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Carotid Artery Blood Flow and Its Association with Stroke during Left Ventricular Assist Device Support
Left ventricular assist device (LVAD) surgery is a life-prolonging therapy for advanced heart failure (HF). Despite many improvements over the years, LVADs continue to be associated with a high incidence of stroke and other vascular complications such as gastrointestinal bleeding (GIB). At present, the pathogenesis of these complications during LVAD support remains unclear. Abnormal structure and hemodynamics in large arteries are a potential contributor. We hypothesized that structural abnormalities and flow alterations will be significantly associated with stroke and a composite outcome of stroke, GIB, and death in HF pa...
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: M.E. Kiyatkin, A.M. Zuver, A. Gaudig, M. Tiburcio, B.J. McDonnell, M. Yuzefpolskaya, P.C. Colombo, E.J. St öhr, J.Z. Willey Tags: 401 Source Type: research

Elevated Outpatient C-Reactive Protein Independently Predicts Stroke and Gastrointestinal Bleeding in LVAD Patients
Inflammation and congestion may contribute to stroke and gastrointestinal bleeding (GIB) in LVAD pts. C-Reactive Protein (CRP), erythrocyte sedimentation rate (ESR), and N-terminal-pro B-type natriuretic peptide (NT-proBNP) are established biomarkers of inflammation and congestion. We aimed to investigate the association of these biomarkers with stroke and GIB in LVAD pts who survived to their first outpt visit.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: Y. Brailovsky, A. Javaid, G.M. Mondellini, L. Braghieri, M. Tiburcio, N. Uriel, G.T. Sayer, V.K. Topkara, K. Takeda, Y. Naka, R.T. Demmer, M. Yuzefpolskaya, P.C. Colombo Tags: (996) Source Type: research

CHA2DS2-Vasc and HAS-BLED Scores as Predictors of Ischemic and Hemorrhagic Stroke Risk After Left Ventricular Assist Device Implantation
CHA2DS2-VASc score predicts thromboembolic event risk and HAS-BLED score predicts major bleeding risk in patients on anticoagulation with atrial fibrillation. We aimed to evaluate if these scoring systems would be predictive of ischemic stroke and intracranial bleeding complications following continuous-flow left ventricular assist device (CF-LVAD) implantation.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: H.S. Kemal, S. Ertugay, S. Nalbantgil, M. Zoghi, C. Engin, T. Yagdi, M. Ozbaran Source Type: research

Increased Aortic Stiffness is Associated with Higher Rates of Stroke, GI-bleeding and Pump Thrombosis in Continuous-Flow Left Ventricular Assist Device Patients
In the general population, increased aortic stiffness (kAo) is associated with risk of cardiovascular events. Continuous-flow left ventricular assist device (CF-LVAD) pts have been reported to have increased kAo. The association between kAo and common adverse events (AEs), including stroke, gastrointestinal bleed (GIB) and pump thrombosis (PT) are unknown in CF-LVAD pts.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: H. Rosenblum, A. Pinsino, R.T. Demmer, P.C. Colombo, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, A. Gaudig, M.T. Pineda, Y. Naka, H. Takayama, K. Takeda, F. Castagna, J.Z. Willey, B.J. McDonnell, J.R. Cockcroft, E.J. St öhr Source Type: research

Natural Antibodies and Left Ventricular Assist Device Complications
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 - March 16, 2019 Category: Transplant Surgery Authors: S.B. See, A. Pinsino, N. Kunimune, D. Onat, E. Hittesdorf, A.R. Garan, V.K. Topkara, N. Yoshifumi, H. Takayama, K. Takeda, P.C. Colombo, G. Wagener, M. Yuzefpolskaya, E. Zorn Tags: 606 Source Type: research

Anti-Coagulation Management in Pediatric Ventricular Assist Device: A Quality Improvement Target
This report describes baseline AC data from ACTION centers, including agents used and aggregate levels of performance, to inform development of specific interventions.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: C. VanderPluym, M. O'Connor, A. Lorts, M. Ploutz, D. Peng, S. Law, M. Zinn, R. Niebler, D. Rosenthal, J. Conway, S. Auerbach, D. Sutcliffe, M. Mehegan Tags: 29 Source Type: research

A Comparative Analysis of Long-Term Outcomes in the MOMENTUM 3 Pivotal Trial and Continued Access Protocol Post-Approval Study Phase: A Study of over 1500 HeartMate 3 Implants
The MOMENTUM 3 pivotal trial conducted from 2014 to 2018 evaluated safety and effectiveness of the HeartMate 3 (HM3) left ventricular assist system (LVAS) compared to the HeartMate II pump. The trial demonstrated superiority of the HM3 LVAS for the primary endpoint of survival free of disabling stroke or reoperation to replace a malfunctioning pump at 2-years. HM3 LVAS superiority was due to improved hemocompatibility with near-elimination of device thrombosis, halving of stroke rates, and a decrease in gastrointestinal bleeding rates compared to the control device.
Source: The Journal of Heart and Lung Transplantation - March 20, 2021 Category: Transplant Surgery Authors: M.R. Mehra Tags: (4) Source Type: research

Protein Biomarkers Predict Risk of Gastrointestinal Bleeding in Left Ventricular Assist Device Patients
This study aims to assess the validity of these biomarkers in predicting the incidence of stroke or GIB in LVAD recipients.
Source: The Journal of Heart and Lung Transplantation - April 1, 2022 Category: Transplant Surgery Authors: K. Cavallo, M. Kanwar, G. Diao, S.S. Sinha, R. Singh, D. Tang, I. Isseh, J. Brocious, P. Bagchi, D. Crandall, D.J. Farrar, S. Murali, J. Walenga, J. Lindenfeld, C. deFilippi, P. Shah Tags: (115) Source Type: research

Gastrointestinal bleeding and subsequent risk of thromboembolic events during support with a left ventricular assist device
Background: Modern left ventricular assist devices (LVAD) require anti-coagulation (AC) with warfarin and anti-platelet therapy to prevent thromboembolic complications in patients. Gastrointestinal bleeding (GI) is a significant adverse event in these patients and treatment typically requires reduction or elimination of AC or anti-platelet therapy. It is not known whether alterations in AC to treat GI bleeding influence subsequent risk of thromboembolic (TE) events during LVAD support.Methods: Between July 2003 and September 2011, 389 patients (308 male) underwent implantation of a continuous-flow LVAD at the University of...
Source: The Journal of Heart and Lung Transplantation - September 9, 2013 Category: Transplant Surgery Authors: John M. Stulak, Dustin Lee, Jonathon W. Haft, Matthew A. Romano, Jennifer A. Cowger, Soon J. Park, Keith D. Aaronson, Francis D. Pagani Tags: Featured Articles Source Type: research

Low-molecular-weight heparin for anti-coagulation after left ventricular assist device implantation
Conclusions: LMWH in the setting of LVAD shows rapid and constant biologic efficacy. Anti-coagulation with LMWH appears feasible after LVAD implantation. These findings support further evaluation of LMWH as an alternative to unfractionated heparin in this patient cohort.
Source: The Journal of Heart and Lung Transplantation - October 28, 2013 Category: Transplant Surgery Authors: Sigrid E. Sandner, Julia Riebandt, Thomas Haberl, Stephane Mahr, Angela Rajek, Heinrich Schima, George M. Wieselthaler, Guenther Laufer, Daniel Zimpfer Tags: Featured Articles Source Type: research

Association between cell-derived microparticles and adverse events in patients with nonpulsatile left ventricular assist devices
Background: Continuous-flow left ventricular assist devices (LVADs) expose blood cells to high shear stress, potentially resulting in the production of microparticles that express phosphatidylserine (PS+) and promote coagulation and inflammation. In this prospective study, we attempted to determine whether PS+ microparticle levels correlate with clinical outcomes in LVAD-supported patients.Methods: We enrolled 20 patients undergoing implantation of the HeartMate II LVAD (Thoratec Corp, Pleasanton, CA) and 10 healthy controls who provided reference values for the microparticle assays. Plasma was collected before LVAD implan...
Source: The Journal of Heart and Lung Transplantation - January 21, 2014 Category: Transplant Surgery Authors: Angelo Nascimbene, Ruben Hernandez, Joggy K. George, Anita Parker, Angela L. Bergeron, Subhashree Pradhan, K. Vinod Vijayan, Andrew Civitello, Leo Simpson, Maria Nawrot, Vei-Vei Lee, Hari R. Mallidi, Reynolds M. Delgado, Jing Fei Dong, O.H. Frazier Tags: Featured Articles Source Type: research

Post-approval study of a highly pulsed, low-shear-rate, continuous-flow, left ventricular assist device, EVAHEART: A Japanese multicenter study using J-MACS
Conclusions: The EVAHEART device provides safe, reliable and long-term circulatory support with improved survival in commercial settings of BTT in Japan, where the transplant waiting period is much longer. Incidences of GI bleeding, hemolysis, right ventricular failure, device thrombosis and mechanical failure were extremely rare in patients on EVAHEART devices.
Source: The Journal of Heart and Lung Transplantation - March 6, 2014 Category: Transplant Surgery Authors: Satoshi Saito, Kenji Yamazaki, Tomohiro Nishinaka, Yuki Ichihara, Minoru Ono, Syunei Kyo, Takashi Nishimura, Takeshi Nakatani, Koichi Toda, Yoshiki Sawa, Ryuji Tominaga, Tadahisa Tanoue, Yoshikatsu Saiki, Yoshiro Matsui, Takahiro Takemura, Hiroshi Niinami Tags: Featured Articles Source Type: research

First Implantation in Man of a New Magnetically Levitated Left Ventricular Assist Device (HeartMate III)
Outcomes of heart failure patients supported by a continuous flow left ventricular assist device (LVAD) have steadily improved over the past decade due in large part to better patient selection and management 1,2. Nevertheless, adverse events such as bleeding, infection, stroke and thrombus persist and limit the overall effectiveness of this therapy. Bleeding is the most common serious adverse event that results from the extensive surgery required for implantation and blood component damage due to shear forces in the small blood flow paths of current design axial-flow and centrifugal-flow pumps.
Source: The Journal of Heart and Lung Transplantation - March 7, 2015 Category: Transplant Surgery Authors: Jan D. Schmitto, Jasmin S. Hanke, Sebastian V. Rojas, Murat Avsar, Axel Haverich Source Type: research

Temporal Distribution of Hematologic Complications During Berlin EXCOR Support
The Berlin Heart EXCOR trial demonstrated a high incidence of bleeding complications and stroke. Little is known, however, with regards to the timing of these events. The purpose of this study is to describe a single center experience with the Berlin EXCOR VAD, with a particular focus on the temporal distribution of these mutually related complications.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: S. Burki, D.H. Mahoney, A. Jeewa, W. Zhang, E. McKenzie, D.L. Morales, C.M. Mery, J.S. Heinle, C.D. Fraser, I. Adachi Source Type: research

Temporal Differences in Adverse Event Rates in Patients Bridged With the HeartWare Left Ventricular Assist Device
Left ventricular assist devices (LVAD) have significantly improved survival and quality of life in patients with advanced heart failure. However, these devices are associated with significant adverse events (AEs), particularly bleeding, infection, stroke and right heart failure. We sought to evaluate temporal differences in AE rates in patients bridged to transplantation.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: S. Maltais, K.D. Aaronson, J.J. Teuteberg, M.S. Slaughter, S.S. Najjar, V. Jeevanandam, D.T. Pham, E.C. McGee, K. Najarian, R.L. Kormos Source Type: research

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