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A multicenter study of the HeartWare ventricular assist device in small children
Continuous-flow ventricular assist devices (CF-VADs), designed for patients with a body surface area (BSA) ≥1.2 m2, have improved survival free from stroke and device failure in adults compared with pulsatile devices.1 Initial experiences in larger children with these CF-VADs have been promising2; however, a large proportion of children needing long-term support as a bridge to heart transplantation (HTx) have a BSA of ≤1 m2. These small children can be successfully supported with paracorporeal pulsatile devices,3 yet rates of thromboembolic events continue to be an ongoing concern.
Source: The Journal of Heart and Lung Transplantation - January 18, 2016 Category: Transplant Surgery Authors: Oliver Miera, Richard Kirk, Holger Buchholz, Katharina R.L. Schmitt, Christina VanderPluym, Ivan M. Rebeyka, Neil Wrightson, Felix Berger, Massimo Griselli, Jennifer Conway Tags: Research Correspondence Source Type: research

A multicenter study of the HeartWare HVAD ventricular assist device in small children
Continuous-flow ventricular assist devices (CF-VADs), designed for body surface areas (BSA) ≥1.2 m², have improved survival free from stroke and device failure in adults compared to pulsatile device.1 First experiences in larger children with these CF-VADs have been promising.2 However, a large proportion of children needing long-term support as a bridge to heart transplantation (HTx) have a BSA of ≤1m². These small children can be successfully supported with paracorporeal pulsatile devices.3 However, the rate of thromboembolic events continue to be an ongoing concern.
Source: The Journal of Heart and Lung Transplantation - January 18, 2016 Category: Transplant Surgery Authors: O. Miera, R. Kirk, H. Buchholz, K.R.L. Schmitt, C. VanderPluym, I.M. Rebeyka, N. Wrightson, F. Berger, M. Griselli, J. Conway Source Type: research

Anticoagulation Reversal With 4-Factor Prothrombin Complex Concentrate in Left Ventricular Assist Device Patients With Acute Hemorrhagic Stroke
Anticoagulation reversal in patients with left ventricular assist devices (LVAD) after acute hemorrhagic stroke must occur rapidly to prevent hemorrhage expansion and limit neurologic sequelae, keeping in mind the risk of thrombotic complications. The purpose of this study was to report a case series of our initial experience using a recently FDA approved (April 2013) 4-factor prothrombin complex concentrate (4F-PCC) for INR normalization after acute hemorrhagic stroke in LVAD patients, and compare the results with traditional INR reversal agents.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: P. Chen, J. Falvey, L. Lowenstein, A. Miranpuri, W. Hallinan, T. Massey Source Type: research

Percutaneous Driveline Infection Does Not Increase Subsequent Risk of Stroke and Pump Thrombus During Support With a Left Ventricular Assist Device
Percutaneous driveline infections (DLI) pose significant risk in patients supported with a left ventricular assist device (LVAD). While INTERMACS data suggests increased incidence of thromboembolic complications in close proximity following DLI, no study has specifically examined this association in a time-dependent manner and analyzed risk of subsequent events. We reviewed the Mechanical Circulatory Support (MCS) Research Network registry.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: J. Van Meeteren, S. Maltais, S. Dunlay, N. Haglund, M.E. Davis, F.D. Pagani, K. Aaronson, J. Cowger, P. Shah, J.M. Stulak 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

Driveline Infection Is Not Associated With Increased Risk of Thrombotic Events in CF-LVAD Patients
It has been debated whether anti-thrombotic therapy should be adjusted in the setting of driveline infection (DLI) as infection may lead to a pro-inflammatory state associated with platelet activation and increased risk of thrombotic complications. The aim of this study was to examine the relationship of DLI and thrombotic complications, notably stroke and device thrombosis (DT), in patients with continuous-flow LVADs.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: J. Fried, B. Cagliostro, A. Levin, O. Wever-Pinzon, A.R. Garan, R. Te-Frey, K.O. Ronquillo, K. Takeda, H. Takayama, M. Yuzefpolskaya, D.M. Mancini, Y. Naka, P.C. Colombo, V. Topkara Source Type: research

Blood pressure and stroke risk in left ventricular assist devices
Ischemic and hemorrhagic stroke are one of the most devastating outcomes arising from treatment of end-stage congestive heart failure with a left ventricular assist device (LVAD)1. Stroke after LVAD is associated with increased risk of mortality and is a leading cause of not qualifying for transplantation. The risk of stroke is one of many factors limiting more widespread adoption of this technology for end-stage heart failure. The risk factors for stroke in LVAD have been the subject of several studies, with recent infection2 and changes in anti-thrombotics being commonly found3.
Source: The Journal of Heart and Lung Transplantation - December 5, 2014 Category: Transplant Surgery Authors: Joshua Z. Willey Source Type: research

Pump size of Berlin Heart EXCOR pediatric device influences clinical outcome in children
Conclusions: The broad range of body sizes in children from newborns to adolescents requires a wide choice of appropriately sized devices. Large pump size in relation to BSA is an independent risk factor for occurrence of thromboembolic events.
Source: The Journal of Heart and Lung Transplantation - April 21, 2014 Category: Transplant Surgery Authors: Oliver Miera, Katharina R.L. Schmitt, Eva Delmo-Walter, Stanislav Ovroutski, Roland Hetzer, Felix Berger Tags: Original Clinical Science 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

Early elevations in pump power with the HeartMate II left ventricular assist device do not predict late adverse events
Background: The aim of this study was to evaluate the prevalence of early pump power elevation events in patients with the HeartMate II (HMII) and its impact on subsequent development of stroke and pump thrombosis.Methods: We analyzed>45,000 measurements of pump power and pump speed measured during the initial hospitalization period and>12,000 follow-up measurements obtained from 138 consecutive patients implanted with a HMII between January 2009 and December 2012. An early power elevation (PEL) event was defined as power ≥10 W within the first 14 post-operative days. Patients were divided into two groups: those with an ...
Source: The Journal of Heart and Lung Transplantation - March 3, 2014 Category: Transplant Surgery Authors: Christopher T. Salerno, Kartik S. Sundareswaran, Thomas P. Schleeter, Sina L. Moanie, David J. Farrar, Mary Norine Walsh 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

Abnormal nutrition affects waitlist mortality in infants awaiting heart transplant
Conclusions: Moderate or severe wasting and an elevated W:H are independent risk factors for waitlist mortality in patients aged
Source: The Journal of Heart and Lung Transplantation - December 2, 2013 Category: Transplant Surgery Authors: Justin Godown, Joshua M. Friedland-Little, Robert J. Gajarski, Sunkyung Yu, Janet E. Donohue, Kurt R. Schumacher 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

Carotid-bulb thrombus and continuous-flow left ventricular assist devices: A novel observation
The continuous-flow left ventricular assist device (LVAD) has emerged as a clinically important treatment strategy for patients with advanced-stage heart failure. However, LVADs are not without associated neurologic complications, including stroke. In one review, the incidence of stroke (both ischemic and hemorrhagic) with the HeartMate II (HM II; Thoratec, Pleasanton, CA) ranged from 2% to 18%. In another recent single-center study, the incidence was 10%. In that study, previous stroke, persistent malnutrition and inflammation, severity of heart failure and post-LVAD infections were associated with neurologic complications.
Source: The Journal of Heart and Lung Transplantation - October 28, 2013 Category: Transplant Surgery Authors: John T. Reul, George J. Reul, O.H. Frazier Tags: Research Correspondence Source Type: research

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