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Colocutaneous Fistula Following Pediatric Bivad Implantation, A Rare but Serious Complication
We present 2 patients who had rare colocutaneous fistulas associated with Berlin Heart EXCOR ® placement.
Source: The Journal of Heart and Lung Transplantation - April 1, 2023 Category: Transplant Surgery Authors: S. Rangu, J. Murray, A. Shiu, E. Martin, T. Nasirov, M. Bruzoni, S. Chen, D. Rosenthal, M. Ma, J. Dykes Tags: (1035) Source Type: research

Impact of Perioperative Sarcopenia and Dysphagia on LVAD Related Complications
Sarcopenia, as defined by decline in muscle quantity/quality, is prevalent in heart failure and associated with high morbidity and mortality. Sarcopenic dysphagia is caused by sarcopenia in the whole body and swallowing-related muscles. We investigated the impact of perioperative sarcopenia and dysphagia on postoperative pneumonia (PNA), stroke, gastrointestinal bleeding (GIB) and 30-d readmission after LVAD.
Source: The Journal of Heart and Lung Transplantation - April 1, 2023 Category: Transplant Surgery Authors: M. Nishikawa, M.R. Carey, A. Ladanyi, G.M. Mondellini, A. Pinsino, K. Antler, E. Goldberg, J. Hastie, K. Clerkin, G.T. Sayer, N. Uriel, K. Takeda, P.C. Colombo, M. Yuzefpolskaya Tags: (765) Source Type: research

Computational Investigation of Outflow Graft Variation Impact on Hemocompatibility Profile in LVADs
This study, used a simulation-based approach to investigate the influence that the cannula orientation has in modulating flow conditions leading to HRAEs.
Source: The Journal of Heart and Lung Transplantation - April 1, 2022 Category: Transplant Surgery Authors: B.A. Zambrano, S. Ingram, M.R. Moreno, M. Kassi Tags: (1161) Source Type: research

Protein Biomarkers Predict Risk of Gastrointestinal Bleeding in Left Ventricular Assist Device Patients
This study aims to assess the validity of these biomarkers in predicting the incidence of stroke or GIB in LVAD recipients.
Source: The Journal of Heart and Lung Transplantation - April 1, 2022 Category: Transplant Surgery Authors: K. Cavallo, M. Kanwar, G. Diao, S.S. Sinha, R. Singh, D. Tang, I. Isseh, J. Brocious, P. Bagchi, D. Crandall, D.J. Farrar, S. Murali, J. Walenga, J. Lindenfeld, C. deFilippi, P. Shah Tags: (115) Source Type: research

Carotid Endarterectomy Prior to Ventricular Assist Device Placement in a Patient with Cardiogenic Shock
Atherosclerotic disease in the cervical vessels may be a contraindication for implantation of left ventricular assist devices (LVADs). The occurrence of ischemic stroke represents an obstacle to rehabilitation, and its incidence seems to be higher in this population. Carotid endarterectomy (CEA) is a preferable surgical treatment in patients with high bleeding risk. This case report suggests that CEA followed by implantation of LVADs can be feasible.
Source: The Journal of Heart and Lung Transplantation - April 1, 2022 Category: Transplant Surgery Authors: M.S. Lira, R.C. Dantas, D.d. Belfort, S.R. Furquim, C.A. Arag ão, B.R. Gomes, B.S. Biselli, S.M. Ferreira, E.A. Bocchi Tags: (558) Source Type: research

Bacteriophage Therapy and the Biofilm: An Old Solution for a Persistent and Desperate Problem?
With the adoption of use of continuous-flow pumps with centrifugal design and complete magnetic levitation (i.e., HeartMate 3, Abbott, Chicago, IL), outcomes following durable left ventricular assist device (LVAD) have continuously improved over the last five years (1). Improved hemocompatibility associated with this device design has translated into a significant reduction in major adverse events, primarily pump thrombosis, stroke, and to a lesser extent, reduction in non-surgical bleeding (1).
Source: The Journal of Heart and Lung Transplantation - February 14, 2022 Category: Transplant Surgery Authors: Pierre-Emmanuel Noly, Francis D. Pagani Tags: Editorial Source Type: research

Clinical Characteristics and Outcomes of Extracorporeal Membrane Oxygenation Support in COVID-19: Retrospective Study of Single Center Experience
This study is to summarize the clinical features, and outcomes of patients with severe ARDS due to COVID-19 treated with ECMO. We analyzed the incidence of morbidity including ischemic/hemorrhagic stroke, gastrointestinal bleeding, pump malfunction, oxygenator dysfunction, infection during VV ECMO.
Source: The Journal of Heart and Lung Transplantation - March 20, 2021 Category: Transplant Surgery Authors: C. Kurihara, A. Manerikar, V. Kandula, A. Bharat Tags: 1004 Source Type: research

Effects of ACE Inhibitors, Angiotensin Receptor Blockers and Angiotensin Receptor-Neprilysin Inhibitors on Survival Free from Gastrointestinal Bleeding in HeartMate 3 Patients - A Marginal Structural Modeling Analysis
The HeartMate 3 (HM3) is superior to HMII in survival free from disabling stroke and pump exchange, however, rates of GIB remain high. Prior studies show a protective effect of digoxin and ACEi/ARB on risk for GIB, whereas phosphodiesterase 5 inhibitors (PDE5i) have opposite effect in HMII using Cox Proportional Hazard (PH) models with inverse probability weighting (IPW). Compared to this approach, marginal structural modeling (MSM) accounts for time-dependent confounding thereby producing results closer to true causal effect.
Source: The Journal of Heart and Lung Transplantation - March 20, 2021 Category: Transplant Surgery Authors: G.M. Mondellini, J. Qi, L. Braghieri, A. Pinsino, A.J. Kim, T. Melie, V.R. Feldman, K. Takeda, Y. Naka, G.T. Sayer, N. Uriel, I. Diaz, M. Yuzefpolskaya, K.L. Hoffman, P.C. Colombo Tags: 1124 Source Type: research

Arterial Pulsatility in Patients with Continuous Flow Left Ventricular Assist Device Support: Comparing Velocity and Mean Arterial Pressure
An increasing number of end-stage heart failure patients are supported by continuous-flow Left Ventricular Assist Devices (cfLVADs) as a bridge to heart transplantation. Accurate assessment of arterial pulsatility remains a challenge because of diminished pulse pressure, which itself can be associated with adverse events such as gastrointestinal bleeding and stroke. Our study investigates the value of simultaneous arterial pressure and arterial blood velocity assessment in cfLVAD patients.
Source: The Journal of Heart and Lung Transplantation - March 20, 2021 Category: Transplant Surgery Authors: S. Emmanuel, A. Adji, D. Robson, P. Jain, C. Hayward Tags: 1138 Source Type: research

A Comparative Analysis of Long-Term Outcomes in the MOMENTUM 3 Pivotal Trial and Continued Access Protocol Post-Approval Study Phase: A Study of over 1500 HeartMate 3 Implants
The MOMENTUM 3 pivotal trial conducted from 2014 to 2018 evaluated safety and effectiveness of the HeartMate 3 (HM3) left ventricular assist system (LVAS) compared to the HeartMate II pump. The trial demonstrated superiority of the HM3 LVAS for the primary endpoint of survival free of disabling stroke or reoperation to replace a malfunctioning pump at 2-years. HM3 LVAS superiority was due to improved hemocompatibility with near-elimination of device thrombosis, halving of stroke rates, and a decrease in gastrointestinal bleeding rates compared to the control device.
Source: The Journal of Heart and Lung Transplantation - March 20, 2021 Category: Transplant Surgery Authors: M.R. Mehra Tags: (4) Source Type: research

Simultaneous Multi-Vascular Bed Imaging in a Patient Supported by a Continuous-Flow LVAD
Patients supported with left ventricular assist devices (LVADs) are burdened by frequent hemocompatibility-related adverse events related to patient-pump interactions. These predominantly vascular events include stroke, gastrointestinal bleeding, and pump thrombosis. Our center performs routine, invasive hemodynamic ramp speed titrations in LVAD patients to determine the optimal rotational speed after implantation. We sought to interrogate changes in vascular hemodynamics during an exercise ramp study to understand the influence of pump speed and exercise on outflow graft and cerebrovascular flow.
Source: The Journal of Heart and Lung Transplantation - March 20, 2021 Category: Transplant Surgery Authors: I. Bole, D. Rodgers, B. Smith, A. Nguyen, B. Chung, S. Kalantari, N. Sarswat, G. Kim, T. Song, T. Ota, V. Jeevanandam, E. Kruse, C. Kordeck, C. Kramer, S. Pinney, J. Grinstein Tags: (1347) Source Type: research

Blood Conservation Strategy at Time of Left Ventricular Assist Device Placement Improves Survival
Bleeding is the most common complication of left ventricular assist device (LVAD) placement. However, excessive transfusion has been linked to heart failure, stroke, and alloimmunization. We compared 90-day outcomes in patients receiving a blood conservation (BCS) versus liberal transfusion strategy during surgery and the subsequent 24 hours.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: K. Stawiarski, O. Agboola, J. Park, A. Mangi, A. Geirsson, F. Lee, D. Jacoby, L. Bellumkonda, T. Ahmad, J. Chou, J.M. Testani, M. Chen, G. McCloskey, P. Bonde Tags: (356) Source Type: research

Natural Antibodies and Left Ventricular Assist Device Complications
Left ventricular assist devices (LVAD) are widely used as a support strategy for advanced heart failure. Complications such as thrombosis and bleeding have been linked to LVAD. We observed that LVAD implantation was followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE) and apoptotic cells. Nabs have been implicated in inflammatory reactions related to atherosclerosis, ischemic stroke and primary graft dysfunction following heart transplantation.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: S.B. See, D. Onat, E. Hittesdorf, F. McDougan, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, Y. Naka, H. Takayama, K. Takeda, G.P. Milligan, D. Wencker, S.A. Hall, M. Askar, P. Kimball, G. Wagener, P. Colombo, E. Zorn Tags: (1211) Source Type: research

Elevated Outpatient C-Reactive Protein Independently Predicts Stroke and Gastrointestinal Bleeding in LVAD Patients
Inflammation and congestion may contribute to stroke and gastrointestinal bleeding (GIB) in LVAD pts. C-Reactive Protein (CRP), erythrocyte sedimentation rate (ESR), and N-terminal-pro B-type natriuretic peptide (NT-proBNP) are established biomarkers of inflammation and congestion. We aimed to investigate the association of these biomarkers with stroke and GIB in LVAD pts who survived to their first outpt visit.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: Y. Brailovsky, A. Javaid, G.M. Mondellini, L. Braghieri, M. Tiburcio, N. Uriel, G.T. Sayer, V.K. Topkara, K. Takeda, Y. Naka, R.T. Demmer, M. Yuzefpolskaya, P.C. Colombo Tags: (996) Source Type: research

Cessation of Anticoagulation for Bleeding and Thrombosis Events with a Fully Magnetically Levitated Centrifugal Left Ventricular Assist Device
Anticoagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 pump. Current anticoagulation guidelines target a goal INR of 2.0 –3.0 with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HeartMate 3 (HM3), have demonstrated a marked decrease in the incidence of pump thrombosis compared to mechanical bearing axial-f...
Source: The Journal of Heart and Lung Transplantation - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: Case Anecdotes, Comments and Opinions Source Type: research

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