Pulmonary Flow Conditions
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

What Really Matters? Understanding Quality of Life Determinants Impacting Ventricular Assist Device Stakeholders
Through the examination of digital channels, this study explores the determinants impacting the quality of life (QoL) of ventricular assist devices (VAD) stakeholders. Using nonparticipant online ethnography and qualitative content analysis, data were collected from 56 digital channels (Facebook, blogs, Forum, Instagram, YouTube, and podcasts) designed for VAD stakeholders. Data were classified across existing domains of QoL determinants to identify 12 new QoL determinants which address VAD stakeholders’ specific needs. Inter-relationships between each stakeholder group’s QoL determinants were also identified a...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Meet the Authors
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Meet the Authors Source Type: research

Comparison of Neurologic Event Rates Among HeartMate II, HeartMate 3, and HVAD
Strokes remain a leading cause of morbidity and mortality in patients with ventricular assist devices (VADs). Varying study populations, event definitions, and reporting methods make direct comparison of neurologic event risk across clinical trials and registries challenging. We aim to highlight important differences among major VAD studies and standardize rates of neurologic events to facilitate a comprehensive and objective comparison. We systematically identified and analyzed key clinical trials and registries evaluating the HeartMate II (HMII), HeartMate 3 (HM3), and HVAD devices. Reported neurologic events were nonexc...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Adult Circulatory Support Source Type: research

Right Ventricular Failure Post-Implantation of Left Ventricular Assist Device: Prevalence, Pathophysiology, and Predictors
Despite advances in left ventricular assist device (LVAD) technology, right ventricular failure (RVF) continues to be a complication after implantation. Most patients undergoing LVAD implantation have underlying right ventricular (RV) dysfunction (either as a result of prolonged LV failure or systemic disorders) that becomes decompensated post-implantation. Additional insults include intra-operative factors or a sudden increase in preload in the setting of increased cardiac output. The current literature estimates post-LVAD RVF from 3.9% to 53% using a diverse set of definitions. A few of the risk factors that have been id...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Review Article Source Type: research

First Successful Treatment of Coronavirus Disease 2019 Induced Refractory Cardiogenic Plus Vasoplegic Shock by Combination of Percutaneous Ventricular Assist Device and Extracorporeal Membrane Oxygenation: A Case Report
The novel coronavirus severe acute respiratory syndrome coronavirus 2 is infecting hundreds of thousands of humans around the globe. The coronavirus disease 2019 (COVID-19) is known to generate mild as well as critical courses. Complications on the intensive care units include acute respiratory distress syndrome, acute cardiac, and kidney injury as well as shock. Here, we present the first case report of a successful treatment of a COVID-19 patient presenting with adult respiratory distress syndrome plus refractory combined cardiogenic and vasoplegic shock, which could be successfully stabilized after implantation of a per...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

COVID-19 Respiratory Failure: Targeting Inflammation on VV-ECMO Support
We present one of the first successful cases of VV-ECMO support to recovery of COVID-19 respiratory failure in North America. (Source: ASAIO Journal)
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

Contributory Role of Positron Emission Tomography in a Left Ventricular Assist Device Recipient at the Time of COVID-19 Pandemic
In this study, We report on the use of fluorine 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) scan examinations for detecting potential COVID-19 respiratory syndrome in asymptomatic left ventricular assist device (LVAD) recipients. Thus, extreme caution and thoughtful approaches should be taken for a timely detection in delicate LVAD populations, especially if patients are living in a high-density COVID-19-infected area, and the potential intention for LVAD treatment is bridge to transplantation. (Source: ASAIO Journal)
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO—A “Living Working Document”
The severe acute respiratory syndrome (SARS)-CoV-2 is an emerging viral pathogen responsible for the global coronavirus disease 2019 (COVID)-19 pandemic resulting in significant human morbidity and mortality. Based on preliminary clinical reports, hypoxic respiratory failure complicated by acute respiratory distress syndrome is the leading cause of death. Further, septic shock, late-onset cardiac dysfunction, and multiorgan system failure are also described as contributors to overall mortality. Although extracorporeal membrane oxygenation and other modalities of mechanical cardiopulmonary support are increasingly being uti...
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: Management of COVID-19 Patients Source Type: research

Learning Case by Case by Case(s)
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - May 30, 2020 Category: Medical Devices Tags: From the Editor’s Desk Source Type: research

Improving Outcomes on Destination Therapy Will Define the Future of Assist Devices
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - April 29, 2020 Category: Medical Devices Tags: Letters to the Editor Source Type: research

How to Achieve Successful Left Ventricular Assist Device Implantation
No abstract available (Source: ASAIO Journal)
Source: ASAIO Journal - April 29, 2020 Category: Medical Devices Tags: Letters to the Editor Source Type: research

Left Ventricular Assist Device Outflow Graft Pseudoaneurysm Treated with Covered Balloon Expandable Stent
Left ventricular assist device (LVAD) outflow graft injury is a very rare complication after LVAD implantation and is usually treated surgically. This is a case report of successful stenting of the damaged outflow graft 2.5 years after LVAD implantation, followed by successful heart transplantation. (Source: ASAIO Journal)
Source: ASAIO Journal - April 29, 2020 Category: Medical Devices Tags: Case Reports Source Type: research

Awake Neonatal Extracorporeal Membrane Oxygenation
In conclusion, in our experience, awake neonatal ECMO appears safe and effective and may offer significant advantages over traditional management in certain clinical scenarios. Prospective comparison trials are warranted to further investigate the clinical benefits and risks of awake neonatal ECMO. (Source: ASAIO Journal)
Source: ASAIO Journal - April 29, 2020 Category: Medical Devices Tags: Case Reports Source Type: research