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Left Ventricular Assist Devices vs. the Total Artificial Heart: Which Causes More Cerebrovascular Accidents?
More recently, the continuous flow left ventricular assist devices (LVADs) have been more commonly used in patients (pts) with severe left heart failure. However, these devices also have risk for strokes, both ischemic and hemorrhagic. The Total Artificial Heart (TAH) has also been used in patients with biventricular heart failure at our single institution. Both continuous flow LVADs and TAH patients are systemically anti-coagulated with warfarin and aspirin. We sought to compare stroke rates between the LVAD patients and TAH pts.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: C. Runyan, F. Arabia, L. Czer, M. Kittleson, E. Passano, F. Liou, J. Yabuno, H. Henry, D.H. Chang, J. Kobashigawa, J. Moriguchi Source Type: research

Effect of Preoperative Atrial Fibrillation on Clinical Outcomes After Continuous Flow-Left Ventricular Assist Device Therapy
Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia, often found in patients with heart failure requiring a ventricular assist device. Our goal was to assess the effect of preoperative AF on the risk of thromboembolic (TE) events (hemolysis, stroke and/or TIA), clinical outcomes and survival in patients receiving a continuous-flow left ventricular assist device (CF-LVAD).
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: E. Lushaj, S. Akhter, T. Kohmoto, L. Lozonschi, M. Murray, S. Osaki 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

Surgical occlusion of the left atrial appendage and thromboembolic complications in left ventricular assist device patients
Thromboembolic complications (TEC) are major adverse events for patients supported by left ventricular assist devices (LVADs). Despite anticoagulation, TEC such as stroke or pump thrombosis still occur in 6.5% of patients.1 Risk of TEC increases with longer duration of device support and is likely a greater risk in destination therapy patients. Surgical or percutaneous occlusion of the left atrial appendage (LAAO) reduces TEC in patients with atrial fibrillation.2,3 The LAA may also be a source of thromboembolism for systolic heart failure patients, even in sinus rhythm.
Source: The Journal of Heart and Lung Transplantation - January 29, 2017 Category: Transplant Surgery Authors: Rebecca S. Lewis, Lian Wang, Kateri J. Spinelli, Gary Y. Ott, Jacob Abraham Source Type: research

Surgical occlusion of the left atrial appendage and thromboembolic complications in patients with left ventricular assist devices
Thromboembolic complications (TECs) are major adverse events for patients supported by left ventricular assist devices (LVADs). Despite anti-coagulation, TECs such as stroke or pump thrombosis occur in 6.5% of patients.1 Risk of TECs increases with longer duration of device support, and the risk is likely greater in patients receiving LVADs as destination therapy. Surgical or percutaneous occlusion of the left atrial appendage (LAA) reduces TECs in patients with atrial fibrillation.2,3 The LAA may also be a source of thromboembolism for patients with systolic heart failure, including patients in sinus rhythm.
Source: The Journal of Heart and Lung Transplantation - January 29, 2017 Category: Transplant Surgery Authors: Rebecca S. Lewis, Lian Wang, Kateri J. Spinelli, Gary Y. Ott, Jacob Abraham Tags: Research Correspondence Source Type: research

Outcomes of Asian-Americans Undergoing Left Ventricular Assist Device Implantations as a Bridge to Transplant or Destination Therapy: An INTERMACS Analysis
Previous studies have demonstrated significant differences between Asians and Caucasian white populations in their propensity for stroke, coronary artery disease, heart failure, inflammation, bleeding and thrombosis. Therefore, we hypothesized that Asian Americans with end stage heart failure undergoing treatment with durable left ventricular assist devices (LVAD) exhibit a different morbidity and mortality risk profile when compared to non-Asian and white Americans populations.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: J.R. Wever Pinzon, W. Wang, N. Hu, R. Larsen, T. Yu, L. Yin, I. Taleb, A. Koliopoulou, S. Mckellar, J. Stehlik, J. Fang, A. Kfoury, C. Selzman, S. Drakos Source Type: research

The Treatment of Patients with Advanced Heart Failure Ineligible for Cardiac Transplantation with the HeartWare Ventricular Assist Device: Results of the ENDURANCE Supplement Trial
The ENDURANCE Trial previously demonstrated non-inferiority of the HeartWare centrifugal flow ventricular assist device system (HVAD) to the control HeartMate II (HMII) axial flow device in 445 end-stage heart failure patients ineligible for heart transplantation. However, the rate of strokes in the HVAD cohort was higher than expected. Analysis of early clinical trial data found that elevated mean arterial blood pressure (MAP) was a highly statistically significant independent risk factor for stroke events.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: C.A. Milano, J.G. Rogers, A.J. Tatooles, G. Bhat, M.S. Slaughter, E.J. Birks, N.A. Mokadam, C. Mahr, J.S. Miller, V. Jeevanandam, K. Leadley, K.D. Aaronson, F.D. Pagani Source Type: research

The Impact of Age, Sex, Therapeutic Intent, Race, and Severity of Advanced Heart Failure on Short-term Principal Outcomes in the MOMENTUM 3 Trial
Primary outcomes analysis of the MOMENTUM 3 trial short term cohort demonstrated a higher survival rate free of debilitating stroke and reoperation to replace/remove the device (primary endpoint) in patients receiving the HeartMate 3 (HM3) compared to the HeartMate (HMII). We sought to evaluate the individual and interactive effects of pre-specified patient subgroups (age, sex, race, therapeutic intent (BTT/BTC/DT) and severity of illness) on primary endpoint outcomes in MOMENTUM 3 patients implanted with HM3 and HMII.
Source: The Journal of Heart and Lung Transplantation - November 3, 2017 Category: Transplant Surgery Authors: Daniel J. Goldstein, Mandeep R. Mehra, Yoshifumi Naka, Christopher Salerno, Nir Uriel, David Dean, Akinobu Itoh, Francis D. Pagani, Eric R. Skipper, Geetha Bhat, Nirav Raval, Brian A. Bruckner, Jerry D. Estep, Rebecca Cogswell, Carmelo Milano, Lahn Fendel Source Type: research

Impact of age, sex, therapeutic intent, race and severity of advanced heart failure on short-term principal outcomes in the MOMENTUM 3 trial
In this study we sought to evaluate the individual and interactive effects of pre-specified patient subgroups (age, sex, race, therapeutic intent [bridge to transplant/bridge to candidacy/destination therapy] and severity of illness) on primary end-point outcomes in MOMENTUM 3 patients implanted with HM3 and HMII devices.
Source: The Journal of Heart and Lung Transplantation - November 3, 2017 Category: Transplant Surgery Authors: Daniel J. Goldstein, Mandeep R. Mehra, Yoshifumi Naka, Christopher Salerno, Nir Uriel, David Dean, Akinobu Itoh, Francis D. Pagani, Eric R. Skipper, Geetha Bhat, Nirav Raval, Brian A. Bruckner, Jerry D. Estep, Rebecca Cogswell, Carmelo Milano, Lahn Fendel Tags: Original Clinical Science Source Type: research

Early stroke post-heart transplant is associated with decreased survival in children
Over the past several decades significant advances in the management have improved the postoperative mortality with pediatric heart transplant (HTx) recipients now surviving for years after transplant surgery.1 –3 For most children with end-stage heart failure, transplantation is the only effective long term therapy, placing demands on the limited donor pool resulting in long waitlist time, particularly in infants.4 While waiting, mechanical circulatory support as a bridge to transplant often becomes a l ifesaving measure in these terminal heart failure patients.
Source: The Journal of Heart and Lung Transplantation - January 8, 2018 Category: Transplant Surgery Authors: Cheryl Cammock, Swati Choudhry, Chesney M. Castleberry, Noor Al-Hammadi, Pirooz Eghtesady, Charles E. Canter, Kathleen E. Simpson Source Type: research

A Co-Rhythmic, Isolable, Self-Maintenance, Assist (CoRISMA) Device for Class III Heart Failure
Mechanical circulatory support for class III heart failure will be acceptable if it is devoid of any adverse events associated with current LVAD devices. Long blood paths, lack of regular maintainence in a pump bathed in blood and tethered operation may account for some of the adverse events witnessed in current LVADs such as stroke, pump thrombosis and infections. An intra-cardiac device with ability to isolate and clean the interior of the pump, powered without driveline is presented.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J. Park, P. Bonde Source Type: research

PAPi Shows a Stronger Correlation With RAP versus RVSWI in Both HFrEF and HFpEF
This study compares the correlation of RAP with PAPi and RVSWI in patients with heart failure with reduced EF (HFrEF) and those with preserved EF (HFpEF).
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: N. Nair, S. Yang, C. Marzbani, L. Truong, E. Gongora Source Type: research

Quantifying the Devastation From Stroke During Support With Continuous Flow Pumps: An Intermacs Analysis
Strokes (S) during continuous flow (CF) left ventricular assist device (LVAD) support are a major barrier to extension of the therapy to less ill ambulatory heart failure (HF) patients. We analyzed the incidence, outcome, and impact of major S in the INTERMACS database.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.K. Kirklin, D.C. Naftel, S.L. Myers, F.D. Pagani, L.W. Stevenson, R.L. Kormos, P.C. Colombo Source Type: research

First-in-Man Use of the MVAD Axial-Flow Pump: Long Term Outcome
The use of durable continuous-flow mechanical assist devices provides selected heart failure patients with both symptomatic and functional benefits; however, they are not without potential complications. Infection, thrombosis, stroke and GI bleeding are amongst the most commonly reported problems of left ventricular assist device (LVAD) therapy.1 –3 In addition, LVAD peripherals can be bulky and heavy for the patient to carry, causing joint stress, discomfort and reduced quality of life. Device miniaturization is one design trend that has enabled device implantation in patients with a broader range of body sizes, and whe...
Source: The Journal of Heart and Lung Transplantation - April 24, 2018 Category: Transplant Surgery Authors: Marian Urban, Anfrew Woods, Nicola Robinson-Smith, Guy MacGowan, Chandrika Roysam, Stephan Schueler Source Type: research

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