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Blood pressure and stroke risk in left ventricular assist devices
Ischemic and hemorrhagic stroke are one of the most devastating outcomes arising from treatment of end-stage congestive heart failure with a left ventricular assist device (LVAD)1. Stroke after LVAD is associated with increased risk of mortality and is a leading cause of not qualifying for transplantation. The risk of stroke is one of many factors limiting more widespread adoption of this technology for end-stage heart failure. The risk factors for stroke in LVAD have been the subject of several studies, with recent infection2 and changes in anti-thrombotics being commonly found3.
Source: The Journal of Heart and Lung Transplantation - December 5, 2014 Category: Transplant Surgery Authors: Joshua Z. Willey Source Type: research

Extracorporeal Membrane Oxygenation: Experience In Acute Graft Failure After Heart Transplantation
ConclusionTemporary ECMO support for postoperative output failure is an acceptable option as a last resort for otherwise doomed patients with fatal graft failure after HTx. The small fraction of patients surviving, appear to have a decent long‐term prognosis.This article is protected by copyright. All rights reserved.
Source: Clinical Transplantation - April 1, 2014 Category: Transplant Surgery Authors: Sven Lehmann, Madlen Uhlemann, Christian D. Etz, Jens Garbade, Thomas Schroeder, Michael Borger, Martin Misfeld, Hartmuth B Bittner, Friedrich Wilhelm Mohr Tags: Original Article Source Type: research

Post-approval study of a highly pulsed, low-shear-rate, continuous-flow, left ventricular assist device, EVAHEART: A Japanese multicenter study using J-MACS
Conclusions: The EVAHEART device provides safe, reliable and long-term circulatory support with improved survival in commercial settings of BTT in Japan, where the transplant waiting period is much longer. Incidences of GI bleeding, hemolysis, right ventricular failure, device thrombosis and mechanical failure were extremely rare in patients on EVAHEART devices.
Source: The Journal of Heart and Lung Transplantation - March 6, 2014 Category: Transplant Surgery Authors: Satoshi Saito, Kenji Yamazaki, Tomohiro Nishinaka, Yuki Ichihara, Minoru Ono, Syunei Kyo, Takashi Nishimura, Takeshi Nakatani, Koichi Toda, Yoshiki Sawa, Ryuji Tominaga, Tadahisa Tanoue, Yoshikatsu Saiki, Yoshiro Matsui, Takahiro Takemura, Hiroshi Niinami Tags: Featured Articles Source Type: research

Incidence of increases in pump power use and associated clinical outcomes with an axial continuous-flow ventricular assist device
Left ventricular assist devices (LVADs) have been shown to improve survival in patients with end-stage heart failure. Newer-generation LVADs with continuous-flow mechanics yield lower rates of disabling stroke, infection, and need for device exchange compared with earlier pulsatile-flow devices. It has been hypothesized that an elevation in the pump power may be an early indication of device thrombosis. Our goal was to define the frequency of pump power elevations, evaluate when they happen in relation to device implantation, and determine the rate at which they precede adverse events suggestive of pump thrombosis.
Source: The Journal of Heart and Lung Transplantation - January 1, 2014 Category: Transplant Surgery Authors: Robert J. Steffen, Edward G. Soltesz, Kimberly Miracle, Sangjin Lee, Maria Mountis, Nader Moazami Tags: Research Correspondence Source Type: research

Carotid-bulb thrombus and continuous-flow left ventricular assist devices: A novel observation
The continuous-flow left ventricular assist device (LVAD) has emerged as a clinically important treatment strategy for patients with advanced-stage heart failure. However, LVADs are not without associated neurologic complications, including stroke. In one review, the incidence of stroke (both ischemic and hemorrhagic) with the HeartMate II (HM II; Thoratec, Pleasanton, CA) ranged from 2% to 18%. In another recent single-center study, the incidence was 10%. In that study, previous stroke, persistent malnutrition and inflammation, severity of heart failure and post-LVAD infections were associated with neurologic complications.
Source: The Journal of Heart and Lung Transplantation - October 28, 2013 Category: Transplant Surgery Authors: John T. Reul, George J. Reul, O.H. Frazier Tags: Research Correspondence Source Type: research

A longer waiting game: Bridging children to heart transplant with the Berlin Heart EXCOR device—the United Kingdom experience
Conclusions: BH use in the UK has allowed significant increases in the number of children with end-stage heart failure who can be successfully bridged to transplant and the length of time they can be supported. The total number of transplants has not increased.
Source: The Journal of Heart and Lung Transplantation - September 23, 2013 Category: Transplant Surgery Authors: Jane Cassidy, Troy Dominguez, Simon Haynes, Michael Burch, Richard Kirk, Aparna Hoskote, Jon Smith, Matthew Fenton, Massimo Griselli, Tain-Yen Hsia, Lee Ferguson, Carin Van Doorn, Asif Hasan, Ann Karimova Tags: Original Clinical Science Source Type: research

Diagnosis of hemolysis and device thrombosis with lactate dehydrogenase during left ventricular assist device support
Mechanical circulatory support (MCS) with a continuous-flow (CF) rotary pump is associated with low levels of hemolysis during normal pump operation. Clinically significant hemolysis can be an early sequelae of pump thrombus. Left ventricular assist device (LVAD) thrombosis may result in stroke, peripheral embolism, heart failure, device exchange, and death. The timely detection of pump thrombus remains challenging.
Source: The Journal of Heart and Lung Transplantation - August 21, 2013 Category: Transplant Surgery Authors: Palak Shah, Vivek M. Mehta, Jennifer A. Cowger, Keith D. Aaronson, Francis D. Pagani Tags: Research Correspondence Source Type: research

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