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Von Willebrand Factor Activation Assays Predict Bleeding And Other Hemocompatibility-Related Adverse Events In Patients With CF-LVAD.
Bleeding and hemocompatibility-related adverse events (HRAEs - bleeding, neurological event, stroke, arterial thrombosis, pump thrombosis, and death) remain significant in LVAD patients; changes in coagulation homeostasis, mainly due to von Willebrand Factor (vWF) structural and functional changes induced by mechanical support have been considered a major player in these adverse events. However, the specific mechanisms and the clinical correlation between coagulation profile parameters and clinical outcomes are not yet completely clarified.
Source: Journal of Cardiac Failure - April 1, 2023 Category: Cardiology Authors: Bansi Vekaria, Eleonora Avenatti, Aayush Shah, Ju Kim, Rayan Yousefzai, Imad Hussain, Ashrith Guha, Arvind Bhimaraj, Janardhana Gorthi, Jian Chen, Edward A Graviss, Duc T Nguyen, Marcos De Oliveira, Lin-Chiang Philip Chou, Erik Suarez, Thomas E. MacGilliv Tags: 193 Source Type: research

Risk Of Pump Thrombosis With Once Daily Enoxaparin For Anticoagulation Bridging In Patients With Heartmate III
Most centers bridge patients with Left Ventricular Assist Device (LVAD) with heparin drip to avoid thromboembolic complications including stroke and pump thrombosis based on data from HeartMate II. Because of improved hemocompatibility of third generation HeartMateIII (HM3), particularly the decreased risk of in-pump thrombosis, outpatient treatment dose of low molecule weight heparin (LWMH) like Enoxaparin has been used to bridge to warfarin when the INR is subtherapeutic. Once daily dosing has been used in select patients with higher bleeding risk.
Source: Journal of Cardiac Failure - April 1, 2023 Category: Cardiology Authors: Modar Alom, Gurjaspreet Bhattal, Nitin Kabra, David Rawitscher, Amit Alam, Cesar Guerrero-Miranda, Sandra Carey, Timothy George, Aasim Afzal Tags: 180 Source Type: research

Atrial fibrillation, thromboembolic risk, and anticoagulation in cardiac amyloidosis: A review
Cardiac amyloidosis results from deposition of abnormal proteins in the heart called amyloid. This protein deposition leads to changes in the heart structure that ultimately predispose to rhythm disturbances, notably atrial fibrillation. The toxic effect of these proteins on the heart as well as resulting structural abnormalities often cause blood clots to form inside the heart, which can lead to stroke. Simultaneously, amyloid proteins can also increase risk of bleeding. Blood thinners are often needed in these patients to prevent stroke.
Source: Journal of Cardiac Failure - September 16, 2022 Category: Cardiology Authors: Syed Bukhari, Syed Zamrak Khan, Zubair Bashir Tags: Review Article Source Type: research

Increased Aortic Stiffness is Associated with Higher Rates of Stroke, GI-bleeding and Pump Thrombosis in CF-LVAD Patients
In the general population, increased aortic stiffness is associated with an increased risk of cardiovascular events. Previous studies have demonstrated an increase in aortic stiffness in continuous-flow left ventricular assist device (CF-LVAD) patients. However, the association between aortic stiffness and common adverse events  is unknown.
Source: Journal of Cardiac Failure - February 23, 2021 Category: Cardiology Authors: Hannah Rosenblum, Alberto Pinsino, Amelia Zuver, Azka Javaid, Giulio Mondellini, Ruiping Ji, John R. Cockcroft, Melana Yuzefpolskaya, A. Reshad Garan, Sofia Shames, Veli K. Topkara, Hiroo Takayama, Koji Takeda, Yoshifumi Naka, Barry J. McDonnell, Joshua Z Tags: Brief Report Source Type: research

Increased Aortic Stiffness Is Associated With Higher Rates of Stroke, Gastrointestinal Bleeding and Pump Thrombosis in Patients With a Continuous Flow Left Ventricular Assist Device
In the general population, increased aortic stiffness is associated with an increased risk of cardiovascular events. Previous studies have demonstrated an increase in aortic stiffness in patients with a continuous flow left ventricular assist device (CF-LVAD). However, the association between aortic stiffness and common adverse events  is unknown.
Source: Journal of Cardiac Failure - February 23, 2021 Category: Cardiology Authors: Hannah Rosenblum, Alberto Pinsino, Amelia Zuver, Azka Javaid, Giulio Mondellini, Ruiping Ji, John R. Cockcroft, Melana Yuzefpolskaya, A. Reshad Garan, Sofia Shames, Veli K. Topkara, Hiroo Takayama, Koji Takeda, Yoshifumi Naka, Barry J. Mcdonnell, Joshua Z Tags: Brief Report Source Type: research

Bridging the Gap to LVAD Recovery and Explantation
Left ventricular assist device (LVAD) implantation continues to occur at an exceedingly high rate due to the donor and supply mismatch when it comes to heart transplantation. LVADs however do not come without risk and have high rates of significant bleeding, stroke, pump thrombosis and infection. Most of the clinical and research efforts thus far have been focused on LVAD insertion with the goal of destination therapy or as a bridge to transplant. The goal of bridge to recovery has often been underestimated despite multiple studies showing reverse remodeling of the myocardium.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Karlee K. Hoffman, Manreet Kanwar Tags: 361 Source Type: research

Mechanical Circulatory Support Driveline Infection Reduction through Nursing Quality Improvement
Infection in patients with left ventricular assist device is a leading cause of morbidity and mortality resulting in increased risk for additional complications such as bleeding, thrombosis and stroke. The purpose of this quality improvement project was to reduce driveline infections through implementation of an evidence-based bundled dressing kit and education to nursing staff.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Tania V. Randell, Tim Madeira, Noelle V. Pavlovic, Martha Abshire Tags: 335 Source Type: research

Comparative Analysis of Established Risk Scores and Novel Hemodynamic Metrics in Predicting Right Ventricular Failure in Left Ventricular Assist Device Patients
Left ventricular assist devices (LVADs) have become an important cornerstone in the management of advanced heart failure (HF) patients. These devices have alleviated the unacceptable mortality that was previously observed in advanced HF, particularly in those waiting on the heart transplant list.1 Despite the widespread adoption and success of LVADs for bridge-to-transplant or destination therapy indications, several attendant complications continue to limit the efficacy of LVADs.2,3 The prevention and management of certain complications such as bleeding, hemolysis, stroke and driveline infections has fortunately improved,...
Source: Journal of Cardiac Failure - February 18, 2019 Category: Cardiology Authors: Anthony E. Peters, LaVone A. Smith, Priscilla Ababio, Khadijah Breathett, Timothy L. McMurry, Jamie L.W. Kennedy, Mohammad Abuannadi, James Bergin, Sula Mazimba Tags: Clinical Investigation Source Type: research

The Hemodynamic Profile of GI Bleeding in Continuous-Flow LVADs: Is it All About the Right Ventricle?
The last decade has seen LVADs emerge as an effective and durable means to support select patients with advanced heart failure. Despite improvements in heart failure morbidity and mortality with mechanical support, device-related complications remain a challenge. While rates of pump thrombosis, driveline infection and stroke have declined with improvements in pump design and patient care strategies, the risk of gastrointestinal (GI) bleeding has remained constant.1 GI bleeding remains the leading cause of hospital readmission following device implant, occurring in 30% of patients with continuous-flow LVADs and negatively i...
Source: Journal of Cardiac Failure - August 2, 2018 Category: Cardiology Authors: Christopher T. Sparrow, Joel D. Schilling Source Type: research

Diffuse Connective Tissue Diseases and Left-Ventricular Assist Devices: Insights from the National Inpatient Sample
Durable left-ventricular assist devices (LVAD) have become an increasingly frequent treatment strategy for end-stage heart failure (HF) but their use remains limited by complications including bleeding, thrombosis, and stroke. The impact of LVAD therapy on outcomes in HF patients with postulated higher risk comorbid conditions, such as diffuse connective tissue diseases (DCTD), has not been well studied to date. Given that these patients have an inherently higher risk of hematological complications than the general population, we aimed to investigate demographic characteristics and outcomes after LVAD implantation in this ...
Source: Journal of Cardiac Failure - August 1, 2018 Category: Cardiology Authors: Ann Gage, Vanessa Blumer, Miguel Ortiz, Emer Joyce Tags: 323 Source Type: research

Effect of Heart Failure Type on Thromboembolic and Bleeding Risk in Atrial Fibrillation Patients on Oral Anticoagulation
Heart failure (HF) increases ischemic stroke (IS) risk in atrial fibrillation (AF) patients. Differential effect of heart failure type on thromboembolic and bleeding risk while on oral anticoagulation (OAC) is unknown.
Source: Journal of Cardiac Failure - August 1, 2018 Category: Cardiology Authors: Amgad Mentias, Ghanshyam Palamaner, Alexandros Briasoulis, Paulino Alvarez, Mary Vaughan-sarrazin Tags: 163 Source Type: research

Clinical Journey of Severe Heart Failure Patients after Left Ventricular Assistance Device Implant
This study aims to model the post-operative care pathway of patients after LVAD implementation using INTERMACS data.
Source: Journal of Cardiac Failure - August 1, 2017 Category: Cardiology Authors: Faezeh Movahedi, Lisa Lohmueller, Yiye Zhang, Rema Padman, James Antaki Source Type: research

Increased Risk of Thromboembolic Events Following Gastrointestinal Bleeds among Left Ventricular Assist Device Patients
Introduction: Patients with left ventricular assist devices (LVADs) are typically treated with warfarin and aspirin to prevent pump thrombosis and ischemic stroke. It has been observed that LVAD patients have a high incidence of bleeding complications, most commonly from the gastrointestinal tract. Patients who experience gastrointestinal bleeds (GIB) requiring hospitalization typically undergo a reduction in their anticoagulation and/or antiplatelet regimen. Few studies have examined the relationship between GIB and thromboembolic (TE) events in this population.
Source: Journal of Cardiac Failure - August 1, 2017 Category: Cardiology Authors: Eric W. Rudofker, Saadia Sherazi, John D. Rice, Brent A. Johnson, Jeffrey D. Alexis Source Type: research

Apixaban Use in LVAD Patient with Recurrent GI Bleeding and Recent Embolic Stroke
Background: Left ventricular assist devices (LVAD) have been shown to improve quality of life and decrease mortality in patients with advanced heart failure. GI bleeding and pump thrombosis are major complications associated with LVAD therapy. Warfarin is the mainstay of anticoagulation for these patients. However, warfarin therapy can be challenging due to a narrow therapeutic window, drug/food interactions and need for frequent monitoring. The direct oral anticoagulants (DOACs) have been shown to be non-inferior or superior to warfarin for preventing stroke and reducing the risk of bleeding in patients with AF.
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Lisa Curran, Ali Cosgrove, Amy Clegg, Molly Reece, Bryan Bartle, Peter Van Trigt, Dalton McLean, Daniel Bensimhon Source Type: research

Effect of Vitamin D Level on Readmission Rates in Patients With Left Ventricular Assist Devices
Background: Vitamin D is an important hormone that regulates cardiac myocytes. Low levels have contributed to the development of cardiovascular disease. In addition, Vitamin D has been implicated in the immune system and the inflammatory cascade led by B and T cells. It is not yet clear whether these effects may have a clinical impact on patients undergoing left ventricular assist device (LVAD) implantation. Patients who undergo LVAD implantation are at increased risk of gastrointestinal bleeding, stroke and driveline infection.
Source: Journal of Cardiac Failure - July 23, 2016 Category: Cardiology Authors: Geetha Bhat, Fadi Abou Obeid, Anup Kumar, Abdelhadi Rifai, Sunil Pauwaa, William Cotts, Erin Drever, Gardner Yost, Antone Tatooles Source Type: research

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