A Particle Image Velocimetry Study of the Penn State 50cc Left Ventricular Assist Device: The Impact of Varying Heart Rate

2011 ◽  
Author(s):  
Michael A. Navitsky ◽  
Jason C. Nanna ◽  
Stephen R. Topper ◽  
Steven Deutsch ◽  
Keefe B. Manning
Keyword(s):  
Heart Failure ◽  
Thrombus Formation ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Bridge To Transplant ◽  
Left Ventricular Assist ◽  
Penn State ◽  
The Impact

Approximately 5.7 million Americans are afflicted with heart failure, with a reported 670,000 new diagnoses each year [1]. Left ventricular assist devices (LVADs) function as a bridge to transplant therapy for advanced staged heart failure patients awaiting a donor heart. A pulsatile 50cc LVAD, Figure 1, is currently under development for cardiac support of patients with limited chest cavity size. Although the 50cc LVAD is functional in assisting a failing ventricle, complications such as thrombus formation may limit long term usage.

Abstract 225: Frequency and Assessment of Poor Global Outcome in Patients with Left Ventricular Assist Devices

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Timothy J Fendler ◽  
Michael E Nassif ◽  
Kevin F Kennedy ◽  
John A Spertus ◽  
Shane J LaRue ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nyha Class ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Bridge To Transplant ◽  
Patient Reported ◽  
Left Ventricular Assist

Background: Left ventricular assist device (LVAD) therapy can improve survival and quality of life in advanced heart failure (HF), but some patients may still do poorly after LVAD. Understanding the likelihood of experiencing poorer outcomes after LVAD can better inform patients and calibrate their expectations. Methods: We analyzed patients receiving LVAD therapy from January 2012 to October 2013 at a single, high-volume, high-acuity center. We defined a poor global outcome at 1 year after LVAD as the occurrence of death, disabling stroke (precluding transplant), poor patient-reported health status (most recent KCCQ at 3, 6, or 12 months < 45, corresponding to NYHA class IV), or recurrent HF (≥2 HF readmissions post-implant). We compared characteristics of those with and without poor global outcome. Results: Among 164 LVAD recipients who had 1-year outcomes data, mean age was 56, 76.7% were white, 20.9% were female, and 85.9% were INTERMACS Profile 1 or 2 (cardiogenic shock or declining despite inotropes). Poor global outcome occurred in 58 (35.4%) patients at 1 year, of whom 37 (63.8%) died, 17 (29.3%) had a most recent KCCQ score < 45, 3 (5.2%) had ≥2 HF readmissions, and 1 (1.7%) had a disabling stroke (Figure). Eight of the patients who died also experienced one of the three other poor outcomes prior to death. Patients who experienced a poor global outcome were more likely to be designated for destination therapy (46.4% vs. 23.6%, p=0.01) than bridge to transplant, have longer index admissions (median [IQR]: 39 [24, 57] days vs. 25 [18, 35] days, p=0.003), and have major GI bleeding (44.2% vs. 27.7%, p=0.056), and were less likely to undergo LVAD exchange (0% vs. 12.3%, p=0.004). Conclusion: In this large, single-center study assessing global outcome after LVAD implantation, we found that about a third of all patients had experienced a poor global outcome at 1 year. While LVAD therapy remains life-saving and the standard of care for many patients with advanced heart failure, these findings could help guide discussions with eligible patients and families. Future work should compare patients’ pre-LVAD expectations with likely outcomes and create risk models to estimate the probability of poorer outcomes for individual patients using pre-procedural factors.

scholarly journals Fluoroscopy-Guided Resolution of Ingested Thrombus Leading to Functional Disturbance of a Continuous-Flow Left Ventricular Assist Device

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Jens Garbade ◽  
Hartmuth B. Bittner ◽  
Friedrich-Wilhelm Mohr ◽  
Markus J. Barten
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Thrombus Formation ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Third Generation ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Functional Disturbance ◽  
Left Ventricular Assist

The third generation of left ventricular assist devices (LVADs) has been shown to improve outcome and quality of life in patients suffering from acute and chronic heart failure. However, VAD-associated complications are still a challenge in the clinical practice. Here we report the resolution of a mobile thrombus formation in the proximity of the inflow cannula of a third generation of LVADs (HVAD Pump, HeartWare, Inc.) in a patient with chronic heart failure 4 months after implantation.

A Correlative Study of Fluid Mechanics and Evidence of Thrombus Formation Within the Penn State 50 CC Left Ventricular Assist Device

2012 ◽  
Author(s):  
Stephen R. Topper ◽  
Michael A. Navitsky ◽  
Christopher A. Siedlecki ◽  
Steven Deutsch ◽  
Gerson Rosenberg ◽  
...  
Keyword(s):  
Thrombus Formation ◽  
Major Complication ◽  
The United States ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Heart Transplants ◽  
Ventricular Assist ◽  
Bridge To Transplant ◽  
Left Ventricular Assist ◽  
Penn State

An estimated 82.6 million American adults live with one or more forms of cardiovascular disease and in past years, it was the cause of over 55% of all deaths in the United States, more than any other type of major disease [1]. With a limited number of available donors, heart transplants are seldom an option. As a result, ventricular assist devices (VADs) have become a viable alternative to immediate transplant. Today, VADs are widely used as bridge-to-recovery, bridge-to-transplant and destination therapy devices. Despite past improvements in VAD design, a major complication that continues to arise is thrombus formation within the pump.

scholarly journals Left ventricular assist devices

2020 ◽  
Vol 21 (4) ◽  
pp. 355-358
Author(s):  
Jennifer CV Gwyn
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Medical Intervention ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
General Physician ◽  
Ventricular Assist ◽  
Bridge To Transplant ◽  
Left Ventricular Assist

Background There is a growing population of patients in the UK with advanced heart failure who are receiving a left ventricular assist device (LVAD) as a bridge to transplant. This is due to the plateauing number of heart transplantations and the increasing evidence of the effectiveness of these devices. It is, therefore, important that all clinicians working in an intensive care setting have an understanding of how LVADs work, whether as a district general physician referring a patient for consideration of implantation or a tertiary centre healthcare professional managing the complications. Presentation This case study describes the journey of a patient presenting with decompensated heart failure who failed to improve despite maximal medical intervention. The patient was not eligible for a heart transplant at the time, so an LVAD was inserted as a bridge to recovery of organ dysfunction and then eventual cardiac transplantation. Discussion This article will focus on providing an overview of the indications and anatomy of LVADs as well as the evidence behind their use so that intensive care professionals are aware of the potential of these devices. There will also be further discussion around complications of these devices and practical points to consider when managing a patient who has an LVAD in situ.

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