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Specialty: Transplant Surgery
Condition: Bleeding

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Total 68 results found since Jan 2013.

Carotid Artery Blood Flow and Its Association with Stroke during Left Ventricular Assist Device Support
Left ventricular assist device (LVAD) surgery is a life-prolonging therapy for advanced heart failure (HF). Despite many improvements over the years, LVADs continue to be associated with a high incidence of stroke and other vascular complications such as gastrointestinal bleeding (GIB). At present, the pathogenesis of these complications during LVAD support remains unclear. Abnormal structure and hemodynamics in large arteries are a potential contributor. We hypothesized that structural abnormalities and flow alterations will be significantly associated with stroke and a composite outcome of stroke, GIB, and death in HF pa...
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: M.E. Kiyatkin, A.M. Zuver, A. Gaudig, M. Tiburcio, B.J. McDonnell, M. Yuzefpolskaya, P.C. Colombo, E.J. St öhr, J.Z. Willey Tags: 401 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

CHA2DS2-Vasc and HAS-BLED Scores as Predictors of Ischemic and Hemorrhagic Stroke Risk After Left Ventricular Assist Device Implantation
CHA2DS2-VASc score predicts thromboembolic event risk and HAS-BLED score predicts major bleeding risk in patients on anticoagulation with atrial fibrillation. We aimed to evaluate if these scoring systems would be predictive of ischemic stroke and intracranial bleeding complications following continuous-flow left ventricular assist device (CF-LVAD) implantation.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: H.S. Kemal, S. Ertugay, S. Nalbantgil, M. Zoghi, C. Engin, T. Yagdi, M. Ozbaran 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

Carotid artery structure and hemodynamics and their association with adverse vascular events in left ventricular assist device patients
We examined the association of these measures with the composite outcome as well as individual subcomponents such as stroke. After adjusting for established risk factors, the composite adverse outcome was associated with pre-operative moderate-to-severe carotid plaque (OR 5.08, 95% CI 1.67 –15.52) as well as pre-operative internal carotid artery stenosis (OR 9.02, 95% CI 1.06–76.56). In contrast, altered hemodynamics during LVAD support were not associated with the composite outcome. Our findings suggest that pre-existing atherosclerosis possibly in combination with LVAD hemodynam ics may be an important contributor to...
Source: Journal of Artificial Organs - January 18, 2021 Category: Transplant Surgery Source Type: research

Atrial fibrillation in dialysis patients: time to abandon warfarin?
Abstract Atrial fibrillation (AF) is a frequent clinical complication in dialysis patients, and warfarin therapy represents the most common approach for reducing the risk of stroke in this population. However, current evidence based on observational studies, offer conflicting results, whereas no randomized controlled trials have been carried out so far. Additionally, many clinicians are wary of the possible role of warfarin as vascular calcification inducer and its potential to increase the high risk of bleeding among patients on dialysis. Ideally the most promising therapy would be based on direct inhibitors of f...
Source: The International Journal of Artificial Organs - April 8, 2016 Category: Transplant Surgery Authors: Brancaccio D, Neri L, Bellocchio F, Barbieri C, Amato C, Mari F, Canaud B, Stuard S Tags: Int J Artif Organs Source Type: research

Natural Antibodies and Left Ventricular Assist Device Complications
Left ventricular assist devices (LVAD) are widely used as a bridge to heart transplantation or destination therapy for advanced heart failure. However, hemocompatibility-related complications such as pump thrombosis, stroke and bleeding remain frequent. We previously reported that LVAD implantation is followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE). 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 16, 2019 Category: Transplant Surgery Authors: S.B. See, A. Pinsino, N. Kunimune, D. Onat, E. Hittesdorf, A.R. Garan, V.K. Topkara, N. Yoshifumi, H. Takayama, K. Takeda, P.C. Colombo, G. Wagener, M. Yuzefpolskaya, E. Zorn Tags: 606 Source Type: research

Anti-Coagulation Management in Pediatric Ventricular Assist Device: A Quality Improvement Target
This report describes baseline AC data from ACTION centers, including agents used and aggregate levels of performance, to inform development of specific interventions.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: C. VanderPluym, M. O'Connor, A. Lorts, M. Ploutz, D. Peng, S. Law, M. Zinn, R. Niebler, D. Rosenthal, J. Conway, S. Auerbach, D. Sutcliffe, M. Mehegan Tags: 29 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

Outcomes of systemic anticoagulation with bivalirudin for Impella 5.0
Int J Artif Organs. 2021 Jul 12:3913988211032238. doi: 10.1177/03913988211032238. Online ahead of print.ABSTRACTTemporary mechanical circulatory support (tMCS) devices are used for the management of cardiogenic shock. The Impella 5.0 (Abiomed; Danvers, MA) (IMP5) is a commonly used, surgically implanted, tMCS device that requires systemic anticoagulation and purge solution to avoid pump failure. To avoid heparin-induced thrombocytopenia (HIT) from unfractionated heparin (UFH) use, our program has explored the utility of bivalirudin (BIV) for systemic anticoagulation in IMP5. This single center, retrospective study included...
Source: The International Journal of Artificial Organs - July 12, 2021 Category: Transplant Surgery Authors: Carly Fabrizio Marissa N Levito Ryan Rivosecchi Michael Bashline Brittany Slocum Arman Kilic Catalin Toma Holt Murray Raj Ramanan Jeffrey Fowler Gavin W Hickey Edward T Horn 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

Use of Left Ventricular Assist Device (HeartMate II): A Singapore Experience
We report our experience with the HeartMate II (HMII) LVAD (Thoratec Corporation, Pleasanton, CA, USA) as a bridge‐to‐heart transplant in our center from 2009 to 2012. This was a retrospective review of 23 consecutive patients who underwent HMII LVAD implantation in our center between May 2009 and December 2012. All patients were classified as Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 to 3 and underwent LVAD implantation as a bridge‐to‐heart transplant. There were 17 male and 6 female patients. The mean age was 43.6 years old (range 14 to 64). The etiologies of heart fa...
Source: Artificial Organs - January 7, 2014 Category: Transplant Surgery Authors: Choon Pin Lim, Cumaraswamy Sivathasan, Teing Ee Tan, Chong Hee Lim, Ka Lee Kerk, David Kheng Leng Sim Tags: Main Text Article Source Type: research

Gastrointestinal bleeding and subsequent risk of thromboembolic events during support with a left ventricular assist device
Background: Modern left ventricular assist devices (LVAD) require anti-coagulation (AC) with warfarin and anti-platelet therapy to prevent thromboembolic complications in patients. Gastrointestinal bleeding (GI) is a significant adverse event in these patients and treatment typically requires reduction or elimination of AC or anti-platelet therapy. It is not known whether alterations in AC to treat GI bleeding influence subsequent risk of thromboembolic (TE) events during LVAD support.Methods: Between July 2003 and September 2011, 389 patients (308 male) underwent implantation of a continuous-flow LVAD at the University of...
Source: The Journal of Heart and Lung Transplantation - September 9, 2013 Category: Transplant Surgery Authors: John M. Stulak, Dustin Lee, Jonathon W. Haft, Matthew A. Romano, Jennifer A. Cowger, Soon J. Park, Keith D. Aaronson, Francis D. Pagani 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