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Single-center experience of the bridge-to-bridge strategy using the Nipro paracorporeal ventricular assist device
AbstractCurrently, we use the Nipro paracorporeal VAD (p-VAD) for initial short-term ventricular support, as a bridge to decision (BTD) or a bridge to candidacy (BTC) treatment, in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 and 2 patients. However, it is possible that compared to patients with primary implantable-VADs (P-iVAD), the bridge-to-bridge (BTB) patients are more likely to develop complications. This retrospective study used data from 24 consecutive BTB patients who were initially implanted with Nipro p-VAD as BTD or BTC treatments between April 2011 and March 2016, and...
Source: Journal of Artificial Organs - June 25, 2018 Category: Transplant Surgery 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

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 gastrointesinal bleeding are among 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.
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 Tags: Case Anecdotes, Comments and Opinions 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

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

4D Flow MRI in 3D Printed Models of Aorta Grafted With a Ventricular Assist Device Allows Detailed Embolic Trajectory Analysis
Embolic stroke remains an important source of morbidity and mortality in heart failure patients treated with Ventricular Assist Devices (VADs). Decreasing the probability of cranial versus descending aortic embolic trajectory by optimizing the VAD outflow graft position and terminal curvature angle could reduce embolic stroke risk. The goal of this study is to investigate particle trajectories released by a VAD into the aorta, and the effect changes in outflow graft insertion site and terminal curve have on those trajectories.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: O. Amili, F. Coletti, R. MacIver 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

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

Hospitalizations for cardiovascular disease after liver transplantation in the United States
Conclusions: CVD after liver transplant is evolving and responsible for growing rates of inpatient care. Transplant hospitals are associated with poor outcomes, even after risk adjustment for patient and hospital characteristics, which may be attributable to selective referral of certain patient phenotypes, but could also be related to differences in quality of care. Further study is warranted. This article is protected by copyright. All rights reserved.
Source: Liver Transplantation - March 15, 2018 Category: Transplant Surgery Authors: Narjeet S. Khurmi, Yu ‐Hui Chang, D. Eric Steidley, Andrew L. Singer, Winston R. Hewitt, Kunam S. Reddy, Adyr A. Moss, Amit K. Mathur Tags: Original Article 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

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

Outcomes of Berlin Heart EXCOR ® pediatric ventricular assist device support in patients with restrictive and hypertrophic cardiomyopathy
This study reviews the North American experience with Berlin Heart EXCOR® ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was reviewed. Patients with primary diastolic dysfunction are included in this study. Twenty pediatric patients with restrictive cardiomyopathy (n = 13), hypertrophic cardiomyopathy (n = 3), or congenital heart disease with restrictive physiology (n = 4) who were supported with EXCOR® were identified. Of these, nine (45%) were successfully bridged to transplant, one (5%) weaned from support, and 10 (50%) died after support was withdrawn. Of...
Source: Pediatric Transplantation - September 1, 2017 Category: Transplant Surgery Authors: Jennifer A. Su, Jondavid Menteer Tags: ORIGINAL ARTICLE Source Type: research

Readmissions after continuous flow left ventricular assist device implantation
AbstractContinuous flow left ventricular assist device (CF-LVAD) therapy has improved the survival of patients with advanced heart failure. However, the readmission rate of CF-LVAD patients is still relatively high. A total of 90 patients who received CF-LVADs between April 2011 and March 2016 at our institute and were discharged home were analyzed retrospectively. They were followed up through March 2017. Clinical data, including frequency, length and etiology of readmission, were obtained from medical records. The mean observation period after initial discharge was 713  ± 322 days. In total, 73 patients (81%) had 236...
Source: Journal of Artificial Organs - July 27, 2017 Category: Transplant Surgery 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

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