A novel metrics to predict right heart failure after left ventricular assist device implantation
ConclusionAmongst available risk scores, EUROMACS-RHF performs best to predict the occurrence of RHF after LVAD implantation. Our model ’s performance compares well to the EUROMACS-RHF score, adding a more objective parameter to RV function evaluation. (Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - April 28, 2022 Category: Transplant Surgery Source Type: research
Three-year experience of catheter-based micro-axial left ventricular assist device, Impella, in Japanese patients: the first interim analysis of Japan registry for percutaneous ventricular assist device (J-PVAD)
AbstractCatheter-based micro-axial ventricular assist device Impella ® (Abiomed, Danvers, MA) has been used in Japanese patients with drug-refractory acute heart failure (AHF) since 2017. This is the first interim analysis of the ongoing Japan Registry for Percutaneous Ventricular Assist Device (J-PVAD) to investigate the safety and efficacy of Impella support. Betw een October 2017 and January 2020, 823 Japanese patients, who were treated with the Impella 2.5, CP, or 5.0 pump, were enrolled. The primary endpoints were safety profiles and cumulative 30-day survival. Among them, 44.8% of patients were acute myocardial infa...
Source: Journal of Artificial Organs - April 25, 2022 Category: Transplant Surgery Source Type: research
Sudden severe left ventricular assist device inflow cannula obstruction caused by huge thrombus after closure of mechanical aortic valve: case report
AbstractThrombus formation is a troublesome and sometimes lethal complication occurring in patients with severe heart failure and supported by a left ventricular assist device (LVAD). Appropriate treatment for pump thrombosis especially in emergency cases with severe pump failure is difficult to choose. Herein, we present important findings of a case of unexpected LVAD pump thrombosis that rapidly developed into serious pump failure and circulatory arrest due to total obstruction of the LVAD inflow tract by a huge thrombus. (Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - April 20, 2022 Category: Transplant Surgery Source Type: research
Development and initial performance of a miniature axial flow blood pump using magnetic fluid shaft seal
In this study, we developed a new catheter-mounted micro-axial flow blood pump (MFBP) using a new miniature magnetic fluid shaft seal (MFSS). The prototype of the catheter-mounted MFBP had a maximum diameter of 8 mm and a length of 50 mm. The new MFSS composed a neodymium magnet ring, an iron ring, and a magnetic fluid particularly designed for the MFSS. The new MFSS had outer and inner diameters of 4.0 mm and 2.6 mm, respectively, and a length of 3.0 mm. The sealing pressure of the MFSS was calculated to be 432 mmHg using FEM (Finite Element Method) result; therefore, the MFSS had sufficient sealing pressure for th...
Source: Journal of Artificial Organs - April 15, 2022 Category: Transplant Surgery Source Type: research
The effect of citrate in cardiovascular system and clot circuit in critically ill patients requiring continuous renal replacement therapy
AbstractWe aimed to evaluate the impact of citrate on hemodynamic responses and secondary outcomes, including the filter life span, metabolic complications, and levels of inflammatory cytokines, in critically ill patients who required CRRT compared with those who underwent the heparin-free method. This prospective, multicenter, open-label randomized trial compared regional citrate anticoagulation (RCA) with a heparin-free protocol in severe acute kidney injury (AKI) patients who received continuous venovenous hemodiafiltration (CVVHDF) in the postdilution mode. We measured hemodynamic changes using the FloTrac Sensor/EV100...
Source: Journal of Artificial Organs - April 12, 2022 Category: Transplant Surgery Source Type: research
Reconfiguration from veno-arterial to veno-arterio-venous extracorporeal membrane oxygenation for massive pulmonary embolism
AbstractDifferential hypoxia may occur after the initiation of femorofemoral veno-arterial extracorporeal membrane oxygenation (VA ECMO) if cardiac function improves while severe respiratory failure is still present, one of the most difficult problems encountered during VA ECMO. Reconfiguration to veno-arterio-venous ECMO (V-AV ECMO) is one of several methods of dealing with differential hypoxia. V-AV ECMO requires triple cannulation and careful management of the reinjection flow, but the risk of bleeding is lower than in a surgical procedure, such as central ECMO or a subclavian artery graft. Herein, we reported a patient...
Source: Journal of Artificial Organs - April 4, 2022 Category: Transplant Surgery Source Type: research
The red blood cell damage after long-term exposure to shear stresses
AbstractArtificial cardiovascular devices, such as vascular stents, artificial valves, and artificial hearts, can rebuild human cardiovascular functionalities via rebuilding the blood flow passing through these devices. To evaluate the red blood cells (RBCs) damage induced by a non-physiological blood flow in these devices, many hemolysis models have been proposed, of which the most popular one is a power function model. However, it was found that the newly obtained experimental data often did not match the existing power function model. In addition, the experimental period was usually short and the summarized power functi...
Source: Journal of Artificial Organs - March 28, 2022 Category: Transplant Surgery Source Type: research
Hypothermic circulatory arrest does not induce coagulopathy in vitro
This study aimed to clarify the impact of hypothermia on coagulation by eliminating clinical biases in vitro. In the hypothermic storage study, blood samples from five healthy volunteers were stored at 37 ℃ (group N) for 3 h or at 20 ℃ for 2 h, followed by 1 h of rewarming at 37 ℃ (group H). Thromboelastography was performed before and after 3 h of storage. In the mock circulation loop (MCL) study, blood samples were placed in the MCL and (a) maintained at 37 ℃ for 4 h (group N,n = 5), or (b) cooled to 20 ℃ to simulate HCA with a 0.1 L/min flow rate for 3 h and then rewarmed to 37 ℃ (group H,n...
Source: Journal of Artificial Organs - March 18, 2022 Category: Transplant Surgery Source Type: research
Novel substitution technique in intermittent infusion hemodiafiltration (I-HDF) therapy using back filtration as substitution
AbstractAn infusion of dialysate into the blood compartment across the membrane using back filtration in dialysis therapy provides a stabilizing blood pressure and a membrane flushing during treatment. We devised a method to flush the membrane effectively and tried to find the optimum infusion patterns for intermittent infusion hemodiafiltration (I-HDF) from the aspect of solute removal by computing the pressure distribution in a diafilter. Bovine blood experiments were performed under following three modes: control HD in which no intentional filtration was involved, and two I-HDF in which back filtration was made either u...
Source: Journal of Artificial Organs - March 18, 2022 Category: Transplant Surgery Source Type: research
Comprehensive analysis of cytokine adsorption properties of polymethyl methacrylate (PMMA) membrane material
In this study, we comprehensively analyzed the adsorption of 48 different cytokines in human plasma to PMMA and polysulfone (PS) membranes. Seventy-nine percent (38/48) of the cytokines were adsorbed more efficiently to the PMMA membrane than the PS membrane, which indicates that the PMMA membrane has high cytokine adsorption ability. The adsorption rate tended to be higher for the cytokines with lower molecular weight, and there was a significant correlation between the molecular weight of the cytokines and the adsorption rates. Electron microscopy showed that the PMMA hollow fiber membrane had a uniform internal structur...
Source: Journal of Artificial Organs - March 17, 2022 Category: Transplant Surgery Source Type: research
Impella 5.0 support as a bridge to the exchange of an infected left ventricular assist device
AbstractA pump infection is a fatal complication specific to left ventricular assist devices. Infection recurrence is a major concern when device exchange is indicated for pump infection. In the present case, we used the Impella 5.0 to maintain proper hemodynamics and to treat the infection in the absence of an implantable device. We demonstrate that the Impella 5.0 can serve as an effective bridge for device exchange by controlling infection and minimizing organ dysfunction, despite prolonged management. (Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - March 16, 2022 Category: Transplant Surgery Source Type: research
A case of successful bedside cannulation with a bicaval dual-lumen cannula guided by transthoracic echocardiography and mobile X-ray for veno-venous extracorporeal membrane oxygenation
(Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - March 9, 2022 Category: Transplant Surgery Source Type: research
Simultaneous electrical online estimation of changes in blood hematocrit and temperature in cardiopulmonary bypass
AbstractTwo equations have been developed from multi-frequency measurements of blood impedanceZb for a simultaneous electrical online estimation of changes in blood hematocritΔH [%] and temperaturesΔT [K] in cardiopulmonary bypass (CPB).Zb of fixed blood volumes at varyingH andT were measured by an impedance analyzer and changes in blood conductivityσb and relative permittivityεb computed. Correlation analysis were based on changes inσb withH orT atf = 1 MHz whileH andT equations were developed by correlating changes inεb withH andT at dual frequencies off = 1 MHz andf = 10 MHz which best capture blood...
Source: Journal of Artificial Organs - March 7, 2022 Category: Transplant Surgery Source Type: research
Biodesign program introduction in Japan: promotion of entrepreneurship and viewpoints of education on medical technology innovation
This study aimed to (1) show the outcomes of leadership talent development, (2) indicate the educational results of the program, and (3) objectively analyze the ways in which the program executed in Japan, effectively promoted entrepreneurship orientation and the origination of new businesses. The latter is especially relevant as Japan has low entrepreneurial awareness and new business entry rates compared to the United States and Europe. Herein, fellows were subjected to questionnaires, interviews, and a survey based on academic papers, extant literature, and treatises issued by the Nihon Biodesign Gakkai (Academic Societ...
Source: Journal of Artificial Organs - March 3, 2022 Category: Transplant Surgery Source Type: research
Preliminary report of de novo adipogenesis using novel bioabsorbable implants and image evaluation using a porcine model
AbstractOur bioabsorbable poly-l-lactic acid (PLLA) mesh implants containing collagen sponge are replaced with adipose tissue after implantation, and this is an innovative method for breast reconstruction. In this preliminary study, we investigated the formation of adipose tissue and evaluated the process via multimodal images in a porcine model using an implant aggregate to generate the larger adipose tissue. The implant aggregate consists of PLLA mesh implants containing collagen sponge and a poly-glycolic acid woven bag covering them. We inserted the implant aggregates under the porcine mammary glands. Magnetic resonanc...
Source: Journal of Artificial Organs - March 2, 2022 Category: Transplant Surgery Source Type: research
