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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

Postcardiotomy mechanical support in patients with mitral valve prostheses is associated with poor survival.
CONCLUSIONS: ECLS is associated with a high in-hospital mortality rate in patients after mitral valve replacement. PMID: 33339476 [PubMed - as supplied by publisher]
Source: The International Journal of Artificial Organs - December 18, 2020 Category: Transplant Surgery Authors: Pingpoh C, Salama A, Diab N, Kreibich M, Puiu P, Martin C, Benk C, Beyersdorf F, Siepe M Tags: Int J Artif Organs Source Type: research

Can the intermittent low-speed function of left ventricular assist device prevent aortic insufficiency?
In this study, the Jarvik 2000 device, which is programmed to reduce the pump speed each minute for 8  s, was chosen to examine this potential effect. Prospectively collected data of 85 heart transplant-eligible Jarvik 2000 recipients who met the study criteria (no pre-existing AI and aortic valve surgery) were retrospectively analyzed for the incidence, correlating factors, and clinical outcomes o f de novo AI. All data were provided by the Japanese Registry for Mechanically Assisted Circulatory Support. De novo AI occurred in 58 patients, 23 of whom developed at least moderate AI during a median support duration of 23.5...
Source: Journal of Artificial Organs - January 9, 2021 Category: Transplant Surgery 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

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

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

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

How well do we understand pulsatility in the context of modern ventricular assist devices?
CONCLUSION: Most publications did not provide a definition for pulsatility. In those that did, the most common measure was PI. Measuring PI was not standardised. Few papers addressed the impact of intrinsic ventricular function and arterial compliance on pulsatility. We suggest that future publications adopt a uniform definition which encompasses both patient and pump characteristics.PMID:33960234 | DOI:10.1177/03913988211012707
Source: The International Journal of Artificial Organs - May 7, 2021 Category: Transplant Surgery Authors: Sam Emmanuel Paul Jansz Christopher Hayward Source Type: research

Comparison of household income in in-hospital outcomes after implantation of left ventricular assist device
CONCLUSION: In patients undergoing LVAD implantation nationwide, low-income was associated with increased comorbidity burden, younger age, and fewer in-hospital complications and all-cause mortality.PMID:34719291 | DOI:10.1177/03913988211056960
Source: The International Journal of Artificial Organs - November 1, 2021 Category: Transplant Surgery Authors: Bertrand Ebner Morgan Karetnick Jelani Grant Louis Vincent Jennifer Maning Neal Olarte Odunayo Olorunfemi Colombo Rosario Sandra Chaparro Source Type: research

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