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4D Flow MRI in 3D Printed Models of Aorta Grafted With a Ventricular Assist Device Allows Detailed Embolic Trajectory Analysis
Embolic stroke remains an important source of morbidity and mortality in heart failure patients treated with Ventricular Assist Devices (VADs). Decreasing the probability of cranial versus descending aortic embolic trajectory by optimizing the VAD outflow graft position and terminal curvature angle could reduce embolic stroke risk. The goal of this study is to investigate particle trajectories released by a VAD into the aorta, and the effect changes in outflow graft insertion site and terminal curve have on those trajectories.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: O. Amili, F. Coletti, R. MacIver 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

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

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

Anticoagulation with VADs and ECMO: walking the tightrope.
Authors: Raffini L Abstract The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, r...
Source: Hematology ASH Education Program - December 10, 2017 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program 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

How Genomic Research is Changing Heart Care
Genomic testing is most frequently associated with cancer testing, but this area of research is beginning to make an impact on cardiovascular care. A recent scientific statement by the American Heart Association shined a spotlight on how the expressed genome can potentially be used to diagnose diseases and predict who will develop diseases such as coronary artery disease (CAD), stroke, heart failure, and arrhythmias. According to the statement, scientists now have the ability to address disease at many levels that were inaccessible during the past century. This includes the genome, transcriptome, epigenome, proteome, metab...
Source: MDDI - October 27, 2017 Category: Medical Devices Authors: Amanda Pedersen Tags: IVD Cardiovascular Source Type: news

Godly gift for arthritis pain
Big Pharma is at it again… Creating and selling a drug that causes thousands of heart attacks and strokes each year. In 2015, the FDA asked drug makers to strengthen their warning labels. Since then, most have listed their dangerous side effects on the bottle. But one manufacturer thought they didn’t have to warn people about their dangerous drug. They marketed their product as a “unique” breakthrough. They even published studies promising it was “safe for long-term use.” 1 The drug is a 7-year-old arthritis drug called Actemra. It’s made by the Swiss pharmaceutical company Roche. ...
Source: Al Sears, MD Natural Remedies - October 5, 2017 Category: Complementary Medicine Authors: Al Sears Tags: Anti-Aging Source Type: news

ISHLT 2017: Medtronic HVAD trial misses primary endpoint, reports lowered stroke rates
Medtronic (NYSE:MDT) said today that results from the Endurance supplemental trial of its HVAD heart pump system did not meet its primary endpoint, but did report  lowered stroke rates compared to standard treatment. The trial aimed to evaluate the use of the HVAD system, which it picked up along with HeartWare last year, as a destination therapy for patients who require a left ventricular assist device and received improved blood pressure management, the Fridley, Minn.-based company said. Data from the study was presented at the 2017 International Society for Heart and Lung Transplantation Scientific Meeting in San Dieg...
Source: Mass Device - April 5, 2017 Category: Medical Equipment Authors: Fink Densford Tags: Cardiac Assist Devices Cardiovascular Clinical Trials HeartWare International Inc. Medtronic Source Type: news

The Treatment of Patients with Advanced Heart Failure Ineligible for Cardiac Transplantation with the HeartWare Ventricular Assist Device: Results of the ENDURANCE Supplement Trial
The ENDURANCE Trial previously demonstrated non-inferiority of the HeartWare centrifugal flow ventricular assist device system (HVAD) to the control HeartMate II (HMII) axial flow device in 445 end-stage heart failure patients ineligible for heart transplantation. However, the rate of strokes in the HVAD cohort was higher than expected. Analysis of early clinical trial data found that elevated mean arterial blood pressure (MAP) was a highly statistically significant independent risk factor for stroke events.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: C.A. Milano, J.G. Rogers, A.J. Tatooles, G. Bhat, M.S. Slaughter, E.J. Birks, N.A. Mokadam, C. Mahr, J.S. Miller, V. Jeevanandam, K. Leadley, K.D. Aaronson, F.D. Pagani 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

Effect of a Multifaceted Team Management Approach on Survival and Stroke Rates in Heartmate 2 Recipients
We report the effect of a comprehensive HM II management strategy on survival and stroke rates.
Source: The Journal of Heart and Lung Transplantation - March 25, 2017 Category: Transplant Surgery Authors: U. Jorde, N. Siddiqi, A. Luke, D.B. Sims, O. Saeed, S.R. Patel, S. Murthy, J. Shin, S. Watts, E. Borukhov, S. Madan, S. Thompson, R. Bello, S. Forest, S. Vukelic, C. Nucci, S. Rangasamy, D. Goldstein Source Type: research

Surgical occlusion of the left atrial appendage and thromboembolic complications in patients with left ventricular assist devices
Thromboembolic complications (TECs) are major adverse events for patients supported by left ventricular assist devices (LVADs). Despite anti-coagulation, TECs such as stroke or pump thrombosis occur in 6.5% of patients.1 Risk of TECs increases with longer duration of device support, and the risk is likely greater in patients receiving LVADs as destination therapy. Surgical or percutaneous occlusion of the left atrial appendage (LAA) reduces TECs in patients with atrial fibrillation.2,3 The LAA may also be a source of thromboembolism for patients with systolic heart failure, including patients in sinus rhythm.
Source: The Journal of Heart and Lung Transplantation - January 29, 2017 Category: Transplant Surgery Authors: Rebecca S. Lewis, Lian Wang, Kateri J. Spinelli, Gary Y. Ott, Jacob Abraham Tags: Research Correspondence Source Type: research

Surgical occlusion of the left atrial appendage and thromboembolic complications in left ventricular assist device patients
Thromboembolic complications (TEC) are major adverse events for patients supported by left ventricular assist devices (LVADs). Despite anticoagulation, TEC such as stroke or pump thrombosis still occur in 6.5% of patients.1 Risk of TEC increases with longer duration of device support and is likely a greater risk in destination therapy patients. Surgical or percutaneous occlusion of the left atrial appendage (LAAO) reduces TEC in patients with atrial fibrillation.2,3 The LAA may also be a source of thromboembolism for systolic heart failure patients, even in sinus rhythm.
Source: The Journal of Heart and Lung Transplantation - January 29, 2017 Category: Transplant Surgery Authors: Rebecca S. Lewis, Lian Wang, Kateri J. Spinelli, Gary Y. Ott, Jacob Abraham Source Type: research

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