225 results on '"assist device"'
Search Results
2. Hand assistive device with suction cup (HADS) technology for poststroke patients.
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Jayavel, Porkodi, Karthik, Varshini, Mathunny, Jaison Jacob, Jothi, Suresh, and Devaraj, Ashokkumar
- Abstract
A stroke is a neurological disease that primarily causes paralysis. Besides paraplegia, all other types of paralysis affect the upper extremity. Advanced technologies, such as wearable devices and rehabilitation regimens, are also being developed to enhance the functional ability of a stroke person to grasp and release daily living objects. In this research, we developed a rehabilitation functional assist device combining a flexion and extension mechanism with suction cup technology (hybrid technology) to help post-stroke patients improve their hand grip strength in day-to-day grasping activities. Ten poststroke hemiplegia patients were studied to test the functional ability of the impaired hand by wearing and not wearing the device. The outcomes were validated by three standard clinical tests, such as the Toronto Rehabilitation Institute – Hand Functional Test (TRI-HFT), the Chedoke Arm Hand Activity Inventory (CAHAI-9), and the Fugl-Meyer Assessment (FMA) with overall score improvements of 14.5 ± 3.8–25 ± 2.2 (p = 0.005), 5.4 ± 2.8–10 ± 1.6 (p = 0.008), and 9.6 ± 2.6–17 ± 2.4 (p = 0.005) respectively. The p -value for each of the three evaluations was less than 0.05, indicating significantly improved results and the average feedback score of the participants was 3.8 out of 5. The proposed device significantly increased impaired hand functionality in post-stroke patients. The subjects could complete some of the grasping tasks that they could not grasp without the device. Clinical trial registration The Clinical Trial Registry of India approved the work CTRI/2022/02/040495 described in this manuscript. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Lifting Assist Device for Transfer in Cooperation with Caregivers
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Kurata, Mari, Jiang, Ming, Hoshiba, Kotaro, Sugahara, Yusuke, Uehara, Takahiro, Kawabata, Masato, Harada, Ken, Takeda, Yukio, Ceccarelli, Marco, Series Editor, Agrawal, Sunil K., Advisory Editor, Corves, Burkhard, Advisory Editor, Glazunov, Victor, Advisory Editor, Hernández, Alfonso, Advisory Editor, Huang, Tian, Advisory Editor, Jauregui Correa, Juan Carlos, Advisory Editor, Takeda, Yukio, Advisory Editor, Petuya, Victor, editor, Quaglia, Giuseppe, editor, Parikyan, Tigran, editor, and Carbone, Giuseppe, editor
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- 2023
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4. Cardiac Muscle Training—A New Way of Recognizing and Supporting Recovery for LVAD Patients in the Pediatric Population.
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Racolta, Anca, Ahn, Jae-Hyun Johannes, Kantzis, Marinos, Milting, Hendrik, Lauenroth, Volker, Körperich, Hermann, Sandica, Eugen, Schubert, Stephan, and Laser, Kai Thorsten
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MYOCARDIUM , *CHILD patients , *HEART assist devices , *ARRHYTHMIA - Abstract
Cardiac Muscle Training - A New Way of Recognizing and Supporting Recovery for LVAD Patients in the Pediatric Population During the weaning protocol, we collected clinical, laboratory (ABG, BNP, troponin, end-organ parameters, e.g., liver and kidney) and 2D echocardiographic data, as well as speckle tracking (ST), VTI measurements and RT3DE recordings of left ventricular enddiastolic (LVEDV) and endsystolic (LVESV), stroke volume (SV) and ejection fraction (EF). Conclusions Retraining a weakened heart may be a viable option for patients with heart failure on VAD therapy. Once the patient has been stabilised, individualised protocols should be established, tailored precisely to the patient's cardiac and clinical situation, even after prolonged VAD therapy. [Extracted from the article]
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- 2022
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5. Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure.
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Mulzer, Johanna, Müller, Marcus, Schoenrath, Felix, Falk, Volkmar, Potapov, Evgenij, and Knierim, Jan
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HEART assist devices , *HEART failure , *NON-Hodgkin's lymphoma , *SURVIVAL rate , *DEEP brain stimulation - Abstract
Objectives: Cancer-therapy-related heart failure (CTrHF) due to cardiotoxic drugs or radiation is a growing cause of end-stage heart failure. Limited knowledge is available concerning the use of continuous-flow left-ventricular-assist devices (cfLVAD) in this setting. Methods: The files of all 1334 patients who underwent cfLVAD implantation between December 2008 and December 2020 were screened for the cause of heart failure. All patients with CTrHF were included in the analysis. Results: A total of 32 patients with a median age of 58 years (IQR: 46–65) were included in the study; 15 (47%) were male. The median time from the first diagnosis of heart failure (HF) to cfLVAD implantation was 6 months (IQR 2–24), and from cancer treatment to cfLVAD implantation 40 months (IQR 5–144). Malignancies comprised non-Hodgkin lymphoma (n = 12, 37%), breast cancer (n = 9, 28%), sarcoma (n = 5, 16%), leukemia (n = 5, 16%), and others (n = 1, 3%). In 24 patients, chemotherapy included anthracyclines (others n = 2, unknown n = 6). Chest radiation was performed in 13 patients (39%). Moreover, 71% were classified as INTERMACS profile 1 or 2. The 30-day survival rate after LVAD implantation was 88%. Rethoracotomy was necessary in nine (29%), and a temporary right ventricular assist device in seven (21%) patients. The median survival was 29 months. There was no significant difference in survival or right HF between patients with CTrHF and a matched control group. Conclusions: CfLVAD implantation is feasible in high-risk patients with CTrHF with or without prior chest radiation. [ABSTRACT FROM AUTHOR]
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- 2022
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6. Impact of left ventricular unloading using a peripheral Impella®‐pump in eCPR patients.
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Gaisendrees, Christopher, Djordjevic, Ilija, Sabashnikov, Anton, Adler, Christopher, Eghbalzadeh, Kaveh, Ivanov, Borko, Walter, Sebastian, Schlachtenberger, Georg, Merkle‐Storms, Julia, Gerfer, Stephen, Carstens, Henning, Deppe, Antje‐Christin, Kuhn, Elmar, and Wahlers, Thorsten
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INTRA-aortic balloon counterpulsation , *HEART assist devices , *EXTRACORPOREAL membrane oxygenation , *ACUTE kidney failure , *CARDIAC arrest , *CARDIOPULMONARY resuscitation - Abstract
Background: Extracorporeal cardiopulmonary resuscitation (eCPR) is a rapidly growing treatment strategy due to increasing survival rates in selected patients. Additional left ventricular mechanical unloading, using a transfemoral micro‐axial blood pump (Impella® Denver, Massachusetts, USA), might improve patients' outcomes. In this regard, we sought to investigate patients who suffered OHCA (out‐of hospital cardiac arrest) or IHCA (in‐hospital cardiac arrest) with subsequent eCPR via VA‐ECMO (veno‐arterial extracorporeal membrane oxygenation) and concomitant Impella® implantation based on survival and feasibility of ECMO weaning. Methods: From January 2016 until December 2020, 108 patients underwent eCPR at our institution. Data prior to eCPR and early outcome parameters were analyzed comparing patients who were supported with an additional Impella® (2.5 or CP) (ECMO+Impella®, n = 18) and patients without additional (ECMO, n = 90) support during V‐A ECMO therapy. The primary endpoint was in‐hospital mortality; secondary endpoints were, among others: ECMO explantation, need for hemodialysis, stroke, and need for blood transfusions. Results: Low‐flow time was significantly lower in the ECMO+Impella group (60 min vs. 55 min, p =.01). All‐cause mortality was significantly lower in the ECMO+Impella® group (82% vs. 56%, p =.01). The time of circulatory support was shorter in the ECMO cohort (2.0 ± 1.73 vs. 4.76 ± 2.88 p =.05). ECMO decannulation was significantly more feasible in patients with ECMO+Impella® (72% vs. 32%, p =.01). Patients treated with additional Impella® showed significantly more acute kidney injury with the need for dialysis (72% vs. 18%, p ≤.01). Conclusion: Concomitant Impella® support might positively influence survival and ECMO weaning in eCPR patients. Treatment‐associated complications such as the need for dialysis were more common in this highly selected patient group. Further studies with larger numbers are necessary to evaluate the clinical relevance of concomitant LV‐unloading in eCPR patients using an Impella® device. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Managing the High-Risk Patient: Critical Care, TAVR, MitraClip, Pressors, and Cardiac Assist Devices
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Wong, Timothy C., DePasquale, Eugene C., Baas, Arnold S., and Naidu, Srihari S., editor
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- 2019
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8. Presence of Intracardiac Thrombus at the Time of Left Ventricular Assist Device Implantation Is Associated With an Increased Risk of Stroke and Death.
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Bravo, Claudio A., Fried, Justin A., Willey, Joshua Z., Javaid, Azka, Mondellini, Giulio M., Braghieri, Lorenzo, Lumish, Heidi, Topkara, Veli K., Kaku, Yuji, Witer, Lucas, Takayama, Hiroo, Takeda, Koji, Sayer, Gabriel, Uriel, Nir, Demmer, Ryan T., Naka, Yoshifumi, Yuzefpolskaya, Melana, and Colombo, Paolo C.
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Background: Heart failure predisposes to intracardiac thrombus (ICT) formation. There are limited data on the prevalence and impact of preexisting ICT on postoperative outcomes in left ventricular assist device patients. We examined the risk for stroke and death in this patient population.Methods and Results: We retrospectively studied patients who were implanted with HeartMate (HM) II or HM3 between February 2009 and March 2019. Preoperative transthoracic echocardiograms, intraoperative transesophageal echocardiograms and operative reports were reviewed to identify ICT. There were 525 patients with a left ventricular assist device (median age 60.6 years, 81.8% male, 372 HMII and 151 HM3) included in this analysis. An ICT was identified in 44 patients (8.4%). During the follow-up, 43 patients experienced a stroke and 55 died. After multivariable adjustment, presence of ICT increased the risk for the composite of stroke or death at 6-month (hazard ratio [HR] 1.82, 95% confidence interval [CI] 1.00-3.33, P = .049). Patients with ICT were also at higher risk for stroke (HR 2.45, 95% CI 1.14-5.28, P = .021) and death (HR 2.36, 95% CI 1.17-4.79 P = .016) at 6 months of follow-up.Conclusions: The presence of ICT is an independent predictor of stroke and death at 6 months after left ventricular assist device implantation. Additional studies are needed to help risk stratify and optimize the perioperative management of this patient population. [ABSTRACT FROM AUTHOR]- Published
- 2021
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9. Temporary right ventricular circulatory support following right ventricular infarction: results of a groin‐free approach
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Jamila Kremer, Mina Farag, Andreas Brcic, Alina Zubarevich, Joel Schamroth, Michael M. Kreusser, Matthias Karck, Arjang Ruhparwar, and Bastian Schmack
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Temporary circulatory support ,Myocardial infarction ,Assist device ,Percutaneous implantation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Acute right heart failure (RHF) is a severe complication of right ventricular infarction. The management of acute RHF poses a number of challenges, such as providing haemodynamic support. Temporary circulatory support (TCS) may be required upon failing medical therapy. The ProtekDuo® dual lumen cannula provides a minimally invasive option for (TCS) through a groin‐free internal jugular vein approach. We present the largest patient series to date using the ProtekDuo® cannula as temporary right ventricular assist device (t‐RVAD) in RHF after acute myocardial infarction (MI). Methods and results From July 2016 to November 2019, 10 patients underwent t‐RVAD implantation for RHF following acute MI. Transthoracic and transoesophageal echocardiography were performed in all patients to assess cardiac function, with a particular focus on RV function. Cumulative 30‐day survival was 60%. Mean TAPSE was 6.4 ± 3.1 mm, mean fractional area change was 12.1 ± 4.2%, and mean right ventricular end diastolic area was 19.8 ± 2.7 cm2. Mean implantation time was 32.8 ± 8.3 min. Mean interval after first cardiac intervention was 4.6 ± 5.8 days. Mean t‐RVAD time was 10.0 ± 7.4 days with a significant reduction in central venous pressure 19.3 ± 2.7 vs. 8.2 ± 2.6 mmHg, P
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- 2020
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10. Post‐transplant inotrope score is associated with clinical outcomes after adult heart transplantation.
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Venema, Constantijn S., Erasmus, Michiel E., Mariani, Massimo, Voors, Adriaan A., and Damman, Kevin
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HEART transplantation , *TREATMENT effectiveness , *ADULTS , *ACUTE kidney failure , *CONGENITAL heart disease - Abstract
Background: Inotrope score has been proposed as a marker of clinical outcome after adult heart transplantation (HTx) but is rarely used in practice. Methods: Inotrope score during the first 48 h after HTx was calculated in 81 patients as: dopamine + dobutamine + amrinone + milrinone (dose × 15) + epinephrine (dose × 100) + norepinephrine (dose × 100) + enoximone + isoprenaline (dose × 100), with each drug in µg/kg/min. Determinants of inotrope score were identified with linear regression. Cox regression was used to determine the association of inotrope score with mortality. Results: The mean recipient age was 52 ± 11 years, and 32 (39.5%) patients were female. Determinants of inotrope score were preoperative C‐reactive protein, serum urea, congenital heart disease, and donor cardiac arrest (R2 =.30). Inotrope score was associated with 5‐year mortality, independent of recipient age and gender (HR 1.03, 95% CI 1.00‐1.07). This association was attenuated when adjusting for female‐to‐male transplant and ischemia time. Inotrope score was also strongly associated with continuous veno‐venous hemofiltration (OR 1.07, 95% CI 1.03‐1.12). Conclusion: High inotrope score post‐HTx was observed in recipient congenital heart disease and was associated with a higher risk of mortality and acute kidney injury. [ABSTRACT FROM AUTHOR]
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- 2021
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11. Pulmonary Assist Device (PAD)
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Baldo Jr., Danny, Esttabridis, Horacio, Tran, Vinson, Fung, Kelsey, Chung, Thanh, and Pham, Anthony
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pulmonary ,pneumothorax ,lung ,assist device ,UROP Fellowship ,UCI Dean's Choice Award 2015 - Abstract
Project Goal:Create device to stabilize patient’s lung after suffering a tension pneumothorax Current treatments involve chest tubes that are prone to clotting and infection Can be used in non-sterile environment Can be used in transit and at the hospital Field and Hospital Versions of PAD Danny Baldo Jr., Horacio Estabridis, Vinson Tran, Kelsey Fung, Thanh Chung, Anthony PhamDepartment of Biomedical Engineering, University of California, IrvineFrancis Duhay: Edwards Lifesciences
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- 2015
12. POST-LVAD Right Ventricular Failure
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Kırali, Kaan, Özer, Tanıl, Selçuk, Emre, Dumitrescu, Silviu Ionel, editor, Ţintoiu, Ion C., editor, and Underwood, Malcolm John, editor
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- 2018
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13. Dilated Cardiomyopathy and Myocarditis
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Alizadehasl, Azin, Sadeghpour, Anita, Sadeghpour, Anita, editor, and Alizadehasl, Azin, editor
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- 2018
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14. Cardiac Muscle Training—A New Way of Recognizing and Supporting Recovery for LVAD Patients in the Pediatric Population
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Anca Racolta, Jae-Hyun Johannes Ahn, Marinos Kantzis, Hendrik Milting, Volker Lauenroth, Hermann Körperich, Eugen Sandica, Stephan Schubert, and Kai Thorsten Laser
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congestive heart failure ,dilatative cardiomyopathy ,assist device ,Berlin Heart ,weaning ,myocarditis ,Science - Abstract
Patients with refractory heart failure due to chronic progressive cardiac myopathy (CM) may require mechanical circulatory support as a bridge to transplantation. A few patients can be weaned from support devices if recovery can be achieved. The identification of these patients is of great importance as recovery may be missed if the heart is unloaded by the ventricular assist device (VAD). Testing the load-bearing capacity of the supported left ventricle (LV) by temporarily and gradually reducing mechanical support during cardiac exercise can help identify responders and potentially aid the recovery process. An exercise training protocol was used in 3 patients (8 months, 18 months and 8 years old) with histological CM findings and myocarditis. They were monitored regularly using clinical information and functional imaging with VAD support. Echocardiographic examination included both conventional real-time 3D echocardiography (RT3DE) and speckle tracking (ST). A daily temporary reduction in pump rate (phase A) was followed by a permanent reduction in rate (phase B). Finally, pump stops of up to 30 min were performed once a week (phase C). The final decision on explantation was based on at least three pump stops. Two patients were weaned and successfully removed from the VAD. One of them was diagnosed with acute viral myocarditis. The other had chronic myocarditis with dilated myopathy and mild interstitial fibrosis. The noninvasive assessment of cardiac output and strain under different loading conditions during VAD therapy is feasible and helps identify candidates for weaning despite severe histological findings. The presented protocol, which incorporates new echocardiographic techniques for determining volume and deformation, can be of great help in positively guiding the process of individual recovery, which may be essential for selecting and increasing the number of patients to be weaned from VAD.
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- 2022
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15. Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure
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Johanna Mulzer, Marcus Müller, Felix Schoenrath, Volkmar Falk, Evgenij Potapov, and Jan Knierim
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assist device ,LVAD cancer ,chemotherapy ,radiation ,heart failure ,Science - Abstract
Objectives: Cancer-therapy-related heart failure (CTrHF) due to cardiotoxic drugs or radiation is a growing cause of end-stage heart failure. Limited knowledge is available concerning the use of continuous-flow left-ventricular-assist devices (cfLVAD) in this setting. Methods: The files of all 1334 patients who underwent cfLVAD implantation between December 2008 and December 2020 were screened for the cause of heart failure. All patients with CTrHF were included in the analysis. Results: A total of 32 patients with a median age of 58 years (IQR: 46–65) were included in the study; 15 (47%) were male. The median time from the first diagnosis of heart failure (HF) to cfLVAD implantation was 6 months (IQR 2–24), and from cancer treatment to cfLVAD implantation 40 months (IQR 5–144). Malignancies comprised non-Hodgkin lymphoma (n = 12, 37%), breast cancer (n = 9, 28%), sarcoma (n = 5, 16%), leukemia (n = 5, 16%), and others (n = 1, 3%). In 24 patients, chemotherapy included anthracyclines (others n = 2, unknown n = 6). Chest radiation was performed in 13 patients (39%). Moreover, 71% were classified as INTERMACS profile 1 or 2. The 30-day survival rate after LVAD implantation was 88%. Rethoracotomy was necessary in nine (29%), and a temporary right ventricular assist device in seven (21%) patients. The median survival was 29 months. There was no significant difference in survival or right HF between patients with CTrHF and a matched control group. Conclusions: CfLVAD implantation is feasible in high-risk patients with CTrHF with or without prior chest radiation.
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- 2022
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16. Acquired von Willebrand Syndrome
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Meyer, Anna L., Netuka, Ivan, Montalto, Andrea, editor, Loforte, Antonio, editor, Musumeci, Francesco, editor, Krabatsch, Thomas, editor, Slaughter, Mark S., editor, and Amarelli, Cristiano, With contrib. by
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- 2017
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17. Berlin Heart EXCOR Paediatric Ventricular Assist Device: Does Weight Matter?
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Fouilloux, Virginie, El Louali, Fedoua, Gran, Célia, Henaine, Roland, Roubertie, François, Chenu, Caroline, Fiorini, Marion, Le Bel, Stéphane, Mauriat, Philippe, Neidecker, Jean, Macé, Loïc, Kreitmann, Bernard, and Ovaert, Caroline
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HEART assist devices , *CORONARY care units , *PEDIATRIC intensive care , *INTENSIVE care units , *CARDIAC intensive care , *DILATED cardiomyopathy , *HEART transplantation , *RETROSPECTIVE studies , *TREATMENT effectiveness , *BARTHEL Index , *HEART failure - Abstract
Background: Berlin Heart EXCOR (BH) ventricular assist devices provide mechanical long-term circulatory support in children with end-stage heart failure, as a bridge to transplantation or to recovery. Most studies are from large-volume paediatric cardiac centres.Aim: The aim of this study was to analyse the experiences of three French centres and to compare these with available published data.Method: We performed a retrospective observational study of three paediatric cardiac intensive care units. All children supported with BH devices were included. Morbidity and mortality data were collected and risk factors analysed.Results: Fifty-four (54) patients (54% male) were included. Survival rate was 73% while on a BH device. Median age at BH device implantation was 17 months (range 2-180 months). The predominant indication was dilated cardiomyopathy (61%). Bi-ventricular assist device was used in 25 (46%) cases. The total length of long-term circulatory support was 3,373 days, with a mean length per patient of 62.5 days (range 5-267 days). Thirty-two (32) patients were transplanted (59%) and seven (13%) were successfully weaned. Type and length of support did not influence morbidity. Main complications were renal dysfunction (57%), bleeding (41%), and infection (39%). In multivariate analysis, a weight <5 kg was significantly associated with higher mortality.Conclusions: The weight seems to be the most important risk factor of mortality in this precarious condition. [ABSTRACT FROM AUTHOR]- Published
- 2021
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18. Temporary right ventricular circulatory support following right ventricular infarction: results of a groin‐free approach.
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Kremer, Jamila, Farag, Mina, Brcic, Andreas, Zubarevich, Alina, Schamroth, Joel, Kreusser, Michael M., Karck, Matthias, Ruhparwar, Arjang, and Schmack, Bastian
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HEART assist devices ,HEART failure ,MYOCARDIAL infarction - Abstract
Aims: Acute right heart failure (RHF) is a severe complication of right ventricular infarction. The management of acute RHF poses a number of challenges, such as providing haemodynamic support. Temporary circulatory support (TCS) may be required upon failing medical therapy. The ProtekDuo® dual lumen cannula provides a minimally invasive option for (TCS) through a groin‐free internal jugular vein approach. We present the largest patient series to date using the ProtekDuo® cannula as temporary right ventricular assist device (t‐RVAD) in RHF after acute myocardial infarction (MI). Methods and results: From July 2016 to November 2019, 10 patients underwent t‐RVAD implantation for RHF following acute MI. Transthoracic and transoesophageal echocardiography were performed in all patients to assess cardiac function, with a particular focus on RV function. Cumulative 30‐day survival was 60%. Mean TAPSE was 6.4 ± 3.1 mm, mean fractional area change was 12.1 ± 4.2%, and mean right ventricular end diastolic area was 19.8 ± 2.7 cm2. Mean implantation time was 32.8 ± 8.3 min. Mean interval after first cardiac intervention was 4.6 ± 5.8 days. Mean t‐RVAD time was 10.0 ± 7.4 days with a significant reduction in central venous pressure 19.3 ± 2.7 vs. 8.2 ± 2.6 mmHg, P < 0.001 and a significant increase in central venous saturation 52.8 ± 15.6 vs. 80.0 ± 6.0%, P < 0.001. Mean intensive care unit stay was 18.6 ± 12.2 days. Four patients were weaned from TCS. Two patients were bridged to a long‐term paracorporeal RVAD. There were no t‐RVAD associated complications. Causes of death (n = 4) were multiorgan failure, electromechanical dissociation, and haemorrhagic stroke. Mean follow‐up time was 96.0 ± 107.6 days. No independent predictors of mortality were identified in univariate analysis. Conclusions: We show that groin‐free, percutaneous implantation of the ProtekDuo® cannula is a feasible and safe tool for TCS in acute RHF post‐MI. This approach provides the advantages of percutaneous implantation including complete mobilization and non‐surgical bedside explantation, as well as the option for adding an oxygenator to the t‐RVAD circuit. [ABSTRACT FROM AUTHOR]
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- 2020
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19. Effects of wearable power assist device on low back fatigue during repetitive lifting tasks.
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Yin, Peng, Yang, Liang, Wang, Chao, and Qu, Shengguan
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BACK , *ELECTROMYOGRAPHY , *HEART beat , *LIFTING & carrying (Human mechanics) , *WEARABLE technology , *ASSISTIVE technology , *TREATMENT effectiveness , *SKELETAL muscle , *DESCRIPTIVE statistics , *ERECTOR spinae muscles , *MUSCLE fatigue - Abstract
A wearable power assist device was developed to reduce the stress on the lower back by using pneumatic muscles. The purpose of this study was to explore whether the assist device could reduce the activity or fatigue of lower back muscles during a repetitive lifting task. Twelve male subjects participated in the study. Electromyography of the thoracic erector spinae at the T9 level and lumbar erector spinae at the L3 level was recorded during 90 lifts in 15 min. Subjects' heart rate and Borg's Rate of Perceived Exertion Scale score were recorded during lifting sessions. The electromyography amplitude of thoracic erector spinae and lumbar erector spinae was only increased by 32.45% and 40.17%, respectively, when the wearable power assist device was used when comparing the pre- and post-lifting task. Whereas it was increased by 125.78% and 85.90%, respectively, when the wearable power assist device was not used. The decrease in electromyography median frequency from the start until the end of the lifting session was significantly lower when wearing the assist device for the thoracic erector spinae (2.72% vs 7.45%) and the lumbar erector spinae (3.91% vs 13.70%). Use of the assist device also significantly reduced the percentage change in heart rate and Borg Scale (p < 0.05). The use of the wearable power assist device showed less back muscle contraction compared to the no-use, which can potentially minimize the level of back muscle fatigue across the lifting session. • One of few existing studies on back support by using an active exoskeleton device. • Determined whether the device could reduce the back fatigue. • Electromyography signals at thoracic and lumbar erector spinae muscles were recorded. • Heart rates were shown before and after using the device. • The device can effectively reduce the muscle fatigue in a human body performing repetitive lifting tasks. [ABSTRACT FROM AUTHOR]
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- 2019
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20. Heart transplantation for dilated cardiomyopathy: a case study.
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Roberts, Elizabeth and Brodie, Lyndell
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EXTRACORPOREAL membrane oxygenation ,CARDIAC rehabilitation ,HEART transplantation ,NURSES ,PATIENT education ,SURGICAL complications ,OCCUPATIONAL roles ,SOCIAL support ,HEART assist devices ,DILATED cardiomyopathy ,REHABILITATION - Abstract
Heart transplantation has become a well-established treatment for end-stage heart failure, with dilated cardiomyopathies (DCM) forming the single largest group of patients to receive a cardiac transplant. This case study presents the surgical journey of a 63-year-old male who underwent a cardiac transplant for DCM. The pathophysiology of DCM is explained within the context of this patient's clinical presentation. His surgical transplant journey is also detailed, with a particular emphasis on his intensive care unit (ICU) stay and complications he experienced, including episodes of haemodynamic compromise and recurrent bleeding. The nursing management of his clinical recovery and patient education is also discussed. [ABSTRACT FROM AUTHOR]
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- 2019
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21. Study and Choice of Actuation for a Walking Assist Device
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Aoustin, Y., Chevallereau, C., Arakalian, V., Ceccarelli, Marco, Series editor, Bleuler, Hannes, editor, Bouri, Mohamed, editor, Mondada, Francesco, editor, Pisla, Doina, editor, Rodic, Aleksandar, editor, and Helmer, Patrick, editor
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- 2016
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22. Pulsatile Mechanical Heart Assist Device
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Pleşoianu, F. A., Pleşoianu, C. E., Corciovă, C., Tinică, G., Magjarevic, Ratko, Editor-in-chief, Ładyżyński, Piotr, Series editor, Ibrahim, Fatimah, Series editor, Lacković, Igor, Series editor, Rock, Emilio Sacristan, Series editor, Sontea, Victor, editor, and Tiginyanu, Ion, editor
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- 2016
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23. Comparison of heart transplant outcomes between recipients with pulsatile- vs continuous-flow LVAD.
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Yazdchi, Farhang, Rajab, Taufiek Konrad, Rinewalt, Daniel, Loberman, Dan, Shekar, Prem, Percy, Edward, Hirji, Sameer, Urban, Read, Lehman, Rebecca R., Mallidi, Hari R., and Singh, Steve K.
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HEART transplantation , *PULSATILE flow , *HEART assist devices , *PROPENSITY score matching , *ARTIFICIAL hearts , *TRANSPLANTATION of organs, tissues, etc. - Abstract
Objective: Continuous-flow (CF) left ventricular assist devices (LVADs) have replaced pulsatile flow (PF) LVADs irrespective of concerns from the physiologic changes/morbidity secondary to lack of pulsatility. Data comparing posttransplant outcomes in patients with CF vs PF LVADs are limited and conflicting. We used the Organ Procurement and Transplant Network database to compare posttransplant outcomes between CF and PF LVAD patients.Methods: From 1 January 2005 to 31 December 2011, 3449 adult patients underwent primary heart alone transplantation. The cohort was restricted to 2741 recipients with LVAD at the time of transplant and divided into two groups: PF (Heartmate XVE) (n = 705) and CF (Heartmate II, HeartWare HVAD, and Jarvik 2000) (n = 2036). Endpoints were 30-day freedom from graft failure, 1-, and 5-year patient survival. Propensity score matching identified 705 pairs for adjusted comparisons.Results: Among propensity-matched patients, 30-day freedom from graft failure after heart transplantation (PF = 94.8% vs CF = 95.2%, P > .7), and 1-, and 5-year patient survival (PF; 87.5% vs CF; 88.9%, P = .4, and PF;75.7% vs CF;77.5%, P = .3) were not different.Conclusion: Survival and freedom from graft failure after heart transplantation is similar between CF and PF LVADs. These findings are relevant as the use of CF devices increases despite physiologic changes related to the absence of pulsatility. [ABSTRACT FROM AUTHOR]- Published
- 2019
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24. Management of cardiogenic shock complicating myocardial infarction: an update 2019.
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Thiele, Holger, Ohman, E Magnus, Waha-Thiele, Suzanne de, Zeymer, Uwe, and Desch, Steffen
- Abstract
Cardiogenic shock (CS) remains the most common cause of death in patients admitted with acute myocardial infarction (AMI) and mortality remained nearly unchanged in the range of 40–50% during the last two decades. Early revascularization, vasopressors and inotropes, fluids, mechanical circulatory support, and general intensive care measures are widely used for CS management. However, there is only limited evidence for any of the above treatment strategies except for revascularization and the relative ineffectiveness of intra-aortic balloon pumping. This updated review will outline the management of CS complicating AMI with major focus on state-of-the art treatment. Download slide Download slide [ABSTRACT FROM AUTHOR]
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- 2019
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25. Assist device in color discrimination using Heilmeier type guest‐host liquid crystal for red‐green color vision defect.
- Author
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Nakayama, Keizo
- Subjects
- *
COLOR vision , *COLOR blindness , *LIQUID crystals , *LIQUID crystal devices , *DIGITAL video , *COLORS - Abstract
For assist in color discrimination of color vision defects, the method of observing objects through colored filter has been known. If red filter, which absorbs mostly all light except red light, is used, only the red objects can be highly visible. In this paper, a Heilmeier type guest‐host liquid crystal device with magenta dye was applied to a filter type assist device for red‐green color vision defect. This device can easily control transmittance of green light by changing applied voltage, and make green objects perceived to flicker synchronously. The subjective appraisal of the assist device in color discrimination was performed by five participants with normal vision using a constructed experimental system using a video camera and a PC with a vision simulator. For the confusion indices of the Panel D‐15 test, the effect of the device was statistically significant at P < .01. Moreover, a participant with color vision deficiency assessed it and got results without color confusion on the Panel D‐15 test. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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26. Effect of Continuous-Flow Left Ventricular Assist Device Support on Coronary Artery Endothelial Function in Ischemic and Nonischemic Cardiomyopathy.
- Author
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Symons, J. David, Deeter, Lance, Deeter, Nicholas, Bonn, Trevor, Jae Min Cho, Ferrin, Peter, McCreath, Lauren, Diakos, Nikolaos A., Taleb, Iosif, Alharethi, Rami, McKellar, Stephen, Wever-Pinzon, Omar, Navankasattusas, Sutip, Selzman, Craig H., Fang, James C., and Drakos, Stavros G.
- Abstract
BACKGROUND: The coronary vasculature encounters a reduction in pulsatility after implementing durable continuous-flow left ventricular assist device (CF-LVAD) circulatory support. Evidence exists that appropriate pulsatility is required to maintain endothelial cell homeostasis. We hypothesized that coronary artery endothelial function would be impaired after CF-LVAD intervention. METHODS AND RESULTS: Coronary arteries from patients with endstage heart failure caused by ischemic cardiomyopathy (ICM; n=16) or non-ICM (n=22) cardiomyopathy were isolated from the left ventricular apical core, which was removed for the CF-LVAD implantation. In 11 of these patients, paired coronary arteries were obtained from an adjacent region of myocardium after the CF-LVAD intervention (n=6 ICM, 5 non- ICM). Vascular function was assessed ex vivo using isometric tension procedures in these patients and in 7 nonfailing donor controls. Maximal endothelium-dependent vasorelaxation to BK (bradykinin; 10-6-10-10 M) was blunted (P<0.05) in arteries from patients with ICM compared with non-ICM and donor controls, whereas responses to sodium nitroprusside (10-4-10-9 M) were similar among the groups. Contrary to our hypothesis, vasorelaxation responses to BK and sodium nitroprusside were similar before and 219±37 days after CF-LVAD support. Of these patients, an exploratory subgroup analysis revealed that BK-induced coronary artery vasorelaxation was greater (P<0.05) after (87±6%) versus before (54±14%) CF-LVAD intervention in ICM patients, whereas sodium nitroprusside-evoked responses were similar. CONCLUSIONS: Coronary artery endothelial function is not impaired by durable CF-LVAD support and in ICM patients appears to be improved. Investigating coronary endothelial function using in vivo approaches in a larger patient population is warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2019
27. Use of a Right Ventricular Continuous Flow Pump to Validate the Distensible Model of the Pulmonary Vasculature.
- Author
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VANDEN EYNDEN, F., SEGERS, P., BOVÉ, T., DE SOMER, F., EL OUMEIRI, B., and VAN NOOTEN, G.
- Subjects
PULMONARY valve ,BLOOD vessels ,PULMONARY circulation ,PULMONARY artery ,ELASTICITY ,GROUNDWATER flow - Abstract
In the pulmonary circulation, resistive and compliant properties overlap in the same vessels. Resistance varies nonlinearly with pressure and flow; this relationship is driven by the elastic properties of the vessels. Linehan et al . (1982) correlated the mean pulmonary arterial pressure and mean flow with resistance using an original equation incorporating the distensibility of the pulmonary arteries. The goal of this study was to validate this equation in an in vivo porcine model. In vivo measurements were acquired in 6 pigs. The distensibility coefficient (DC) was measured by placing piezo-electric crystals around the pulmonary artery (PA). In addition to experiments under pulsatile conditions, a right ventricular (RV) bypass system was used to induce a continuous pulmonary flow state. The Linehan's equation was then used to predict the pressure from the flow under continuous flow conditions. The diameter-derived DC was 2.4 %/mmHg (±0.4 %), whereas the surface area-based DC was 4.1 %/mmHg (±0.1 %). An increase in continuous flow was associated with a constant decrease in resistance, which correlated with the diameter-based DC (r=-0.8407, p=0.044) and the surface areabased DC (r=-0.8986, p=0.028). In contrast to the Linehan's equation, our results showed constant or even decreasing pressure as flow increased. Using a model of continuous pulmonary flow induced by an RV assist system, pulmonary pressure could not be predicted based on the flow using the Linehan's equation. Measurements of distensibility based on the diameter of the PA were inversely correlated with the resistance. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
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28. Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial.
- Author
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IABPSHOCK II Trial (Intraaortic Balloon Pump in Cardiogenic Shock II) Investigators, Thiele, Holger, Abdel-Wahab, Mohamed, Desch, Steffen, Böhm, Michael, Werdan, Karl, Felix, Stephan B., Hennersdorf, Marcus, Zeymer, Uwe, Schneider, Steffen, Ouarrak, Taoufik, Thelemann, Nathalie, Meyer-Saraei, Roza, Fuernau, Georg, Eitel, Ingo, de Waha-Thiele, Suzanne, Neumann, Franz-Josef, Hausleiter, Jörg, Hambrecht, Rainer, and IABP-SHOCK II Trial (Intraaortic Balloon Pump in Cardiogenic Shock II) Investigators
- Subjects
- *
CARDIOGENIC shock , *MYOCARDIAL infarction , *CLINICAL trial registries , *BALLOONS - Abstract
Background: The role of intraaortic balloon counterpulsation (IABP) in cardiogenic shock is still a subject of intense debate despite the neutral results of the IABP-SHOCK II trial (Intraaortic Balloon Pump in Cardiogenic Shock II) with subsequent downgrading in international guidelines. So far, randomized data on the impact of IABP on long-term clinical outcomes in patients with cardiogenic shock complicating acute myocardial infarction are lacking. Furthermore, only limited evidence is available on general long-term outcomes of patients with cardiogenic shock treated by contemporary practice.Methods: The IABP-SHOCK II trial is a multicenter, randomized, open-label trial. Between 2009 and 2012, 600 patients with cardiogenic shock complicating acute myocardial infarction undergoing early revascularization were randomized to IABP versus control.Results: Long-term follow-up was performed 6.2 years (interquartile range 5.6-6.7) after initial randomization. Follow-up was completed for 591 of 600 patients (98.5%). Mortality was not different between the IABP and the control group (66.3% versus 67.0%; relative risk, 0.99; 95% CI, 0.88-1.11; P=0.98). There were also no differences in recurrent myocardial infarction, stroke, repeat revascularization, or rehospitalization for cardiac reasons (all P>0.05). Survivors' quality of life as assessed by the EuroQol 5D questionnaire and the New York Heart Association class did not differ between groups.Conclusions: IABP has no effect on all-cause mortality at 6-year long-term follow-up. Mortality is still very high, with two thirds of patients with cardiogenic shock dying despite contemporary treatment with revascularization therapy.Clinical Trial Registration: URL: https://www.Clinicaltrials: gov/. Unique identifier: NCT00491036. [ABSTRACT FROM AUTHOR]- Published
- 2019
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29. ECPella
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P. Meani, Roberto Lorusso, and Federico Pappalardo
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Shock, Cardiogenic ,PERCUTANEOUS CORONARY INTERVENTION ,030204 cardiovascular system & hematology ,ASSIST DEVICE ,EXTRACORPOREAL MEMBRANE-OXYGENATION ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,030202 anesthesiology ,Extracorporeal membrane oxygenation ,medicine ,Humans ,In patient ,Intensive care medicine ,Device Removal ,Impella ,Retrospective Studies ,RISK ,LEFT-VENTRICULAR DISTENSION ,business.industry ,Cardiogenic shock ,impella ,cardiogenic shock ,INTRAAORTIC BALLOON PUMP ,VA ECLS ,MECHANICAL CIRCULATORY SUPPORT ,medicine.disease ,Anesthesiology and Pain Medicine ,IMPELLA 5.0 ,ecpella ,physiology ,CARDIOGENIC-SHOCK ,HEART-FAILURE ,Heart-Assist Devices ,Cardiology and Cardiovascular Medicine ,business - Abstract
Addition of Impella on top of venoarterial extracorporeal membrane oxygenation (VA-ECMO) has gained wide interest as it might portend improved outcomes in patients with cardiogenic shock. This has been consistently reported in retrospective propensity-matched studies, case series, and meta-analyses. The pathophysiologic background is based on the mitigation of ECMO-related side effects and the additive benefit of myocardial unloading. In this perspective, thorough knowledge of these mechanisms is required to optimize the management of mechanical circulatory support with this approach and introduce best practices, as the interplay between the two devices and the implantation-explantation strategies are key for success. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
- Published
- 2022
30. Three‐dimensional echocardiography of mechanical circulatory support devices.
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Nguyen, Vidang P., Qin, Alex, and Kirkpatrick, James N.
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- *
ECHOCARDIOGRAPHY , *HEART assist devices - Abstract
Two‐dimensional echocardiography is a crucial component for assessing the position and function of mechanical circulatory support devices, but three‐dimensional echocardiography provides additional information to aid in management and may improve accuracy in the assessment of these devices. In this article, we review the utility of three‐dimensional echocardiography of various mechanical circulatory support devices. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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31. Kardiales Reverse Remodeling unter dauerhafter mechanischer Kreislaufunterstützung
- Author
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Knierim, Jan
- Subjects
recovery ,assist device ,LVAD ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit - Abstract
Die Implantation eines modernen Linksventrikulären Assist Devices (LVAD) hat sich zu einer etablierten Methode zur Therapie der schweren Herzinsuffizienz entwickelt. Sie ermöglicht die zügige Stabilisierung der Situation, erhebliche Besserung der Symptomatik und Verlängerung des Überlebens. Neben der Überbrückung der Zeit bis zur Herztransplantation hat sich die LVAD-Implantation auch als langfristige Therapie (Destination Therapy) durchgesetzt. Unter mechanischer Entlastung des linken Ventrikels kommt es zu erheblichen Veränderungen der myokardialen Struktur. Der rechte Ventrikel verändert seinen Kontraktionsablauf. Die longitudinale Bewegung nimmt ab. Dieser Effekt wird durch eine vermehrte Einwärtsbewegung kompensiert. Die Größe des rechten Herzens bleibt im Wesentlichen stabil. Klappeninsuffizienzen (z.B. der Trikuspidalklappe) können sich erheblich verbessern, aber auch neu auftreten. Der linke Ventrikel verkleinert sich und zeigt eine gebesserte Kontraktion. Diese kann in einigen Fällen, insbesondere unter intensiver Herzinsuffizienztherapie, so nachhaltig sein, dass eine Explantation des LVAD erwogen werden kann. Für die Evaluation vor LVAD-Explantation stehen verschiedenste Untersuchungsverfahren zur Verfügung. Gängig ist eine Echokardiographie, gelegentlich auch eine Belastungsuntersuchung und häufig eine zusätzliche Rechtsherzkatheteruntersuchung. Wenn die Patienten standardisiert nach einem entsprechenden Protokoll untersucht werden und spezifische Kriterien erfüllen, ist eine Explantation mit niedrigem Risiko und gutem Langzeit-Outcome möglich.
- Published
- 2023
32. Size Reduction Machine. Innovative Technology Summary Report
- Published
- 2000
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33. Association of pre-left ventricular assist device defibrillator shocks for ventricular arrhythmia with clinical outcomes after left ventricular assist device implantation.
- Author
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Wann DG, Baird AS, Wang NC, Mulukutla SR, Thoma FW, Sezer A, Canterbury AM, Barakat AF, Gardner MW, Skowronski JN, Aronis KN, Voigt AH, Jain SK, Saba SF, Bhonsale A, Estes NAM, Keebler ME, Hickey GW, Bazaz RR, and Kancharla K
- Abstract
Background: Implantable cardioverter-defibrillation (ICD) shocks after left ventricular assist device therapy (LVAD) are associated with adverse clinical outcomes. Little is known about the association of pre-LVAD ICD shocks on post-LVAD clinical outcomes and whether LVAD therapy affects the prevalence of ICD shocks., Objectives: The purpose of this study was to determine whether pre-LVAD ICD shocks are associated with adverse clinical outcomes post-LVAD and to compare the prevalence of ICD shocks before and after LVAD therapy., Methods: Patients 18 years or older with continuous-flow LVADs and ICDs were retrospectively identified within the University of Pittsburgh Medical Center system from 2006-2020. We analyzed the association between appropriate ICD shocks within 1 year pre-LVAD with a primary composite outcome of death, stroke, and pump thrombosis and secondary outcomes of post-LVAD ICD shocks and ICD shock hospitalizations., Results: Among 309 individuals, average age was 57 ± 12 years, 87% were male, 80% had ischemic cardiomyopathy, and 42% were bridge to transplantation. Seventy-one patients (23%) experienced pre-LVAD shocks, and 69 (22%) experienced post-LVAD shocks. The overall prevalence of shocks pre-LVAD and post-LVAD were not different. Pre-LVAD ICD shocks were not associated with the composite outcome. Pre-LVAD ICD shocks were found to predict post-LVAD shocks (hazard ratio [HR] 5.7; 95% confidence interval [CI] 3.42-9.48; P <.0001) and hospitalizations related to ICD shocks from ventricular arrhythmia (HR 10.34; 95% CI 4.1-25.7; P <.0001)., Conclusion: Pre-LVAD ICD shocks predicted post-LVAD ICD shocks and hospitalizations but were not associated with the composite outcome of death, pump thrombosis, or stroke at 1 year. The prevalence of appropriate ICD shocks was similar before and after LVAD implantation in the entire cohort., (© 2023 Heart Rhythm Society. Published by Elsevier Inc.)
- Published
- 2023
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34. Exposing the Cardiopulmonary Block
- Author
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Houser, Stuart Lair and Houser, Stuart Lair
- Published
- 2009
- Full Text
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35. Percutaneous short-termactive mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials.
- Author
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Thiele, Holger, Jobs, Alexander, Ouwenee, Dagmar M., Henriques, Jose P.S., Seyfarth, Melchior, Desch, Steffen, Eitel, Ingo, Pöss, Janine, Fuernau, Georg, and de Waha, Suzanne
- Abstract
Aims Evidence on the impact on clinical outcome of active mechanical circulatory support (MCS) devices in cardiogenic shock (CS) is scarce. This collaborative meta-analysis of randomized trials thus aims to investigate the efficacy and safety of percutanzeous active MCS vs. control in CS. Methods and results Randomized trials comparing percutaneous active MCS to control in patients with CS were identified through searches of medical literature databases. Risk ratios (RR) and 95% confidence intervals (95% CI) were calculated to analyse the primary endpoint of 30-day mortality and device-related complications including bleeding and leg ischaemia. Mean differences (MD) were calculated for mean arterial pressure (MAP), cardiac index (CI), pulmonary capillary wedge pressure (PCWP), and arterial lactate. Four trials randomizing 148 patients to either TandemHeartT℣ or ImpellaV® MCS (n = 77) vs. control (n = 71) were identified. In all four trials intra-aortic balloon pumping (IABP) served as control. There was no difference in 30-day mortality (RR 1.01, 95% CI 0.70 to 1.44, P = 0.98, I2 = 0%) for active MCS compared with control. Active MCS significantly increased MAP (MD 11.85 mmHg, 95% CI 3.39 to 20.31, P = 0.02, I
2 = 32.7%) and decreased arterial lactate (MD - 1.36 mmol/L, 95% CI - 2.52 to - 0.19, I2 = 0%, P = 0.02) at comparable CI (MD 0.32, 95% CI - 0.24 to 0.87, P = 0.14, I2 = 44.1%) and PCWP (MD - 5.59, 95% -15.59 to 4.40, P = 0.14, I2 = 81.1%). No significant difference was observed in the incidence of leg ischaemia (RR 2.64, 95% CI 0.83 to 8.39, P = 0.10, I2 = 0%), whereas the rate of bleeding was significantly increased in MCS compared to IABP (RR 2.50, 95% CI 1.55 to 4.04, P < 0.001, I2 = 0%). Conclusion Results of this collaborative meta-analysis do not support the unselected use of active MCS in patients with CS complicating AMI. [ABSTRACT FROM AUTHOR]- Published
- 2017
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36. Mechanical Circulatory Support as a Bridge to Definitive Treatment in Post-Infarction Ventricular Septal Rupture
- Subjects
mechanical circulatory support ,ACUTE MYOCARDIAL-INFARCTION ,OUTCOMES ,SURGERY ,TOTAL ARTIFICIAL-HEART ,SURGICAL REPAIR ,extracorporeal life support ,ASSIST DEVICE ,EXTRACORPOREAL MEMBRANE-OXYGENATION ,myocardial infarction ,ventricular septal rupture ,DEFECT ,CARDIOGENIC-SHOCK ,MANAGEMENT ,heart rupture - Abstract
Ventricular septal rupture (VSR) represents a rare complication of acute myocardial infarction, often presenting with cardiogenic shock and associated with high in-hospital mortality despite prompt intervention. Although immediate surgery is recommended for patients who cannot be effectively stabilized, the ideal timing of intervention remains controversial. Mechanical circulatory support (MCS) may allow hemodynamic stabilization and delay definitive treatment even in critical patients. However, the interactions between MCS and VSR pathophysiology as well as potentially related adverse effects remain unclear. A systematic review was performed, from 2000 onward, to identify reports describing MCS types, effects, complications, and outcomes in the pre-operative VSR-related setting. One hundred eleven studies (2,440 patients) were included. Most patients had well-known negative predictors (e.g., cardiogenic shock, inferior infarction). Almost all patients had intra-aortic balloon pumps, with additional MCS adopted in 129 patients (77.5% being venoarterial extracorporeal membrane oxygenation). Mean MCS bridging time was 6 days (range: 0 to 23 days). Inhospital mortality was 50.4%, with the lowest mortality rate in the extracorporeal membrane oxygenation group (29.2%). MCS may enhance hemodynamic stabilization and delayed VSR treatment. However, the actual effects and interaction of the MCS-VSR association should be carefully assessed to avoid further complications or incorrect MCS-VSR coupling. (C) 2021 by the American College of Cardiology Foundation.
- Published
- 2021
37. Mechanical Circulatory Support as a Bridge to Definitive Treatment in Post-Infarction Ventricular Septal Rupture
- Author
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Silvia Marra, Claudio Corazzari, Matteo Matteucci, Giulio Massimi, Jos G. Maessen, Cesare Beghi, Federica Torchio, Roberto Lorusso, Daniele Ronco, and Justine M. Ravaux
- Subjects
medicine.medical_specialty ,ACUTE MYOCARDIAL-INFARCTION ,SURGERY ,medicine.medical_treatment ,Heart Rupture ,Shock, Cardiogenic ,030204 cardiovascular system & hematology ,extracorporeal life support ,ASSIST DEVICE ,Ventricular Septal Rupture ,EXTRACORPOREAL MEMBRANE-OXYGENATION ,03 medical and health sciences ,0302 clinical medicine ,Extracorporeal Membrane Oxygenation ,ventricular septal rupture ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,MANAGEMENT ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,heart rupture ,mechanical circulatory support ,OUTCOMES ,business.industry ,Cardiogenic shock ,Shock ,Cardiogenic ,medicine.disease ,TOTAL ARTIFICIAL-HEART ,SURGICAL REPAIR ,myocardial infarction ,Treatment Outcome ,Myocardial Infarction ,Bridge (graph theory) ,DEFECT ,Circulatory system ,CARDIOGENIC-SHOCK ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Complication - Abstract
Ventricular septal rupture (VSR) represents a rare complication of acute myocardial infarction, often presenting with cardiogenic shock and associated with high in-hospital mortality despite prompt intervention. Although immediate surgery is recommended for patients who cannot be effectively stabilized, the ideal timing of intervention remains controversial. Mechanical circulatory support (MCS) may allow hemodynamic stabilization and delay definitive treatment even in critical patients. However, the interactions between MCS and VSR pathophysiology as well as potentially related adverse effects remain unclear. A systematic review was performed, from 2000 onward, to identify reports describing MCS types, effects, complications, and outcomes in the pre-operative VSR-related setting. One hundred eleven studies (2,440 patients) were included. Most patients had well-known negative predictors (e.g., cardiogenic shock, inferior infarction). Almost all patients had intra-aortic balloon pumps, with additional MCS adopted in 129 patients (77.5% being venoarterial extracorporeal membrane oxygenation). Mean MCS bridging time was 6 days (range: 0 to 23 days). Inhospital mortality was 50.4%, with the lowest mortality rate in the extracorporeal membrane oxygenation group (29.2%). MCS may enhance hemodynamic stabilization and delayed VSR treatment. However, the actual effects and interaction of the MCS-VSR association should be carefully assessed to avoid further complications or incorrect MCS-VSR coupling. (C) 2021 by the American College of Cardiology Foundation.
- Published
- 2021
38. Left Ventricle Assist Device
- Author
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Patel, Rudra Dharmeshbhai
- Subjects
- Assist Device, PIV, LVAD, etc.
- Abstract
This research paper highlights the significance of mock circulatory loops in aiding the development and testing of left ventricle assist devices (LVADs). Heart disease is the leading cause of death in America, and LVAD offers an effective solution to patients with severe coronary artery disease who are not eligible for heart transplants. However, before testing LVADs in-vivo, extensive performance and reliability testing is required as per Food and Drug Administration guidelines. Mock circulatory loops are useful for simulating the cardiac cycle and capturing pressure and flow meter readings. The research focused on developing and testing a mock circulatory loop that accurately captures pressure and flow meter readings. The team experimented with various silicone elastomers and a urethane-based material, ClearFlex 30, to create a transparent phantom. The report highlights the importance of surface roughness for optical clarity, with an average surface roughness of 0.186 μ being ideal for optimal clarity achieved with 800-grit sandpaper. The impact of pressure differences between the aortic and mitral inlet/outlets was also studied, and it was found that the loop's resistance can be modified to achieve elevated pressure in the aortic outlet. The report further emphasized the importance of refractive index matching to perform particle image velocity. Matching the refractive index of the phantom with the medium is critical to avoid distortion and refraction of the light. Glycerol water was found to be an effective medium for refractive index matching. Overall, the successful testing of the mock circulatory loop provides valuable insights into the flow structure within the heart, aiding in the development of future LVADs. This research is significant in advancing the cardiology field and will potentially benefit many patients suffering from heart disease.
- Published
- 2023
39. Assist Devices
- Author
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Catapano, Gerardo and Barbucci, Rolando, editor
- Published
- 2002
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40. Japanese registry for Mechanically Assisted Circulatory Support: First report.
- Author
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Nakatani, Takeshi, Sase, Kazuhiro, Oshiyama, Hiroaki, Akiyama, Masatoshi, Horie, Masao, Nawata, Kan, Nishinaka, Tomohiro, Tanoue, Yoshihisa, Toda, Koichi, Tozawa, Masao, Yamazaki, Shunichi, Yanase, Masanobu, Ohtsu, Hiroshi, Ishida, Michiko, Hiramatsu, Ayaka, Ishii, Kensuke, and Kitamura, Soichiro
- Subjects
- *
HEART assist devices , *HEART failure treatment , *HEART transplantation , *ORGAN & tissue transplantation laws , *NATIONAL health insurance - Abstract
Background In Japan, ventricular assist devices (VADs) have been used for patients with severe heart failure as a bridge to transplantation (BTT) since 1992. However, it was not until 1997, when the Organ Transplant Law was enacted, that medical devices received approval by the national health insurance system for that use. To encourage research and development of innovative medical devices, the Pharmaceuticals and Medical Devices Agency has established a public–private partnership in collaboration with academic societies, hospitals and manufacturers. Methods The Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) is a prospective registry designed to be harmonized with the Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS). Participation in J-MACS is mandatory for device manufacturers to meet the conditions of approval as well as for hospitals to obtain authorization for reimbursement from the national health insurance system. Results From June 2010 to April 2015, 476 patients were registered at 31 hospitals. Of these, analysis of primary VAD patients ( n = 332) revealed that their overall 360-day survival was 91% (implantable 93%, extracorporeal 84%). Conclusions This initial report from J-MACS focuses on patients’ demographics, device types, survival, competing outcomes, adverse events and successful examples of system failure detection. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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41. Effectiveness of Extracorporeal Life Support for Patients With Cardiogenic Shock Due To Intractable Arrhythmic Storm.
- Author
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Le Pennec-Prigent, Solène, Flecher, Erwan, Auffret, Vincent, Leurent, Guillaume, Daubert, Jean-Claude, Leclercq, Christophe, Mabo, Philippe, Verhoye, Jean-Philippe, and Martins, Raphael P.
- Subjects
- *
EXTRACORPOREAL membrane oxygenation , *CARDIOGENIC shock , *ARRHYTHMIA treatment , *MYOCARDIAL depressants , *CARDIOPULMONARY resuscitation , *VENTRICULAR arrhythmia , *PREVENTION , *PATIENTS - Abstract
Objectives: Extracorporeal life support is used for patients with severe heart failure as a bridge to heart transplantation or recovery. We aimed at analyzing the efficacy and safety of extracorporeal life support to treat refractory arrhythmic storm responsible for cardiogenic shock in patients resistant to antiarrhythmic drugs.Design: Retrospective study.Setting: University Hospital of Rennes, France.Patients: Patients with refractory arrhythmic storm admitted between January 2005 and March 2015.Interventions: Patients with intractable refractory arrhythmic storm and cardiogenic shock despite optimal medical therapy were implanted with an extracorporeal life support. Patients' characteristics and outcomes after extracorporeal life support implantation were analyzed.Measurements and Main Results: Twenty-six patients (23 men, 52.4 ± 9.2 yr old) were included, most of them having ischemic cardiomyopathy (65.4%). Stable sinus rhythm restoration was immediate in 61.5% of patients and occurred after a median time of 3 hours after extracorporeal life support implantation for the remaining ones. Thirteen patients (50%) eventually died, none of them due to extracorporeal life support-related complications, but mostly due to the occurrence of multiple organ failure, and occurred after a median time of 4 days. The remaining 13 patients (50%) had extracorporeal life support withdrawn after 6.7 ± 3.6 days and were discharged after 34.7 ± 14.7 days after admission. Patients with repetitive ventricular tachycardia/ventricular fibrillation episodes alternating with periods of sinus rhythm at the time of implantation had a better survival than those in refractory ventricular fibrillation (p = 0.017).Conclusions: This is the largest database of patients temporary implanted with extracorporeal life support for refractory arrhythmic storm responsible for cardiogenic shock resistant to antiarrhythmic drugs. It provides efficient hemodynamic support and survival rate after the implantation is 50%. [ABSTRACT FROM AUTHOR]- Published
- 2017
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42. Development and assessment of a hand assist device: GRIPIT.
- Author
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Byungchul Kim, Hyunki In, Dae-Young Lee, Kyu-Jin Cho, Kim, Byungchul, In, Hyunki, Lee, Dae-Young, and Cho, Kyu-Jin
- Subjects
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PEOPLE with paralysis , *PARALYSIS , *ROBOTS , *PATIENTS with spinal cord injuries , *PHYSIOLOGICAL stress , *EQUIPMENT & supplies - Abstract
Background: Although various hand assist devices have been commercialized for people with paralysis, they are somewhat limited in terms of tool fixation and device attachment method. Hand exoskeleton robots allow users to grasp a wider range of tools but are heavy, complicated, and bulky owing to the presence of numerous actuators and controllers. The GRIPIT hand assist device overcomes the limitations of both conventional devices and exoskeleton robots by providing improved tool fixation and device attachment in a lightweight and compact device. GRIPIT has been designed to assist tripod grasp for people with spinal cord injury because this grasp posture is frequently used in school and offices for such activities as writing and grasping small objects.Methods: The main development objective of GRIPIT is to assist users to grasp tools with their own hand using a lightweight, compact assistive device that is manually operated via a single wire. GRIPIT consists of only a glove, a wire, and a small structure that maintains tendon tension to permit a stable grasp. The tendon routing points are designed to apply force to the thumb, index finger, and middle finger to form a tripod grasp. A tension-maintenance structure sustains the grasp posture with appropriate tension. Following device development, four people with spinal cord injury were recruited to verify the writing performance of GRIPIT compared to the performance of a conventional penholder and handwriting. Writing was chosen as the assessment task because it requires a tripod grasp, which is one of the main performance objectives of GRIPIT.Results: New assessment, which includes six different writing tasks, was devised to measure writing ability from various viewpoints including both qualitative and quantitative methods, while most conventional assessments include only qualitative methods or simple time measuring assessments. Appearance, portability, difficulty of wearing, difficulty of grasping the subject, writing sensation, fatigability, and legibility were measured to assess qualitative performance while writing various words and sentences. Results showed that GRIPIT is relatively complicated to wear and use compared to a conventional assist device but has advantages for writing sensation, fatigability, and legibility because it affords sufficient grasp force during writing. Two quantitative performance factors were assessed, accuracy of writing and solidity of writing. To assess accuracy of writing, we asked subjects to draw various figures under given conditions. To assess solidity of writing, pen tip force and the angle variation of the pen were measured. Quantitative evaluation results showed that GRIPIT helps users to write accurately without pen shakes even high force is applied on the pen.Conclusions: Qualitative and quantitative results were better when subjects used GRIPIT than when they used the conventional penholder, mainly because GRIPIT allowed them to exert a higher grasp force. Grasp force is important because disabled people cannot control their fingers and thus need to move their entire arm to write, while non-disabled people only need to move their fingers to write. The tension-maintenance structure developed for GRIPIT provides appropriate grasp force and moment balance on the user's hand, but the other writing method only fixes the pen using friction force or requires the user's arm to generate a grasp force. [ABSTRACT FROM AUTHOR]- Published
- 2017
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43. Extracorporeal membrane oxygenation in peripartum cardiomyopathy
- Subjects
HEART-FAILURE ASSOCIATION ,OUTCOMES ,Peripartum cardiomyopathy ,Extracorporeal membrane oxygenation ,Survival ,TRANSPLANTATION ,LIFE-SUPPORT ,RECOVERY ,PATIENT ,EUROPEAN-SOCIETY ,BRIDGE ,ASSIST DEVICE ,Pregnancy ,MANAGEMENT ,ECMO ,Cardiogenic shock - Abstract
Aims: Data on the use of extracorporeal membrane oxygenation (ECMO) for cardiogenic shock in peripartumcardiomyopathy (PPCM) is limited. We queried the Extracorporeal Life Support Organization (ELSO) Registry for PPCMpatients treatedwith ECMO in order to characterize demographic and clinical features, complications, survival, and variables associated with mortality.Methods and results: This was a retrospective review of patients voluntarily entered into the ELSO Registry. Deidentified data was collected on patients with a diagnosis of PPCM based on ICD-9/ICD-10 coding who received ECMO between 2007 and 2019. Collected data included demographics, ECMOmode, cannulation strategies, preECMO ventilator, biochemical, and hemodynamic parameters, run duration, complications, and survival towean off ECMO and hospital discharge. Our primary outcome measure was survival to discharge. In the final analysis, 88 veno-arterial (VA) ECMO patients were included. Overall, 72% of patients were weaned off ECMO, including 10% who were weaned to ventricular assist device or heart transplantation, and 64% survived to hospital discharge. Extracorporeal cardiopulmonary resuscitation (ECPR) was performed in 11% of patients with 60% survival. Factors associated with decreased survival included neurologic complications (p = 0.03), specifically central nervous system hemorrhage (p= 0.01).Conclusion: Our review is the largest to date of PPCM patients supported with VA ECMO for cardiogenic shock. ECMO and ECPR are valuable forms of short-termmechanical circulatory support with acceptable mortality profiles for PPCMpatients who remain refractory to aggressive medicalmanagement. Complications should be meticulously avoided, especially neurologic complications. (c) 2020 Elsevier B.V. All rights reserved.
- Published
- 2020
44. Extracorporeal membrane oxygenation in peripartum cardiomyopathy: A review of the ELSO Registry
- Author
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Erika R O'Neil, Roberto Lorusso, T.L. Olson, Graeme MacLaren, Marc Anders, and Kollengode R. Ramanathan
- Subjects
medicine.medical_specialty ,Survival ,Peripartum cardiomyopathy ,medicine.medical_treatment ,LIFE-SUPPORT ,Shock, Cardiogenic ,030204 cardiovascular system & hematology ,PATIENT ,BRIDGE ,Extracorporeal ,ASSIST DEVICE ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,Pregnancy ,MANAGEMENT ,Peripartum Period ,Extracorporeal membrane oxygenation ,Humans ,Medicine ,Extracorporeal cardiopulmonary resuscitation ,Registries ,030212 general & internal medicine ,Cardiogenic shock ,Retrospective Studies ,HEART-FAILURE ASSOCIATION ,OUTCOMES ,TRANSPLANTATION ,business.industry ,RECOVERY ,medicine.disease ,EUROPEAN-SOCIETY ,Transplantation ,Treatment Outcome ,surgical procedures, operative ,Ventricular assist device ,Life support ,Emergency medicine ,ECMO ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims: Data on the use of extracorporeal membrane oxygenation (ECMO) for cardiogenic shock in peripartumcardiomyopathy (PPCM) is limited. We queried the Extracorporeal Life Support Organization (ELSO) Registry for PPCMpatients treatedwith ECMO in order to characterize demographic and clinical features, complications, survival, and variables associated with mortality. Methods and results: This was a retrospective review of patients voluntarily entered into the ELSO Registry. Deidentified data was collected on patients with a diagnosis of PPCM based on ICD-9/ICD-10 coding who received ECMO between 2007 and 2019. Collected data included demographics, ECMOmode, cannulation strategies, preECMO ventilator, biochemical, and hemodynamic parameters, run duration, complications, and survival towean off ECMO and hospital discharge. Our primary outcome measure was survival to discharge. In the final analysis, 88 veno-arterial (VA) ECMO patients were included. Overall, 72% of patients were weaned off ECMO, including 10% who were weaned to ventricular assist device or heart transplantation, and 64% survived to hospital discharge. Extracorporeal cardiopulmonary resuscitation (ECPR) was performed in 11% of patients with 60% survival. Factors associated with decreased survival included neurologic complications (p = 0.03), specifically central nervous system hemorrhage (p= 0.01). Conclusion: Our review is the largest to date of PPCM patients supported with VA ECMO for cardiogenic shock. ECMO and ECPR are valuable forms of short-termmechanical circulatory support with acceptable mortality profiles for PPCMpatients who remain refractory to aggressive medicalmanagement. Complications should be meticulously avoided, especially neurologic complications. (c) 2020 Elsevier B.V. All rights reserved.
- Published
- 2020
45. Pulmonary artery cannulation to enhance extracorporeal membrane oxygenation management in acute cardiac failure
- Author
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Antonio Loforte, Samuel Heuts, Paolo Meani, Elham Bidar, Ehsan Natour, Roberto Lorusso, Giuseppe Maria Raffa, Thijs Delnoij, Valeria Lo Coco, CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, RS: Carim - Vessels, MUMC+: MA Med Staf Artsass CTC (9), MUMC+: MA Alg Ond Onderz CTC (9), MUMC+: MA Medische Staf IC (9), and MUMC+: MA Med Staf Spec Cardiologie (9)
- Subjects
Male ,Pulmonary and Respiratory Medicine ,output syndrome ,Cardiac Catheterization ,medicine.medical_specialty ,assist device ,Percutaneous ,SURGERY ,Heart Ventricles ,medicine.medical_treatment ,Left ventricular failure ,heart ,Pulmonary Artery ,030204 cardiovascular system & hematology ,extracorporeal life support ,Right ventricular failure ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,SUPPORT ,Extracorporeal membrane oxygenation ,Humans ,Medicine ,right-ventricular failure ,bypass ,Aged ,Retrospective Studies ,Heart Failure ,business.industry ,SECONDARY ,Hemodynamics ,Pericardial fluid ,pseudoaneurysm ,EuroSCORE ,Middle Aged ,Cardiac surgery ,Cannula ,surgical procedures, operative ,030228 respiratory system ,Respiratory failure ,Pulmonary artery ,Cardiology ,Female ,Respiratory Insufficiency ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES Pulmonary artery (PA) cannulation during peripheral venoarterial extracorporeal membrane oxygenation (ECMO) has been shown to be effective either for indirect left ventricular (LV) unloading or to allow right ventricular (RV) bypass with associated gas-exchange support in case of acute RV with respiratory failure. This case series reports the results of such peculiar ECMO configurations with PA cannulation in different clinical conditions. METHODS All consecutive patients receiving PA cannulation (direct or percutaneous) from January 2015 to September 2018 in 3 institutions were retrospectively reviewed. Isolated LV unloading or RV support, as well as dynamic support including initial drainage followed by perfusion through the PA cannula, was used as part of the ECMO configuration according to the type of patient and the patient’s haemodynamic/functional needs. RESULTS Fifteen patients (8 men, age range 45–73 years, EuroSCORE log range 14.45–91.60%) affected by acute LV, RV or biventricular failure of various aetiologies, were supported by this ECMO mode. Percutaneous PA cannulation was performed in 10 patients and direct PA cannulation, in 5 cases. Dynamic ECMO management (initially draining and then perfusing through the PA cannula) was carried out in 6 patients. Mean ECMO duration was 9.1 days (range 6–17 days). One patient exhibited pericardial fluid during the implant of a PA cannula (no lesion found when the chest was opened), and weaning from temporary circulatory support was achieved in 14 patients (1 who received a transplant). Three patients (20%) died in-hospital, and 12 patients were successfully discharged without major complications. CONCLUSIONS Effective indirect LV unloading in peripheral venoarterial ECMO as well as isolated RV support can be achieved by PA cannulation. Such an ECMO configuration may allow the counteraction of common venoarterial ECMO shortcomings or allow dynamic/adjustable management of ECMO according to specific ventricular dysfunction and haemodynamic needs. Percutaneous PA cannulation was shown to be safe and feasible without major complications. Additional investigation is needed to confirm the safety and efficacy of such an ECMO configuration and management in a larger patient population.
- Published
- 2020
46. The UCLA Experience with Assist Devices as a Bridge to Transplantation in End-Stage Heart Failure
- Author
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Nonoyama, Masaki, Laks, Hillel, Drinkwater, Davis C., Jr., Brauner, Ron, Ruzevich, Shelly, Kobashigawa, Jon A., Akutsu, Tetsuzo, editor, and Koyanagi, Hitoshi, editor
- Published
- 1998
- Full Text
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47. Experience with a standardized protocol to predict successful explantation of left ventricular assist devices.
- Author
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Hrytsyna, Yuriy, Kneissler, Simon, Kaufmann, Friedrich, Müller, Marcus, Schoenrath, Felix, Mulzer, Johanna, Sündermann, Simon H., Falk, Volkmar, Potapov, Evgenij, and Knierim, Jan
- Abstract
Patients with a continuous-flow left ventricular assist device may show recovery of myocardial function with unloading. Identifying candidates for and predicting clinical and hemodynamic stability after left ventricular assist device explantation remain challenging. Retrospective analysis of patients who underwent evaluation for left ventricular assist device explantation following a standardized protocol from January 2016 to March 2020. Patients who met screening criteria underwent echocardiography under "baseline," "minimal net flow," and "pump stop" conditions. If the protocol criteria were met, right heart catheterization with left ventricular assist device stoppage and occlusion of the outflow graft with a balloon catheter were performed. In patients with pulmonary capillary wedge pressure less than 16 mm Hg, explantation was performed under "pump stop" conditions. A total of 544 patients were screened. Of these, 57 (10.5%) underwent a total of 73 echocardiography under "baseline" "minimal net flow" and "pump stop" conditions and 46 underwent left ventricular assist device stoppage and occlusion of the outflow graft with balloon catheter maneuvers. Complications during the procedure were rare. Ultimately, 21 patients (3.9%) underwent explantation. The left ventricular ejection fraction at baseline was 55.5% ± 6.5%. The mean pulmonary capillary wedge pressure was 8.1 ± 2.6 mm Hg and increased to 10.7 ± 2.9 mm Hg under left ventricular assist device stoppage and occlusion of the outflow graft with a balloon catheter. A nonischemic cause of cardiomyopathy was more likely to be found in patients who underwent explantation (20/21 patients [95%], P =.020). The survival 1 year after explantation was 95.2%, with 1 death occurring 222 days after left ventricular assist device explantation. At follow-up (median 24.9 months [interquartile range, 16.4-43.1 months]), patients were in New York Heart Association class 1 (61.9%), 2 (28.6%), and 3 (9.5%). Our 4-year experience with a standardized protocol for left ventricular assist device explantation showed a low rate of adverse events. If all criteria are met, explantation can be performed safely and with an excellent survival and functional class. [Display omitted] [ABSTRACT FROM AUTHOR]
- Published
- 2022
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48. Active assist device for simultaneous reduction of heat and vibration in precision scanning stages.
- Author
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Yoon, Deokkyun and Okwudire, Chinedum E.
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MANUFACTURING processes , *VIBRATION (Mechanics) , *HEAT , *INERTIA (Mechanics) , *PERMANENT magnet motors , *TRAJECTORIES (Mechanics) , *OPTIMAL control theory , *SILICON wafer manufacturing - Abstract
Scanning stages are used for precise positioning in a variety of advanced manufacturing processes, and must deliver high accelerations/decelerations at motion reversals to achieve high throughput. The resulting inertial forces cause excessive motor heating and residual vibration of the stage, both of which must be mitigated to preserve positioning accuracy. A novel scanning stage, having a permanent magnet based device that actively provides assist forces to the motor to simultaneously reduce motor heating and residual vibration, is presented. The active assist device is optimally designed to be versatile, allowing it to provide adequate assist for scan trajectories involving the widest range of scan strokes/positions. A basis–spline-based method is proposed for optimal control of the device, to maximize the assist it provides for scan trajectories with varying scan strokes/positions. Experiments conducted with a prototype stage involving scanning trajectories commonly employed in silicon wafer processing are used to demonstrate up to 60% and 34% reductions in heat and vibration-induced errors, respectively, when compared to cases without the proposed active assist device. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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49. The role of FDG-PET-CT in pediatric cardiac patients and patients with congenital heart defects.
- Author
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Meyer, Zora, Fischer, M., Koerfer, J., Laser, K.T., Kececioglu, D., Burchert, W., Ulrich, S., Preuss, R., and Haas, N.A.
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- *
PEDIATRIC cardiology , *CONGENITAL heart disease , *DIAGNOSTIC imaging , *POSITRON emission tomography , *COMPUTED tomography - Abstract
Aim Medical imaging by using FDG-PET/CT (PET-CT) can detect, confirm or eliminate with high sensitivity areas of suspected infections in case of persistent fever of unknown origin in combination with other bacteriological examinations. The aim of this study was to assess the potential role of PET-CT in detecting or excluding infections or other inflammatory processes in patients with congenital heart defects (CHD). In addition we wanted to evaluate the practical impact of PET-CT on the subsequent clinical management. Methods In this retrospective study we analyzed the data of all CHD patients who underwent PET-CT over a 5 year period in our institution. The results were then evaluated with regard to the potential impact on clinical decision making. Results Between 2010 and 2015 PET-CT was performed in 30 patients. The mean age was 26 years (SD 15 years, range 1 to 66 years). The diagnoses covered a large field of CHD. 11 patients (4/11 with assist device) were assessed before heart transplantation; suspected malignancies or infections were excluded and transplant listing was possible. In another 5/6 patients suspected assist device infection could be confirmed with PET/CT. Endocarditis was suspected in 13 patients, 2 of whom underwent previous MRI without confirmation and ECHO was inconclusive. Endocarditis was finally excluded in 5/13 patients but confirmed in 8/13 patients by PET-CT. Conclusion In this study we could show a high sensitivity of PET-CT for specific localization of infections and with high impact on subsequent therapy. Based on this results clinical management could be targeted and adapted. We could demonstrate that PET-CT has a high impact on the subsequent clinical therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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50. Partial cavopulmonary assist from the inferior vena cava to the pulmonary artery improves hemodynamics in failing Fontan circulation: a theoretical analysis.
- Author
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Shimizu, Shuji, Kawada, Toru, Une, Dai, Fukumitsu, Masafumi, Turner, Michael, Kamiya, Atsunori, Shishido, Toshiaki, and Sugimachi, Masaru
- Abstract
Cavopulmonary assist (CPA) for failing Fontan patients remains a challenging issue in the clinical setting. To evaluate the effectiveness of a partial CPA from the inferior vena cava (IVC) to the pulmonary artery (PA), we performed a theoretical analysis using a computational model of the Fontan circulation. Cardiac chambers and vascular systems were described as the time-varying elastance model and the modified three-element Windkessel model, respectively. A rotational pump described as a non-linear function was inserted between the IVC and the PA. When pulmonary vascular resistance index varied from 2.1 to 5.9 Wood units m, the partial CPA maintained cardiac index as efficiently as total CPA and markedly reduced the IVC pressure compared with total CPA. However, the partial CPA increased the superior vena cava pressure substantially. The modification from total to partial CPA is potentially an effective alternative in failing Fontan patients suffering from high IVC pressure. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
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