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Condition: Bleeding
Procedure: Lung Transplant

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Total 72 results found since Jan 2013.

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

Unusual Techniques for Preserving Surgical and Oncologic Safety in Hepatectomy of Advanced Adrenal Malignancy with Vena Cava and Liver Invasion
We report herein three cases of major hepatectomy with IVC invasion and discuss several surgical tips.Patients and MethodsFrom March 2011 to February 2014, we retrospectively reviewed three cases of adrenal malignancy with liver and IVC invasion. Based on the severity of the malignant tumor, each case illustrates a different method to address surgical complications and maintain oncologic safety. Case 1: A 34-year-old woman was diagnosed with adrenocortical tumor during medical examination. Tumor invaded the right lobe of the liver and very close to the IVC. Fortunately, there was little thrombosis inside the IVC; we perfor...
Source: Annals of Surgical Oncology - September 6, 2018 Category: Cancer & Oncology 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

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

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

Intraoperative extracorporeal membrane oxygenation versus cardiopulmonary bypass for lung transplantation: A meta-analysis
Conclusion: ECMO support for LuTx showed better clinical outcomes compared to CPB.
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Magouliotis, D., Svokos, A., Svokos, K., Olland, A., Massard, G., Tasiopoulou, V., Zacharoulis, D. Tags: Transplantation 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

Lung Transplantation and the Routine Use of Cardiopulmonary Bypass and Median Sternotomy: Experience at the Ochsner Multi-Organ Transplant Institute.
CONCLUSION: Patients' early outcomes appear to have improved with the use of CPB and median sternotomy; however, 3-year survival is similar to the non-CPB group. Technical benefits of CPB with median sternotomy include decreased warm ischemia time during graft implantation, controlled hemodynamics and reperfusion, avoidance of single-lung ventilation of a freshly implanted graft, and the option to open the left atrium for implantation of a venous cuff without using a clamp. The surgical exposure facilitated by CPB with median sternotomy for lung transplantation appears to be a safe and feasible approach for lung transplant...
Source: Ochsner Journal - March 25, 2017 Category: Journals (General) Tags: Ochsner J Source Type: research

Transcatheter Aortic Valve Implantation for Treatment of Aortic Valve Stenosis: A Health Technology Assessment.
CONCLUSIONS: Moderate quality evidence showed that TAVI and SAVR had similar mortality rates in patients who were eligible for surgery. Information about quality of life showed similar results for TAVI and SAVR in the first year, but was based on low quality evidence. Moderate quality evidence also showed that TAVI was associated with higher rates of adverse events than SAVR. In patients who were not suitable candidates for surgery, moderate quality evidence showed that TAVI improved survival compared with balloon aortic valvuloplasty. When TAVI was compared with SAVR, the incremental cost-effectiveness ratio was $51,988 p...
Source: Ontario Health Technology Assessment Series - December 21, 2016 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

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