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Specialty: Transplant Surgery
Condition: Bleeding

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Total 68 results found since Jan 2013.

Flow Performance of the CorWave LVAD Membrane Wave Pump
Implantable long-term blood pumps currently available or in development employ high speed rotary impellers. Use of these devices is currently limited due to relatively high rates of stroke, bleeding complications and infection. A new blood pump technology is under development inspired by the swimming motion of a fish. High frequency, low amplitude linear actuation creates a wave motion on a polymer membrane, gently pushing the blood through the pump. This approach offers a less damaging method for pumping blood, provides full physiologic pulsatility and can operate efficiently over a wide range of operating conditions.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: C.N. Botterbusch, P. Monticone, L. Polverelli Source Type: research

Bayesian Model for Predicting 90 Day Event Free Survival in LVAD Patients
Potential adverse outcomes are often quoted individually to patients (e.g. 4% risk of stroke or bleeding) pre LVAD implantation. However, technical medical aspects may impact their grasp of perceived ‘overall’ risk and hence their ability to match expectations and post-op consequences. We assessed survival free from any major adverse event (MAE) and predict their occurrence within the first 90 days after LVAD implant.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: M. Kanwar, L. Lohmueller, R. Kormos, C. Mcilvennan, S. Bailey, S. Murali, J. Antaki 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

Novel Oral Anticoagulants in Patients with Continuous Flow Left Ventricular Assist Devices
The gold standard for anticoagulation in patients with continuous flow left ventricular assist device (CF-LVADs) is warfarin. However, many patients fail warfarin therapy due to thromboembolic and bleeding events. Warfarin requires regular monitoring and dosage adjustments, and is associated with significant patient time outside recommended therapeutic INR range. Novel oral anticoagulation (NOAC) has been shown to be non-inferior compared to warfarin in stroke prevention with less intracranial hemorrhage in patients with atrial fibrillation.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: V. Parikh, U. Parikh, A.M. Ramirez, H. Lamba, J. George, S. Fedson, F. Cheema, A. Civitello, A. Nair, A. Shafii, G. Loor, T. Rosengart, O. Frazier, J. Morgan, R. Delgado Tags: 1072 Source Type: research

Comorbidities and Biomarkers Vary between United States and Japanese LVAD Patients
Left ventricular assist device (LVAD) outcomes differ between Japan and US. While GI bleeding is common in US and rare in Japan, stroke and driveline infections are more common in Japan than US. The aim of this study was to explore whether inflammatory and angiogenesis biomarkers can explain these differences.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: T. Imamura, A. Nguyen, D. Nitta, T. Fujino, L. Holzhauser, D. Rodgers, S. Kalantari, B. Smith, J. Raikhelkar, N. Narang, B. Chung, I. Ebong, C. Juricek, P. Combs, D. Onsager, T. Song, T. Ota, V. Jeevanandam, G. Kim, G. Sayer, M. Ono, N. Uriel Tags: 1065 Source Type: research

Digoxin is Associated with Decreased Survival Free from Hemocompatibility-Related Adverse Events in LVAD Patients - A Propensity Score Matched Analysis
Hemocompatibility-related adverse events (HRAEs) (stroke, suspected pump thrombosis (sPT), gastrointestinal bleeding (GIB)) reduce survival and quality of life in LVAD pts. The association between pharmacotherapy and both HRAEs and survival is poorly characterized. We aimed to assess this association in HeartMate II (HMII) pts.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: A. Pinsino, A. Gaudig, K.L. Hoffman, D. D'Angelo, E.A. Royzman, G.M. Mondellini, F. Castagna, A.M. Zuver, A.R. Garan, H. Takayama, K. Takeda, Y. Naka, R.T. Demmer, M. Yuzefpolskaya, P.C. Colombo Tags: 397 Source Type: research

A Trial of Complete Withdrawal of Anticoagulation Therapy in the Heartmate 3 Pump
The HeartMate 3 Left Ventricular Assist System has demonstrated absence of confirmed de-novo pump thrombosis and reduction in stroke. However, bleeding related adverse events persist under standard anticoagulation targeting a INR range of 2.0-3.0. In an initial experience we demonstrated safety of transition to low intensity anticoagulation (INR target 1.5-1.9, n=15, follow up of at least 6 months). Whether complete cessation of anticoagulation maintains “thromboresistance” in the HeartMate 3 pump remains unknown.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: I. Netuka, P. Ivak, Z. Tucanova, S. Gregor, O. Szarszoi, J. Rimsans, J. Connors, D. Crandall, P. Sood, M. Mehra Tags: 254 Source Type: research

A Comparison of Middle Cerebral Artery and Central Retinal Artery Hemodynamics in HM II Patients
In the normal, pulsatile circulation, the hemodynamic pattern of the middle cerebral artery (MCA) differs from the central retinal artery (CRA). Whether continuous flow from a left ventricular assist device (LVAD) alters this relationship is not known. Since serious adverse events in different end-organs, such as stroke and GI bleeding, are frequent in LVAD patients, comparing hemodynamics in different arterial beds may enhance our understanding of the specific pathophysiology of these complications.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: E.J. St öhr, R. Ji, K. Akiyama, F. Castagna, A. Pinsino, J.R. Cockcroft, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, R.T. Te-Frey, H. Takayama, K. Takeda, Y. Naka, P.C. Colombo, J.Z. Willey, B.J. McDonnell Tags: 200 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

Cessation of anti-coagulation for bleeding and subsequent thrombosis events with a fully magnetically levitated centrifugal left ventricular assist device
Anti-coagulation 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 (HM3) pump. Current anti-coagulation guidelines target a goal international normalized ratio (INR) of 2.0 to 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 HM3, have demonstrated a marked decrease in the incidence of pump thrombosis compared w...
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

High-frequency operation of pulsatile ventricular assist devices: A computational study on circular and elliptically shaped pumps.
Abstract Pulsatile positive displacement pumps as ventricular assist devices were gradually replaced by rotary devices due to their large volume and high adverse event rates. Nevertheless, pulsatile ventricular assist devices might be beneficial with regard to gastrointestinal bleeding and cardiac recovery. Therefore, aim of this study was to investigate the flow field in new pulsatile ventricular assist devices concepts with an increased pump frequency, which would allow lower stroke volumes to reduce the pump size. We developed a novel elliptically shaped pulsatile ventricular assist devices, which we compared t...
Source: The International Journal of Artificial Organs - July 4, 2019 Category: Transplant Surgery Authors: Loosli C, Rupp S, Thamsen B, Rebholz M, Kress G, Meboldt M, Ermanni P Tags: Int J Artif Organs Source Type: research

Complications of veno-arterial extracorporeal membrane oxygenation for refractory cardiogenic shock or cardiac arrest.
CONCLUSION: Although veno-arterial extracorporeal membrane oxygenation can improve the survival, it is associated with morbidity. Therefore, risk-benefit analysis for veno-arterial extracorporeal membrane oxygenation and prevention of complications are important to improve prognosis. PMID: 31394965 [PubMed - as supplied by publisher]
Source: The International Journal of Artificial Organs - August 7, 2019 Category: Transplant Surgery Authors: Lee SY, Jeon KH, Lee HJ, Kim JB, Jang HJ, Kim JS, Kim TH, Park JS, Choi RK, Choi YJ Tags: Int J Artif Organs Source Type: research

Haemodynamic evaluation of the new pulsatile-flow generation method in vitro.
Abstract Continuous-flow ventricular-assist devices are widely used to support patients with advanced heart failure, because continuous-flow ventricular-assist devices are more durable, have smaller sizes and have better survival rates for patients compared to the pulsatile-flow ventricular-assist devices. Nevertheless, continuous-flow ventricular-assist devices often cause complications such as gastrointestinal bleeding, haemorrhagic stroke, and aortic insufficiency and have a negative impact on the microcirculation for both long-time implantable and short-time extracorporeal systems. The aim of this study is the...
Source: The International Journal of Artificial Organs - October 10, 2019 Category: Transplant Surgery Authors: Itkin GP, Bychnev AS, Kuleshov AP, Drobyshev AA Tags: Int J Artif Organs Source Type: research