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Two-Year Outcomes in HeartMate 3 versus HeartWare HVAD Patients Implanted as Destination Therapy
The ENDURANCE trial demonstrated noninferiority of the intrapericardial centrifugal-flow HeartWare HVAD compared to the axial-flow HeartMate II left ventricular assist device (LVAD) regarding survival in patients with advanced heart failure ineligible for heart transplantation, but stroke was more common. Most recently, the MOMENTUM 3 trial demonstrated superiority of the intrathoracic, fully magnetically levitated centrifugal-flow HeartMate 3 (HM3) LVAD compared to the HeartMate II. A clinical trial evaluating the HM3 and HVAD has not been performed, therefore the purpose of this study was to compare outcomes between these two devices.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: L. Coyle, C. Gallagher, L. Kukla, R. Paliga, R. Siemeck, G. Yost, M. Dia, A. Tatooles Tags: (1039) Source Type: research

Natural Antibodies and Left Ventricular Assist Device Complications
Left ventricular assist devices (LVAD) are widely used as a support strategy for advanced heart failure. Complications such as thrombosis and bleeding have been linked to LVAD. We observed that LVAD implantation was followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE) and apoptotic cells. Nabs have been implicated in inflammatory reactions related to atherosclerosis, ischemic stroke and primary graft dysfunction following heart transplantation.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: S.B. See, D. Onat, E. Hittesdorf, F. McDougan, M. Yuzefpolskaya, A.R. Garan, V.K. Topkara, Y. Naka, H. Takayama, K. Takeda, G.P. Milligan, D. Wencker, S.A. Hall, M. Askar, P. Kimball, G. Wagener, P. Colombo, E. Zorn Tags: (1211) Source Type: research

The Impact of Statin Therapy on Neurological Events Following Left Ventricular Assist System Implantation in Advanced Heart Failure
Stroke is a leading cause of disability and death in advanced heart failure patients supported with continuous-flow left ventricular assist systems (CF-LVAS). Statins (HMG-CoA Reductase Inhibitors) reduce the risk of major cardiovascular and neurological events, such as stroke, but their impact has not been evaluated in patients implanted with CF-LVAS. We sought to explore the association between use of statin therapy and subsequent occurrence of neurological events, particularly stroke, following CF-LVAS implantation.
Source: The Journal of Heart and Lung Transplantation - March 3, 2020 Category: Transplant Surgery Authors: Jefferson L. Vieira, Michael Pfeffer, Brian L. Claggett, Garrick C. Stewart, Michael M. Givertz, Lara Coakley, Hari R. Mallidi, Mandeep R. Mehra Tags: Original Clinical Science Source Type: research

First Human Implantation of A Miniaturized Axial Flow Ventricular Assist Device in a Child with End-Stage Heart Failure
Small children with end-stage heart failure who require left ventricular assist device (LVAD) support to heart transplant have limited device options leading to high morbidity and mortality and chronic hospitalization until transplant.1,2 The only FDA-approved durable LVAD for children is a paracorporeal pulsatile device that carries a high stroke risk and lacks portability precluding hospital discharge.1 Temporary paracorporeal continuous flow (CF) devices have also been used off-label for bridge-to-transplant but carry higher mortality, require lengthy paracorporeal cannulas prone to circuit thrombus, and typically requi...
Source: The Journal of Heart and Lung Transplantation - September 10, 2019 Category: Transplant Surgery Authors: Antonio Amodeo, Sergio Filippelli, Gianluigi Perri, Roberta Iacobelli, Rachele Adorisio, Francesca Iodice, Alessandra Rizza, M. Patricia Massicotte, J. Timothy Baldwin, Christopher S.D. Almond Tags: Case Anecdotes, Comments and Opinions Source Type: research

Different Risk Factors for Ischemic and Hemorrhagic Stroke on Continuous Flow Left Ventricular Assist Device Support
Patients with end-stage heart failure on left ventricular assist devices are predisposed to stroke. Preoperative factors associated with increased stroke risk are poorly understood.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: H.K. Lamba, M. Kim, L. Hart, B. Chou, C. Rao, S. Chatterjee, S. Sattee, F. Cheema, A. Civitello, R. Delgado, A. Nair, A. Shafii, G. Loor, T. Rosengart, O. Frazier, J. Morgan Tags: 402 Source Type: research

Carotid Artery Blood Flow and Its Association with Stroke during Left Ventricular Assist Device Support
Left ventricular assist device (LVAD) surgery is a life-prolonging therapy for advanced heart failure (HF). Despite many improvements over the years, LVADs continue to be associated with a high incidence of stroke and other vascular complications such as gastrointestinal bleeding (GIB). At present, the pathogenesis of these complications during LVAD support remains unclear. Abnormal structure and hemodynamics in large arteries are a potential contributor. We hypothesized that structural abnormalities and flow alterations will be significantly associated with stroke and a composite outcome of stroke, GIB, and death in HF pa...
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: M.E. Kiyatkin, A.M. Zuver, A. Gaudig, M. Tiburcio, B.J. McDonnell, M. Yuzefpolskaya, P.C. Colombo, E.J. St öhr, J.Z. Willey Tags: 401 Source Type: research

Mechanical Circulatory Support Patients Awaiting Heart Transplant with Positive AT1R Antibodies Have Acceptable Outcome Post-Heart Transplant
AT1R antibodies (Abs) are known to occur in patients (pts) with heart failure. It has been reported that when AT1R Abs are detected at high levels in mechanical circulatory support (MCS) pts, MCS mortality is increased. AT1R has been associated with the development of an inflammatory state inciting thrombosis. It may be that AT1R Abs are associated with pump thrombosis or even possibly thrombotic stroke. Furthermore, it is not clear whether these pts with MCS and AT1R Abs are at increased risk for post-heart transplant complications such as primary graft dysfunction (PGD) due to the recipients ’ highly inflamed state whi...
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: D.H. Chang, J. Patel, M. Kittleson, D. Geft, S. Dimbil, R. Levine, C. Kawata, L. Czer, J. Moriguchi, D. Ramzy, J.A. Kobashigawa Tags: 502 Source Type: research

Natural Antibodies and Left Ventricular Assist Device Complications
Left ventricular assist devices (LVAD) are widely used as a bridge to heart transplantation or destination therapy for advanced heart failure. However, hemocompatibility-related complications such as pump thrombosis, stroke and bleeding remain frequent. We previously reported that LVAD implantation is followed by a sharp increase in serum levels of IgG natural antibodies (Nabs) recognizing oxidation-specific epitopes (OSE). Nabs have been implicated in inflammatory reactions related to atherosclerosis, ischemic stroke and primary graft dysfunction following heart transplantation.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: S.B. See, A. Pinsino, N. Kunimune, D. Onat, E. Hittesdorf, A.R. Garan, V.K. Topkara, N. Yoshifumi, H. Takayama, K. Takeda, P.C. Colombo, G. Wagener, M. Yuzefpolskaya, E. Zorn Tags: 606 Source Type: research

Preoperative Computational Fluid Dynamics Simulation of the Best Anastomosis Site and Angle of the Outflow Graft and Ascending Aorta in Continuous Flow Mechanical Assist Devices
Left ventricle assist devices (LVAD) have contributed to improve survival and quality of life in patients with advanced heart failure, in temporary or lifetime support. Despite technological, bio-compatibility and hemodynamic progress, patients with LVAD have still a relevant incidence of adverse events, such as disabling stroke. The outflow cannula (OC) position and angulation, and the anastomosis site seem to modify the flow in the ascending aorta (AA), and consequently the incidence of cerebral embolism and aortic cusps stress.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: A. Giacomini, A. Esposito, T. Nisi, E. Lapenna, S. Bartesaghi, D. Redaelli, F. Pappalardo, G. Colombo, M. De Bonis Tags: 863 Source Type: research

Positive Correlation between P Wave Analysis and Severity of Heart Failure with Preserved and Reduced Ejection Fraction
Two separate studies by Morris et al. in 1964 and then He at al in 2017 were able to show a direct relationship between P wave analysis and valvular heart disease and ischemic stroke, respectively. We hope to continue this progress by establishing a relationship between P wave morphology, duration, PR interval, and P wave terminal force with the severity of Heart Failure with Preserved Ejection Fraction in our patient population.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: H. Patel, B. Allen, S. Almhameed, C. Musser Tags: 956 Source Type: research

Use of Pulmonary Arterial Catheters for Management of Acute Decompensated Heart Failure and Peri-Operative Monitoring in Children
Pulmonary arterial catheters (PAC) provide real-time hemodynamic data that has been used to tailor ICU therapies, aid in surgical decision making in adults with ADHF and in predicting right-heart failure (RHF) in adults undergoing LVAD evaluation. Approximately 1/3 of patients develop RVF after LVAD insertion. Patients who required rescue RVAD have increased mortality when compared to planned BiVAD implantation. Right ventricular stroke work index (RVSWI) has been demonstrated to predict RHF in adults.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: P. Esteso, E.D. Blume, C. VanderPluym, F. Fynn-Thompson, K.P. Daly Tags: 1179 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

Quantifying the Devastation From Stroke During Support With Continuous Flow Pumps: An Intermacs Analysis
Strokes (S) during continuous flow (CF) left ventricular assist device (LVAD) support are a major barrier to extension of the therapy to less ill ambulatory heart failure (HF) patients. We analyzed the incidence, outcome, and impact of major S in the INTERMACS database.
Source: The Journal of Heart and Lung Transplantation - March 31, 2018 Category: Transplant Surgery Authors: J.K. Kirklin, D.C. Naftel, S.L. Myers, F.D. Pagani, L.W. Stevenson, R.L. Kormos, P.C. Colombo Source Type: research

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