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Prognostic Implications of Intermediate Hemolysis in Continuous Flow Left Ventricular Assist Device Patients
Hemolysis is an early marker of device thrombosis in pts on continuous flow left ventricular assist device (CF-LVAD). For pts with high levels of hemolysis (LDH>700 U/L) treatment with device exchange rather than medical therapy leads to improvement in stroke free survival. We aimed to investigate outcomes and optimal treatment (tx) strategies for outpts on CF-LVAD demonstrating intermediate levels of hemolysis (LDH 500-700 U/L).
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: H. Rosenblum, A. Pinsino, M. Gavalas, A. Zuver, K. Parikh, G. Parkis, M. Flannery, M. Mabasa, E.A. Royzman, A. Gaudig, A.R. Garan, V.K. Topkara, H. Takayama, K. Takeda, Y. Naka, M. Yuzefpolskaya, P.C. Colombo Source Type: research

Laterality of Cerebral Artery Hemodynamics in Continuous-Flow LVAD Patients: A Pilot Study in Relation to Stroke
A predominance of ischemic stroke in the right hemisphere among patients with continuous-flow left ventricular assist device (LVAD) support has been noted. The reasons for this clinical presentation are unknown, though others have hypothesized greater blood flow to the right common carotid artery. Since arterial pulsatility and blood velocity (as a surrogate for flow) have been associated with cerebrovascular complications, we hypothesized that significant differences in the pulsatility and/or Vmax of the left and right middle cerebral artery may be present in LVAD patients.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: E.J. St öhr, A. Gaudig, A. Pinsino, F. Castagna, P.C. Colombo, M. Yuzefspolskaya, A.R. Garan, V.K. Topkara, H. Takayama, K. Takeda, Y. Naka, J.R. Cockroft, B.J. McDonnell, J.Z. Willey Source Type: research

PAPi Shows a Stronger Correlation With RAP versus RVSWI in Both HFrEF and HFpEF
This study compares the correlation of RAP with PAPi and RVSWI in patients with heart failure with reduced EF (HFrEF) and those with preserved EF (HFpEF).
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: N. Nair, S. Yang, C. Marzbani, L. Truong, E. Gongora Source Type: research

Stroke Patterns and Implications for Ventricular Functional Remodeling in Left Ventricular Assist Systems
Ischemic stroke-related complications (particularly in the right hemisphere) are frequently encountered with Left Ventricular Assist Systems (LVAS). The neuro-cardiac axis may influence ventricular remodeling. However it remains unknown if stroke patterns are related to ventricular remodeling after facilitated hemodynamic support with LVAS. We hypothesized that strokes occurring in the right hemisphere, within the insula region, may enhance left ventricular remodeling through unopposed activation of the left insular region.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: D.F. Snipelisky, P. Ivak, G. Stewart, M. Givertz, M. Pfeffer, J. Groarke, S. Singh, I. Netuka, M. Mehra Source Type: research

Cardiovascular Magnetic Resonance Imaging for Risk Assessment and Prediction of Clinical Worsening in Pulmonary Arterial Hypertension
To determine the clinically detectable changes of right ventricular (RV) volume and stroke volume (SV) that predicts clinical worsening in patients with pulmonary arterial hypertension (PAH).
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: C. G öransson, N. Vejlstrup, J. Carlsen Source Type: research

A Co-Rhythmic, Isolable, Self-Maintenance, Assist (CoRISMA) Device for Class III Heart Failure
Mechanical circulatory support for class III heart failure will be acceptable if it is devoid of any adverse events associated with current LVAD devices. Long blood paths, lack of regular maintainence in a pump bathed in blood and tethered operation may account for some of the adverse events witnessed in current LVADs such as stroke, pump thrombosis and infections. An intra-cardiac device with ability to isolate and clean the interior of the pump, powered without driveline is presented.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J. Park, P. Bonde Source Type: research

Strategy for Surgical Correction and Mitigation of Outflow Graft Twist with a Centrifugal-Flow Left Ventricular Assist System
A fully magnetically levitated centrifugal-flow left ventricular assist system (LVAS) has been introduced with demonstration of improved hemocompatibility, reduced rates of pump malfunction and stroke.1 –4 This LVAS, the HeartMate 3 (Abbott, IL, USA) pump, has been observed to have isolated cases of an outflow graft twist occurring in follow-up periods, later in the course of support.1,5 The mechanism for this development is incompletely understood, however it may be related to the proximal outfl ow graft metallic swivel joint that allows relatively free rotation of this graft once implanted (Figure 1), which is designed...
Source: The Journal of Heart and Lung Transplantation - March 22, 2018 Category: Transplant Surgery Authors: Evgenij V. Potapov, Ivan Netuka, Friedrich Kaufmann, Volkmar Falk, Mandeep R. Mehra Source Type: research

Strategy for surgical correction and mitigation of outflow graft twist with a centrifugal-flow left ventricular assist system
A fully magnetically levitated centrifugal-flow left ventricular assist system (LVAS) has been introduced, with demonstration of improved hemocompatibility and reduced rates of pump malfunction, and stroke.1 –4 This LVAS, the HeartMate 3 (Abbott, Abbott Park, IL) pump, has been observed to have isolated cases of an outflow graft twist occurring in follow-up periods, later in the course of support.1,5 The mechanism for this development is incompletely understood. It may, however, be related to the prox imal outflow graft metallic swivel joint that allows relatively free rotation of this graft once implanted (Figure 1), wh...
Source: The Journal of Heart and Lung Transplantation - March 22, 2018 Category: Transplant Surgery Authors: Evgenij V. Potapov, Ivan Netuka, Friedrich Kaufmann, Volkmar Falk, Mandeep R. Mehra Tags: Research Correspondence Source Type: research

Early stroke post –heart transplant is associated with decreased survival in children
In this study we aimed to characterize early MNEs (stroke, isolated seizures not from stroke and posterior reversible leukoencephalopathy [PRES] within 1 year after primary pediatric HTx) and evaluate their impact on 1-year post-HTx survival. We hypothesized that early an MNE after HTx is associated with decreased 1-year patient survival.
Source: The Journal of Heart and Lung Transplantation - January 8, 2018 Category: Transplant Surgery Authors: Cheryl Cammock, Swati Choudhry, Chesney M. Castleberry, Noor Al-Hammadi, Pirooz Eghtesady, Charles E. Canter, Kathleen E. Simpson Tags: Original Clinical Science Source Type: research

Early stroke post-heart transplant is associated with decreased survival in children
Over the past several decades significant advances in the management have improved the postoperative mortality with pediatric heart transplant (HTx) recipients now surviving for years after transplant surgery.1 –3 For most children with end-stage heart failure, transplantation is the only effective long term therapy, placing demands on the limited donor pool resulting in long waitlist time, particularly in infants.4 While waiting, mechanical circulatory support as a bridge to transplant often becomes a l ifesaving measure in these terminal heart failure patients.
Source: The Journal of Heart and Lung Transplantation - January 8, 2018 Category: Transplant Surgery Authors: Cheryl Cammock, Swati Choudhry, Chesney M. Castleberry, Noor Al-Hammadi, Pirooz Eghtesady, Charles E. Canter, Kathleen E. Simpson Source Type: research

Early stroke post –heart transplant is associated with decreased survival in children
In this study we aimed to characterize early MNEs (stroke, isolated seizures not from stroke and posterior reversible leukoencephalopathy [PRES] within 1 year after primary pediatric HTx) and evaluate their impact on 1-year post-HTx survival. We hypothesized that early an MNE after HTx is associated with decreased 1-year patient survival.
Source: The Journal of Heart and Lung Transplantation - January 8, 2018 Category: Transplant Surgery Authors: Cheryl Cammock, Swati Choudhry, Chesney M. Castleberry, Noor Al-Hammadi, Pirooz Eghtesady, Charles E. Canter, Kathleen E. Simpson Tags: Original Clinical Science Source Type: research

Ischemic Stroke and Subsequent Thrombosis within a HeartMate 3 Left Ventricular Assist System: A Cautionary Tale
Introduction of the centrifugal continuous flow-pump, the Heartmate 3 Left Ventricular Assist System (LVAS) has been heralded with the unique observation that de-novo pump thrombosis has not been reported to occur with this device in the pivotal clinical trials.1,2 While engineering principles inherent in this LVAS obviate the initial development of thrombosis within the pump, they cannot protect against ingestion of thrombus or other circulating materials. Similarly, if such ingested material (or thrombus) remains trapped within the device and materially influences its function, it may set-up a nidus for propagation of th...
Source: The Journal of Heart and Lung Transplantation - November 6, 2017 Category: Transplant Surgery Authors: Ivan Netuka, Mandeep R. Mehra Source Type: research

The Impact of Age, Sex, Therapeutic Intent, Race, and Severity of Advanced Heart Failure on Short-term Principal Outcomes in the MOMENTUM 3 Trial
Primary outcomes analysis of the MOMENTUM 3 trial short term cohort demonstrated a higher survival rate free of debilitating stroke and reoperation to replace/remove the device (primary endpoint) in patients receiving the HeartMate 3 (HM3) compared to the HeartMate (HMII). We sought to evaluate the individual and interactive effects of pre-specified patient subgroups (age, sex, race, therapeutic intent (BTT/BTC/DT) and severity of illness) on primary endpoint outcomes in MOMENTUM 3 patients implanted with HM3 and HMII.
Source: The Journal of Heart and Lung Transplantation - November 3, 2017 Category: Transplant Surgery Authors: Daniel J. Goldstein, Mandeep R. Mehra, Yoshifumi Naka, Christopher Salerno, Nir Uriel, David Dean, Akinobu Itoh, Francis D. Pagani, Eric R. Skipper, Geetha Bhat, Nirav Raval, Brian A. Bruckner, Jerry D. Estep, Rebecca Cogswell, Carmelo Milano, Lahn Fendel Source Type: research

Impact of age, sex, therapeutic intent, race and severity of advanced heart failure on short-term principal outcomes in the MOMENTUM 3 trial
In this study we sought to evaluate the individual and interactive effects of pre-specified patient subgroups (age, sex, race, therapeutic intent [bridge to transplant/bridge to candidacy/destination therapy] and severity of illness) on primary end-point outcomes in MOMENTUM 3 patients implanted with HM3 and HMII devices.
Source: The Journal of Heart and Lung Transplantation - November 3, 2017 Category: Transplant Surgery Authors: Daniel J. Goldstein, Mandeep R. Mehra, Yoshifumi Naka, Christopher Salerno, Nir Uriel, David Dean, Akinobu Itoh, Francis D. Pagani, Eric R. Skipper, Geetha Bhat, Nirav Raval, Brian A. Bruckner, Jerry D. Estep, Rebecca Cogswell, Carmelo Milano, Lahn Fendel Tags: Original Clinical Science Source Type: research

Impact of a Modified Anti-Thrombotic Guideline On Stroke In Children Supported with A Pediatric Ventricular Assist Device
Stroke is the most feared complication associated with the Berlin Heart EXCOR ® Pediatric ventricular assist device (VAD), the most commonly used VAD in children, and affects one in three children. We sought to determine whether a modified anti-thrombotic guideline, involving more intense platelet inhibition and less reliance on platelet function testing, is associated with a lower incidence of stroke.
Source: The Journal of Heart and Lung Transplantation - May 20, 2017 Category: Transplant Surgery Authors: David N. Rosenthal, Chacy A. Lancaster, Doff B. McElhinney, Sharon Chen, MaryLyn Stein, Aileen Lin, Lan Doan, Jenna M. Murray, Mary Alice Gowan, Katsuhide Maeda, Olaf Reinhartz, Christopher S. Almond Source Type: research

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