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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

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

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

Type II Minimal ‐Invasive Extracorporeal Circuit for Aortic Valve Replacement: A Randomized Controlled Trial
Abstract Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally‐invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end‐points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC. Fifty patients were prospectively randomized to MiECC or CECC...
Source: Artificial Organs - February 12, 2018 Category: Transplant Surgery Authors: Erich Gygax, Hans ‐Ulrich Kaeser, Mario Stalder, Brigitta Gahl, Robert Rieben, Thierry Carrel, Gabor Erdoes Tags: Main Text Source Type: research

Outcomes of Berlin Heart EXCOR ® pediatric ventricular assist device support in patients with restrictive and hypertrophic cardiomyopathy
This study reviews the North American experience with Berlin Heart EXCOR® ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was reviewed. Patients with primary diastolic dysfunction are included in this study. Twenty pediatric patients with restrictive cardiomyopathy (n = 13), hypertrophic cardiomyopathy (n = 3), or congenital heart disease with restrictive physiology (n = 4) who were supported with EXCOR® were identified. Of these, nine (45%) were successfully bridged to transplant, one (5%) weaned from support, and 10 (50%) died after support was withdrawn. Of...
Source: Pediatric Transplantation - September 1, 2017 Category: Transplant Surgery Authors: Jennifer A. Su, Jondavid Menteer Tags: ORIGINAL ARTICLE Source Type: research

Long-term follow-up of continuous flow left ventricular assist devices: complications and predisposing risk factors.
CONCLUSIONS: LVADs are associated with significant long-term complications including stroke and sepsis and minimizing time on LVADs may decrease the risk of complications and subsequent morbidity and mortality. PMID: 28777392 [PubMed - as supplied by publisher]
Source: The International Journal of Artificial Organs - August 2, 2017 Category: Transplant Surgery Authors: Adesiyun TA, McLean RC, Tedford RJ, Whitman GJR, Sciortino CM, Conte JV, Shah AS, Russell SD Tags: Int J Artif Organs Source Type: research

Managing Anticoagulation in LVAD Patients: The Harefield Experience
Anticoagulation management in patients with Left Ventricular Assist devices (LVAD) continues to be a challenge. Patients and their clinicians are faced with the daily challenge of needing adequate anticoagulation versus the bleeding risks that are associated with anticoagulation.Warfarin is the recommended oral anticoagulant for all currently available LVAD devices.Warfarin is known to be a difficult medication to manage due to its narrow therapeutic window, and its many interactions .Dlott et al (2014) describe in Circulation the overall time in therapeutic range for patients on warfarin as 53.7%, Time in therapeutic rang...
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: R. Hards, G. Edwards, C. Kavanagh, M. Hedger, A.R. Simon Source Type: research

Increased Frequency of Bleeding Complications in Females Following LVAD Implant
While females are at increased risk for stroke after left ventricular assist device (LVAD), the impact of sex on mortality has been met with conflicting results and there is few data on sex specific bleeding rates. Bleeding is a major source of morbidity and mortality in the LVAD population. The aim of this analysis is to define the incidence and clinical impact of bleeding stratified by sex.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: Z. Yavar, J. Cowger, S. Moainie, C. Salerno, A.K. Ravichandran Source Type: research

Outcomes of Asian-Americans Undergoing Left Ventricular Assist Device Implantations as a Bridge to Transplant or Destination Therapy: An INTERMACS Analysis
Previous studies have demonstrated significant differences between Asians and Caucasian white populations in their propensity for stroke, coronary artery disease, heart failure, inflammation, bleeding and thrombosis. Therefore, we hypothesized that Asian Americans with end stage heart failure undergoing treatment with durable left ventricular assist devices (LVAD) exhibit a different morbidity and mortality risk profile when compared to non-Asian and white Americans populations.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: J.R. Wever Pinzon, W. Wang, N. Hu, R. Larsen, T. Yu, L. Yin, I. Taleb, A. Koliopoulou, S. Mckellar, J. Stehlik, J. Fang, A. Kfoury, C. Selzman, S. Drakos 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

Low incidence of gastrointestinal bleeding and pump thrombosis in patients receiving the INCOR LVAD system in the long-term follow-up.
CONCLUSIONS: In this cohort of high-risk, advanced HF patients, the INCOR LVAD provided effective support with improved survival. Moreover, the absence of GI bleeding and pump thrombosis demonstrates a favorable characteristic of this device. Further prospective studies are needed to confirm these data. PMID: 26541278 [PubMed - as supplied by publisher]
Source: The International Journal of Artificial Organs - October 28, 2015 Category: Transplant Surgery Authors: Iacovoni A, Centofanti P, Attisani M, Verde A, Terzi A, Senni M, Maiani M, Baronetto A, Livi U, Frigerio M, Rinaldi M Tags: Int J Artif Organs 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

Temporal Differences in Adverse Event Rates in Patients Bridged With the HeartWare Left Ventricular Assist Device
Left ventricular assist devices (LVAD) have significantly improved survival and quality of life in patients with advanced heart failure. However, these devices are associated with significant adverse events (AEs), particularly bleeding, infection, stroke and right heart failure. We sought to evaluate temporal differences in AE rates in patients bridged to transplantation.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: S. Maltais, K.D. Aaronson, J.J. Teuteberg, M.S. Slaughter, S.S. Najjar, V. Jeevanandam, D.T. Pham, E.C. McGee, K. Najarian, R.L. Kormos Source Type: research

Temporal Distribution of Hematologic Complications During Berlin EXCOR Support
The Berlin Heart EXCOR trial demonstrated a high incidence of bleeding complications and stroke. Little is known, however, with regards to the timing of these events. The purpose of this study is to describe a single center experience with the Berlin EXCOR VAD, with a particular focus on the temporal distribution of these mutually related complications.
Source: The Journal of Heart and Lung Transplantation - April 1, 2015 Category: Transplant Surgery Authors: S. Burki, D.H. Mahoney, A. Jeewa, W. Zhang, E. McKenzie, D.L. Morales, C.M. Mery, J.S. Heinle, C.D. Fraser, I. Adachi Source Type: research

First Implantation in Man of a New Magnetically Levitated Left Ventricular Assist Device (HeartMate III)
Outcomes of heart failure patients supported by a continuous flow left ventricular assist device (LVAD) have steadily improved over the past decade due in large part to better patient selection and management 1,2. Nevertheless, adverse events such as bleeding, infection, stroke and thrombus persist and limit the overall effectiveness of this therapy. Bleeding is the most common serious adverse event that results from the extensive surgery required for implantation and blood component damage due to shear forces in the small blood flow paths of current design axial-flow and centrifugal-flow pumps.
Source: The Journal of Heart and Lung Transplantation - March 7, 2015 Category: Transplant Surgery Authors: Jan D. Schmitto, Jasmin S. Hanke, Sebastian V. Rojas, Murat Avsar, Axel Haverich Source Type: research

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