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Condition: Thrombosis
Procedure: Transplants

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Total 252 results found since Jan 2013.

Factors Associated with Prolonged Survival in Left Ventricular Assist Device Recipients.
CONCLUSIONS: Preoperative diabetes and amiodarone use were associated with poor long-term survival in LVAD recipients. Development of early complications of stroke, gastrointestinal bleeding, hemolysis, or pump thrombosis was also associated with poor long-term survival. Early diagnosis and treatment of these complications may improve survival in LVAD recipients. PMID: 30316851 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - October 11, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Xia Y, Forest S, Friedmann P, Chou LC, Patel S, Jorde U, Goldstein D Tags: Ann Thorac Surg Source Type: research

Decannulation of a Ventricular Assist Device
BECAUSE OF the donor organ shortage, an increasing number of patients with advanced heart failure are receiving ventricular assist devices (VADs) as a bridge to transplantation or as a destination therapy.1 Patients with advanced heart failure who receive a VAD have significantly greater survival rates compared with those who are treated with only medication.2 However, short- and long-term complications of VADs still are a major concern.3 There are perioperative risks attributed to patient comorbidities; risks of surgery and anesthesia; and postoperative risks such as bleeding, thrombosis, stroke, infection, right ventricu...
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 4, 2018 Category: Anesthesiology Authors: Tuan-Yen Wu Tags: Case Report Source Type: research

The value of Stanford integrated psychosocial assessment for transplantation (SIPAT) in prediction of clinical outcomes following left ventricular assist device (LVAD) implantation
ConclusionIn this single-center retrospective study, SIPAT did not predict cumulative re-admissions. Further study is required to validate SIPAT before clinical implementation.
Source: Heart and Lung: The Journal of Acute and Critical Care - September 16, 2018 Category: Respiratory Medicine Source Type: research

Thrombus on the inflow cannula of the HeartWare HVAD: an update
The HeartWare ™ HVAD™ (Medtronic, Inc., Minneapolis, MN) is a continuous-flow left ventricular assist device (LVAD) approved by the FDA in 2012 as a bridge to transplant in patients with end-stage left ventricular heart failure. The current inflow cannula has a smooth outer surface near the inflow edge and a sintered collar of titanium microspheres near the pump. A previous case series of HVAD patients bridged to transplant revealed thrombus on the outer surface of the inflow cannula in 8/8 patients, predominantly at the smooth-sintered interface, that was associated with a clinical stroke rate of 12.5% .
Source: Cardiovascular Pathology - September 14, 2018 Category: Cardiology Authors: Carolyn H. Glass, Alexander Christakis, Gregory A. Fishbein, Jaclyn C. Watkins, Kyle C. Strickland, Richard N. Mitchell, Robert F. Padera Tags: Orignal Article Source Type: research

A Tale of the Twist in the Outflow Graft: An Analysis from the MOMENTUM 3 Trial
Heralded as a significant step forward in the evolution of left ventricular assist systems (LVAS), the HeartMate 3 device (Abbott, Abbott Park, Il, USA) has demonstrated improved outcomes by averting de-novo intra-pump thrombosis leading to pump related malfunction, and in reducing the incidence of stroke events when compared with the axial flow HeartMate II LVAS.1,2,3,4 Moreover, the HeartMate 3 LVAS experience has reduced the vexing incidence of hemocompatibility related adverse outcomes.5,6,7 On the heels of these advances, intriguing reports began to surface of a twist within the outflow graft that caused disruption in...
Source: The Journal of Heart and Lung Transplantation - August 24, 2018 Category: Transplant Surgery Authors: Mandeep R. Mehra, Christopher Salerno, Yoshifumi Naka, Nir Uriel, Joseph C. Cleveland, Douglas Horstmanshof, Daniel J. Goldstein, for the MOMENTUM 3 Investigators Tags: Editorial Source Type: research

Left ventricular assist device exchange for the treatment of HeartMate II pump thrombosis.
Conclusions: It is generally feasible to treat pump thrombosis via LVAD exchange. Yet, the exchange procedure is not without risk and the risk of re-thrombosis (34%), stroke (29%), postoperative dialysis (29%) and perioperative complications remains high. PMID: 30034845 [PubMed]
Source: Journal of Thoracic Disease - July 25, 2018 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Living Without a Pulse: The Vascular Implications of Continuous-Flow Left Ventricular Assist Devices Advances in Mechanical Circulatory Support
Pulsatility seems to have a teleological role because evolutionary hierarchy favors higher ordered animals with more complex, multichamber circulatory systems that generate higher pulse pressure compared with lower ordered animals. Yet despite years of such natural selection, the modern generation of continuous-flow left ventricular assist devices (CF-LVADs) that have been increasingly used for the last decade have created a unique physiology characterized by a nonpulsatile, nonlaminar blood flow profile with the absence of the usual large elastic artery Windkessel effect during diastole. Although outcomes and durability h...
Source: Circulation: Heart Failure - June 14, 2018 Category: Cardiology Authors: Purohit, S. N., Cornwell, W. K., Pal, J. D., Lindenfeld, J., Ambardekar, A. V. Tags: Translational Studies, Vascular Biology, Heart Failure, Cardiovascular Surgery, Transplantation Advances in Mechanical Circulatory Support 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

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

A Review of the Use of Direct Oral Anticoagulant Use in Orthotopic Heart Transplantation Recipients
Over 60 years ago, the vitamin K antagonist (VKA) warfarin was approved and remained the only oral anticoagulation agent until recently [1]. Currently, within North America and Europe there are four DOACs available. Dabigatran, first approved in Europe and Canada in 2008, then in the United States of America in 2010, followed by rivaroxaban, apixaban, and most recently edoxaban. The introduction of direct oral anticoagulants (DOACs) has been a major advancement and these agents are the preferred to VKAs for many indications [2 –5], including stroke prevention in nonvalvular atrial fibrillation (NVAF), acute treatment and...
Source: Transplantation Reviews - April 16, 2018 Category: Transplant Surgery Authors: Rosaleen Boswell, Glen J. Pearson Tags: Review article 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

Predictive Value of Mean Arterial Pressure Versus Systolic Blood Pressure and Visit-To-Visit Blood Pressure Variability for Stroke and Pump Thrombosis in HeartMate II Patients
Elevated blood pressure (BP) in pts on left ventricular assist device (LVAD) support is a risk factor for adverse events (AEs) such as stroke and pump thrombosis (PT). Current guidelines recommend a mean arterial pressure (MAP) ≤ 80mmHg. Above-median systolic BP (SBP) at discharge after HeartMate II (HMII) implant has been associated with an increased risk of stroke. We sought to 1) compare the predictive value of outpt MAP and SBP on AEs, 2) examine the association of visit-to-visit variability (VVV) of BP with AEs in H MII pts.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: A. Pinsino, F. Castagna, J.Z. Willey, A.M. Zuver, M.A. Flannery, B. Cagliostro, J.R. Cockroft, A.R. Garan, V.K. Topkara, H. Takayama, K. Takeda, Y. Naka, R.T. Demmer, P.C. Colombo, M. Yuzefpolskaya Source Type: research

Risk Predictors for Ischemic Stroke in CF-LVAD Patients by Pump Flow Type
Risk of stroke continues to be a major adverse event post-LVAD implantation, limiting wider application and utility of the device. Even with aggressive blood pressure control, patients with LVADs are at higher risk of stroke due to combination of pump-dependent factors including loss of natural pulsatility, anticoagulation, and thrombosis risk from blood-pump interaction. We used a Bayesian Network machine-learning approach to derive comparative risk factors for ischemic stroke in patients with axial versus centrifugal flow pumps at 3 months post LVAD implant.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: M. Kanwar, L. Lohmueller, R. Kormos, S. Bailey, C. Mcilvennan, S. Murali, J. Antaki Source Type: research