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Source: The Journal of Heart and Lung Transplantation
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Total 231 results found since Jan 2013.
Cessation of anti-coagulation for bleeding and subsequent thrombosis events with a fully magnetically levitated centrifugal left ventricular assist device
Anti-coagulation therapy for patients supported by a left ventricular assist device (LVAD) has not been adequately evaluated in relevance to newer pumps, such as the fully magnetically levitated HeartMate 3 (HM3) pump. Current anti-coagulation guidelines target a goal international normalized ratio (INR) of 2.0 to 3.0, with vitamin K antagonists to mitigate the risk of pump thrombosis and ischemic stroke, but are based on historical trials with older devices. Long-term outcomes associated with newer devices, such as the centrifugal-flow HM3, have demonstrated a marked decrease in the incidence of pump thrombosis compared w...
Source: The Journal of Heart and Lung Transplantation - April 28, 2019 Category: Transplant Surgery Authors: Igor Gosev, Brian Ayers, Katherine Wood, Bryan Barrus, Sunil Prasad Tags: CASE ANECDOTES, COMMENTS AND OPINIONS Source Type: research
Usefulness of anti-platelet therapy testing in children supported with a ventricular assist device
Stroke is the most recognized complication associated with the Berlin Heart EXCOR pediatric ventricular assist device (VAD).1 –3 Thromboelastography with Platelet Mapping (TEG/PM) has become the most commonly used platelet function test utilized in U.S. children supported with the EXCOR4 after it was incorporated into the Edmonton Antithrombotic Guideline for the U.S. Food and Drug Administration Trial of the EXCOR (refe r to Supplementary Material available online at www.jhltonline.org/).1 Despite its use, stroke occurred in one third of children in the EXCOR trial.
Source: The Journal of Heart and Lung Transplantation - April 2, 2019 Category: Transplant Surgery Authors: Lindsay J. May, Xiaoxi Liu, Tiffany Tesoro, Jaden Yang, Clara Lo, Sharon Chen, Jenna Murray, David N. Rosenthal, Alan D. Michelson, Christopher S. Almond Tags: RESEARCH CORRESPONDENCE Source Type: research
Usefulness of antiplatelet therapy testing in children supported with a ventricular assist device
Stroke is the most recognized complication associated with the Berlin Heart EXCOR ® Pediatric ventricular assist device (VAD).1-3 Thromboelastography with Platelet Mapping® (TEG/PM) has become the most commonly used platelet function test in US children supported with the EXCOR®4 after it was incorporated into the Edmonton Antithrombotic Guideline for the FDA Trial of the EXCO R® (Supplementary File).1 Despite its use, stroke occurred in one-third of children in the EXCOR® trial.1-3 Thus, some clinicians have questioned its validity as a primary means to guide antiplatelet therapy dosing in EXCOR® recipients.
Source: The Journal of Heart and Lung Transplantation - April 2, 2019 Category: Transplant Surgery Authors: Lindsay J. May, Xiaoxi Liu, Tiffany Tesoro, Jaden Yang, Clara Lo, Sharon Chen, Jenna Murray, David N. Rosenthal, Alan D. Michelson, Christopher S. Almond Tags: Research Correspondence Source Type: research
Stroke and death risk in ventricular assist device patients varies by ISHLT infection category: An INTERMACS analysis
Ventricular assist device (VAD) patients often experience infections, which increase the risk of stroke and mortality. Using the definitions of the International Society for Heart and Lung Transplantation (ISHLT), we have characterized differences in clinical outcomes for categories of infection: VAD-specific (e.g., pump component related); VAD-related (e.g., bloodstream infection, BSI); and non-VAD infections (e.g., pneumonia).
Source: The Journal of Heart and Lung Transplantation - April 2, 2019 Category: Transplant Surgery Authors: Palak Shah, Sarah E. Birk, Lauren B. Cooper, Mitchell A. Psotka, James K. Kirklin, Scott D. Barnett, Shalika B. Katugaha, Sheila Phillips, Mary M. Looby, Francis D. Pagani, Jennifer A. Cowger Tags: ORIGINAL CLINICAL SCIENCE Source Type: research
Peak Left Atrial Appendage Emptying Velocity Remains Reduced in Atrial Fibrillation during Continuous Flow Left Ventricular Assist Device Support
Although regions of stasis such as the left atrial appendage (LAA) may be potential sites of thrombus formation during atrial fibrillation (AF), its thrombotic contribution during high flow mechanical unloading is unknown. Moreover, registry studies only show a mixed association of AF and stroke during continuous flow left ventricular assist device (CF LVAD) support. Since a lower peak Left Atrial Appendage Emptying Velocity (LAAEV) of less than 40 cm/s during AF, mechanistically contributes to thrombosis and stroke in non-CF LVAD populations, we sought to evaluate the LAAEV in CF LVAD patients with and without AF.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: A. Rahman, E. Tam, L. ZHeng, J. Fontes, S. Forest, S. Vukelic, D. Sims, J. Shin, S. Patel, D.J. Goldstein, U.P. Jorde, O. Saeed Tags: 88 Source Type: research
Anti-Coagulation Management in Pediatric Ventricular Assist Device: A Quality Improvement Target
This report describes baseline AC data from ACTION centers, including agents used and aggregate levels of performance, to inform development of specific interventions.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: C. VanderPluym, M. O'Connor, A. Lorts, M. Ploutz, D. Peng, S. Law, M. Zinn, R. Niebler, D. Rosenthal, J. Conway, S. Auerbach, D. Sutcliffe, M. Mehegan Tags: 29 Source Type: research
Increased Risk of Stroke and Death in Ventricular Assist Device Patients Varies by ISHLT Infection Category: An INTERMACS Analysis
Ventricular assist device (VAD) patients experience infections, which increase the risk of stroke and mortality. We aimed to characterize key differences in clinical outcomes for VAD patients based on the ISHLT categorization of infections: VAD-specific (e.g. pump component related), VAD-related (e.g. bloodstream infection, BSI) and non-VAD infections (e.g. pneumonia).
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: P. Shah, S.E. Birk, L.B. Cooper, M.A. Psotka, J.K. Kirklin, S.D. Barnett, S.B. Katugaha, S. Phillips, M.M. Looby, F.D. Pagani, J.A. Cowger Tags: 224 Source Type: research
A Comparison of Middle Cerebral Artery and Central Retinal Artery Hemodynamics in HM II Patients
In the normal, pulsatile circulation, the hemodynamic pattern of the middle cerebral artery (MCA) differs from the central retinal artery (CRA). Whether continuous flow from a left ventricular assist device (LVAD) alters this relationship is not known. Since serious adverse events in different end-organs, such as stroke and GI bleeding, are frequent in LVAD patients, comparing hemodynamics in different arterial beds may enhance our understanding of the specific pathophysiology of these complications.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: E.J. St öhr, R. Ji, K. Akiyama, F. Castagna, A. Pinsino, J.R. Cockcroft, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, R.T. Te-Frey, H. Takayama, K. Takeda, Y. Naka, P.C. Colombo, J.Z. Willey, B.J. McDonnell Tags: 200 Source Type: research
Occurrence and Clinical Patterns of Stroke Based on Arterial Cannulation Strategy during Veno-Arterial Extracorporeal Membrane Oxygenation Support
Stroke is a major complication with potentially devastating consequences for patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Arterial cannulation sites for VA-ECMO include ascending aorta, axillary artery, and femoral artery. However, rates of stroke according to cannulation site are currently unknown. The purpose of this study was to investigate the association between occurrence and patterns of stroke with ECMO arterial cannulation sites.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: M. Nishikawa, J. Willey, A.R. Garan, M. Cevasco, L. Witer, J. Sanchez, P. Kurlansky, A. Kirtane, D. Brodie, M. Yuzefpolskaya, P. Colombo, H. Takayama, Y. Naka, K. Takeda Tags: 148 Source Type: research
Presence of Left Atrial or Left Ventricular Thrombus at the Time of CF-LVAD Implantation is Associated with Increased Post-Operative Risk of Stroke or Death
Patients with advanced HF are at increased risk for intra-cardiac thrombus formation. The impact of pre-existing left atrial (LA) or left ventricular (LV) thrombi on post-operative outcomes in LVAD patients is unknown.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: J.A. Fried, H. Lumish, A.M. Zuver, A.R. Garan, V.K. Topkara, B. Cagliostro, G. Parkis, M. Cevasco, M.T. Pineda, G.M. Mondellini, K. Ross, L. Witer, H. Takayama, K. Takeda, Y. Naka, M. Yuzefpolskaya, R.T. Demmer, P.C. Colombo Tags: 147 Source Type: research
Impact of Stroke Onset Severity on 2-Year Survival in Destination Therapy Patients Supported by Centrifugal Flow versus Axial Flow Ventricular Assist Devices
The ENDURANCE Supplemental Trial (DT2) was designed to prospectively study whether improved blood pressure management would reduce the incidence of strokes in destination therapy patients receiving an HVAD. The trial not only demonstrated a significant reduction in hemorrhagic strokes, but also some reductions in stroke-related severity. This analysis seeks to study further the impact of stroke severity on 2-year survival in both the HVAD and control cohorts of DT2.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: P. Shah, C. Mahr, J. Rogers, M. Kiernan, S. Boyce, N.A. Mokadam, F. Pagani, T. Vassiliades, J. Teuteberg Tags: 145 Source Type: research
Understanding Risk Factors for Stroke Subtypes in the ENDURANCE Trials
Stroke is one of the most devastating morbidities associated with left ventricular assist device (LVAD) support. Improved blood pressure management in LVAD patients has been shown to significantly reduce strokes, in particular hemorrhagic strokes. However, little is known regarding clinical risk factors for stroke subtypes.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: S. Cho, R. Starling, J. Teuteberg, J. Rogers, F. Pagani, P. Shah, K. Uchino, T. Vassiliades Tags: 142 Source Type: research
Speaking the Same Language? Assessing Blood Pressure Measurement and Effectiveness in Pediatric VAD Patients
This report describes the methods used to obtain BP and effectiveness of BP control among ACTION members. We also describe the development of a BP clinical decision support (CDS) tool to standardize BP reporting and goals.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: C. Villa, D. Peng, S. Auerbach, S. Kindel, S. Law, A. Lorts, M. Mehegan, M. O'Connor, M. Ploutz, D. Rosenthal, C. VanderPluym, M. Zinn, D. Sutcliffe Tags: 262 Source Type: research
A Trial of Complete Withdrawal of Anticoagulation Therapy in the Heartmate 3 Pump
The HeartMate 3 Left Ventricular Assist System has demonstrated absence of confirmed de-novo pump thrombosis and reduction in stroke. However, bleeding related adverse events persist under standard anticoagulation targeting a INR range of 2.0-3.0. In an initial experience we demonstrated safety of transition to low intensity anticoagulation (INR target 1.5-1.9, n=15, follow up of at least 6 months). Whether complete cessation of anticoagulation maintains “thromboresistance” in the HeartMate 3 pump remains unknown.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: I. Netuka, P. Ivak, Z. Tucanova, S. Gregor, O. Szarszoi, J. Rimsans, J. Connors, D. Crandall, P. Sood, M. Mehra Tags: 254 Source Type: research
It Takes a Village: Pediatric Ventricular Assist Device Training and Education Practices among ACTION Centers
The last decade has seen a dramatic increase in the number of ventricular assist devices (VADs) implanted in children. Despite the increases, the procedure remains uncommon at individual centers making patient, family and staff education challenging. ACTION (Advanced Cardiac Therapies Improving Outcomes Network) is the first pediatric VAD quality improvement network. The initial goal of ACTION is stroke reduction. We sought to describe the education and care delivery structure among members of the ACTION pediatric VAD quality improvement collaborative.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: K. Fields, B. Hawkins, J. Lantz, M. Mehegan, J. Murray, L. Burkhart, C. Villa Tags: 471 Source Type: research
