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Source: The Journal of Heart and Lung Transplantation
Condition: Thrombosis

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Total 65 results found since Jan 2013.

A Tale of the Twist in the Outflow Graft: An Analysis from the MOMENTUM 3 Trial
Heralded as a significant step forward in the evolution of left ventricular assist systems (LVAS), the HeartMate 3 device (Abbott, Abbott Park, Il, USA) has demonstrated improved outcomes by averting de-novo intra-pump thrombosis leading to pump related malfunction, and in reducing the incidence of stroke events when compared with the axial flow HeartMate II LVAS.1,2,3,4 Moreover, the HeartMate 3 LVAS experience has reduced the vexing incidence of hemocompatibility related adverse outcomes.5,6,7 On the heels of these advances, intriguing reports began to surface of a twist within the outflow graft that caused disruption in...
Source: The Journal of Heart and Lung Transplantation - August 24, 2018 Category: Transplant Surgery Authors: Mandeep R. Mehra, Christopher Salerno, Yoshifumi Naka, Nir Uriel, Joseph C. Cleveland, Douglas Horstmanshof, Daniel J. Goldstein, for the MOMENTUM 3 Investigators Tags: Editorial 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

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

Predictive Value of Mean Arterial Pressure Versus Systolic Blood Pressure and Visit-To-Visit Blood Pressure Variability for Stroke and Pump Thrombosis in HeartMate II Patients
Elevated blood pressure (BP) in pts on left ventricular assist device (LVAD) support is a risk factor for adverse events (AEs) such as stroke and pump thrombosis (PT). Current guidelines recommend a mean arterial pressure (MAP) ≤ 80mmHg. Above-median systolic BP (SBP) at discharge after HeartMate II (HMII) implant has been associated with an increased risk of stroke. We sought to 1) compare the predictive value of outpt MAP and SBP on AEs, 2) examine the association of visit-to-visit variability (VVV) of BP with AEs in H MII pts.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: A. Pinsino, F. Castagna, J.Z. Willey, A.M. Zuver, M.A. Flannery, B. Cagliostro, J.R. Cockroft, A.R. Garan, V.K. Topkara, H. Takayama, K. Takeda, Y. Naka, R.T. Demmer, P.C. Colombo, M. Yuzefpolskaya Source Type: research

Risk Predictors for Ischemic Stroke in CF-LVAD Patients by Pump Flow Type
Risk of stroke continues to be a major adverse event post-LVAD implantation, limiting wider application and utility of the device. Even with aggressive blood pressure control, patients with LVADs are at higher risk of stroke due to combination of pump-dependent factors including loss of natural pulsatility, anticoagulation, and thrombosis risk from blood-pump interaction. We used a Bayesian Network machine-learning approach to derive comparative risk factors for ischemic stroke in patients with axial versus centrifugal flow pumps at 3 months post LVAD implant.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: M. Kanwar, L. Lohmueller, R. Kormos, S. Bailey, C. Mcilvennan, S. Murali, J. Antaki Source Type: research

Systolic Blood Pressure and Outcomes in Patients on Continuous Flow LVAD Support: An INTERMACS Analysis
High mean arterial pressures in continuous flow (cf) LVAD patients are associated with increased stroke and pump thrombosis risks. Optimal thresholds for systolic blood pressure are unknown.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.A. Cowger, T. Chamogeorgakis, J. Borgi, G. Grafton, Y. Selektor, H. Nemeh, C. Williams, C. Tita, D. Lanfear Source Type: research

Increased Pump Speed is Associated with Reduced Rates of Stroke on HeartMate II LVAD Support
Higher pump speeds have recently been associated with reduced rates of pump thrombosis in the HeartMate II LVAD population. Whether pump speed is associated with stroke has not been well established. In this analysis we use a single center cohort to determine the association with discharge speed and all-cause stroke.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.N. Schultz, R. Cogswell, M. Prtizker, E. Missov, K. Liao, J. Misialek, R. John Source Type: research

Prognostic Implications of Intermediate Hemolysis in Continuous Flow Left Ventricular Assist Device Patients
Hemolysis is an early marker of device thrombosis in pts on continuous flow left ventricular assist device (CF-LVAD). For pts with high levels of hemolysis (LDH>700 U/L) treatment with device exchange rather than medical therapy leads to improvement in stroke free survival. We aimed to investigate outcomes and optimal treatment (tx) strategies for outpts on CF-LVAD demonstrating intermediate levels of hemolysis (LDH 500-700 U/L).
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: H. Rosenblum, A. Pinsino, M. Gavalas, A. Zuver, K. Parikh, G. Parkis, M. Flannery, M. Mabasa, E.A. Royzman, A. Gaudig, A.R. Garan, V.K. Topkara, H. Takayama, K. Takeda, Y. Naka, M. Yuzefpolskaya, P.C. Colombo 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

Ischemic Stroke and Subsequent Thrombosis within a HeartMate 3 Left Ventricular Assist System: A Cautionary Tale
Introduction of the centrifugal continuous flow-pump, the Heartmate 3 Left Ventricular Assist System (LVAS) has been heralded with the unique observation that de-novo pump thrombosis has not been reported to occur with this device in the pivotal clinical trials.1,2 While engineering principles inherent in this LVAS obviate the initial development of thrombosis within the pump, they cannot protect against ingestion of thrombus or other circulating materials. Similarly, if such ingested material (or thrombus) remains trapped within the device and materially influences its function, it may set-up a nidus for propagation of th...
Source: The Journal of Heart and Lung Transplantation - November 6, 2017 Category: Transplant Surgery Authors: Ivan Netuka, Mandeep R. Mehra Source Type: research

Sildenafil Reduces Risk of Ischemic Stroke and Pump Thrombosis with Ongoing Low Level Hemolysis During Heart Mate II Support
Low level hemolysis after Heart Mate (HM) II implantation, as evident by an elevated discharge lactate dehydrogenase (LDH) level>400 U/L, is linked to subsequent thrombotic events. Free hemoglobin from ongoing hemolysis scavenges nitric oxide (NO) to create a NO deficiency which can augment platelet function. We hypothesized the potentiation of NO signaling during low level hemolysis with a phosphodiesterase-5 inhibitor, sildenafil, may lead to reduced thrombotic events.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: O. Saeed, S. Rangasamy, A. Luke, S.P. Patel, D.B. Sims, J. Shin, M. Reyes Gil, M.J. Slepian, H.H. Billett, D.J. Goldstein, U.P. Jorde 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

Low Dose tPA as a Therapeutic Strategy in Suspected Pump Thrombosis in HeartMate II
Tissue plasminogen activator (tPA) is a known treatment for DVT and thromboembolic stroke. Our study aim was to determine the safety and efficacy of a low dose tPA protocol in suspected pump thrombosis in HMII.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: A.S. Cruz-Solbes, M.I. Achi, J. Amione-Guerra, E. Karanja, B. Trachtenberg, A. Bhimaraj, J. Estep, G. Torre-Amione, I. Hussain, M. Park, B. Bruckner, A. Guha Source Type: research

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