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Specialty: Transplant Surgery
Condition: Bleeding
Procedure: Heart Transplant

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Total 53 results found since Jan 2013.

Can the intermittent low-speed function of left ventricular assist device prevent aortic insufficiency?
In this study, the Jarvik 2000 device, which is programmed to reduce the pump speed each minute for 8  s, was chosen to examine this potential effect. Prospectively collected data of 85 heart transplant-eligible Jarvik 2000 recipients who met the study criteria (no pre-existing AI and aortic valve surgery) were retrospectively analyzed for the incidence, correlating factors, and clinical outcomes o f de novo AI. All data were provided by the Japanese Registry for Mechanically Assisted Circulatory Support. De novo AI occurred in 58 patients, 23 of whom developed at least moderate AI during a median support duration of 23.5...
Source: Journal of Artificial Organs - January 9, 2021 Category: Transplant Surgery Source Type: research

Blood Conservation Strategy at Time of Left Ventricular Assist Device Placement Improves Survival
Bleeding is the most common complication of left ventricular assist device (LVAD) placement. However, excessive transfusion has been linked to heart failure, stroke, and alloimmunization. We compared 90-day outcomes in patients receiving a blood conservation (BCS) versus liberal transfusion strategy during surgery and the subsequent 24 hours.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: K. Stawiarski, O. Agboola, J. Park, A. Mangi, A. Geirsson, F. Lee, D. Jacoby, L. Bellumkonda, T. Ahmad, J. Chou, J.M. Testani, M. Chen, G. McCloskey, P. Bonde Tags: (356) Source Type: research

Natural Antibodies and Left Ventricular Assist Device Complications
Left ventricular assist devices (LVAD) are widely used as a support strategy for advanced heart failure. Complications such as thrombosis and bleeding have been linked to LVAD. We observed that LVAD implantation was followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE) and apoptotic cells. 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 31, 2020 Category: Transplant Surgery Authors: S.B. See, D. Onat, E. Hittesdorf, F. McDougan, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, Y. Naka, H. Takayama, K. Takeda, G.P. Milligan, D. Wencker, S.A. Hall, M. Askar, P. Kimball, G. Wagener, P. Colombo, E. Zorn Tags: (1211) 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

Haemodynamic evaluation of the new pulsatile-flow generation method in vitro.
Abstract Continuous-flow ventricular-assist devices are widely used to support patients with advanced heart failure, because continuous-flow ventricular-assist devices are more durable, have smaller sizes and have better survival rates for patients compared to the pulsatile-flow ventricular-assist devices. Nevertheless, continuous-flow ventricular-assist devices often cause complications such as gastrointestinal bleeding, haemorrhagic stroke, and aortic insufficiency and have a negative impact on the microcirculation for both long-time implantable and short-time extracorporeal systems. The aim of this study is the...
Source: The International Journal of Artificial Organs - October 10, 2019 Category: Transplant Surgery Authors: Itkin GP, Bychnev AS, Kuleshov AP, Drobyshev AA Tags: Int J Artif Organs Source Type: research

Cessation of Anticoagulation for Bleeding and Thrombosis Events with a Fully Magnetically Levitated Centrifugal Left Ventricular Assist Device
Anticoagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 pump. Current anticoagulation guidelines target a goal INR of 2.0 –3.0 with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HeartMate 3 (HM3), have demonstrated a marked decrease in the incidence of pump thrombosis compared to mechanical bearing axial-f...
Source: The Journal of Heart and Lung Transplantation - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: Case Anecdotes, Comments and Opinions Source Type: research

Cessation of anti-coagulation for bleeding and subsequent thrombosis events with a fully magnetically levitated centrifugal left ventricular assist device
Anti-coagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 (HM3) pump. Current anti-coagulation guidelines target a goal international normalized ratio (INR) of 2.0 to 3.0, with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HM3, have demonstrated a marked decrease in the incidence of pump thrombosis compared w...
Source: The Journal of Heart and Lung Transplantation - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: CASE ANECDOTES, COMMENTS AND OPINIONS 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 Comparison of Middle Cerebral Artery and Central Retinal Artery Hemodynamics in HM II Patients
In the normal, pulsatile circulation, the hemodynamic pattern of the middle cerebral artery (MCA) differs from the central retinal artery (CRA). Whether continuous flow from a left ventricular assist device (LVAD) alters this relationship is not known. Since serious adverse events in different end-organs, such as stroke and GI bleeding, are frequent in LVAD patients, comparing hemodynamics in different arterial beds may enhance our understanding of the specific pathophysiology of these complications.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: E.J. St öhr, R. Ji, K. Akiyama, F. Castagna, A. Pinsino, J.R. Cockcroft, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, R.T. Te-Frey, H. Takayama, K. Takeda, Y. Naka, P.C. Colombo, J.Z. Willey, B.J. McDonnell Tags: 200 Source Type: research

A Trial of Complete Withdrawal of Anticoagulation Therapy in the Heartmate 3 Pump
The HeartMate 3 Left Ventricular Assist System has demonstrated absence of confirmed de-novo pump thrombosis and reduction in stroke. However, bleeding related adverse events persist under standard anticoagulation targeting a INR range of 2.0-3.0. In an initial experience we demonstrated safety of transition to low intensity anticoagulation (INR target 1.5-1.9, n=15, follow up of at least 6 months). Whether complete cessation of anticoagulation maintains “thromboresistance” in the HeartMate 3 pump remains unknown.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: I. Netuka, P. Ivak, Z. Tucanova, S. Gregor, O. Szarszoi, J. Rimsans, J. Connors, D. Crandall, P. Sood, M. Mehra Tags: 254 Source Type: research

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

Digoxin is Associated with Decreased Survival Free from Hemocompatibility-Related Adverse Events in LVAD Patients - A Propensity Score Matched Analysis
Hemocompatibility-related adverse events (HRAEs) (stroke, suspected pump thrombosis (sPT), gastrointestinal bleeding (GIB)) reduce survival and quality of life in LVAD pts. The association between pharmacotherapy and both HRAEs and survival is poorly characterized. We aimed to assess this association in HeartMate II (HMII) pts.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: A. Pinsino, A. Gaudig, K.L. Hoffman, D. D'Angelo, E.A. Royzman, G.M. Mondellini, F. Castagna, A.M. Zuver, A.R. Garan, H. Takayama, K. Takeda, Y. Naka, R.T. Demmer, M. Yuzefpolskaya, P.C. Colombo Tags: 397 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

Novel Oral Anticoagulants in Patients with Continuous Flow Left Ventricular Assist Devices
The gold standard for anticoagulation in patients with continuous flow left ventricular assist device (CF-LVADs) is warfarin. However, many patients fail warfarin therapy due to thromboembolic and bleeding events. Warfarin requires regular monitoring and dosage adjustments, and is associated with significant patient time outside recommended therapeutic INR range. Novel oral anticoagulation (NOAC) has been shown to be non-inferior compared to warfarin in stroke prevention with less intracranial hemorrhage in patients with atrial fibrillation.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: V. Parikh, U. Parikh, A.M. Ramirez, H. Lamba, J. George, S. Fedson, F. Cheema, A. Civitello, A. Nair, A. Shafii, G. Loor, T. Rosengart, O. Frazier, J. Morgan, R. Delgado Tags: 1072 Source Type: research

Comorbidities and Biomarkers Vary between United States and Japanese LVAD Patients
Left ventricular assist device (LVAD) outcomes differ between Japan and US. While GI bleeding is common in US and rare in Japan, stroke and driveline infections are more common in Japan than US. The aim of this study was to explore whether inflammatory and angiogenesis biomarkers can explain these differences.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: T. Imamura, A. Nguyen, D. Nitta, T. Fujino, L. Holzhauser, D. Rodgers, S. Kalantari, B. Smith, J. Raikhelkar, N. Narang, B. Chung, I. Ebong, C. Juricek, P. Combs, D. Onsager, T. Song, T. Ota, V. Jeevanandam, G. Kim, G. Sayer, M. Ono, N. Uriel Tags: 1065 Source Type: research