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Specialty: Transplant Surgery
Condition: Bleeding

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Total 68 results found since Jan 2013.

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

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

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

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

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

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

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