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.

scholarly journals 644 Clinical outcomes of patients with end-stage heart failure treated with left ventricular assist devices

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Marta Di Carlo ◽  
Maria Francesca Marchetti ◽  
Corrado Tramontin ◽  
Marco Corda ◽  
Maurizio Porcu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Third Generation ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
End Stage Heart Failure ◽  
End Stage

Abstract Aims During the last decades left ventricular assist devices (LVAD) have assumed a central role in the management of patients with symptomatic end-stage heart failure (HF). The mortality rate and prognosis of these patients is poor, but the substantial progress in LVAD technologies has led to significant improvements in clinical outcomes. The third generation LVADs are small, centrifugal flow pumps, contained within the pericardium and based on full magnetic levitation, which allow to reduce the risks of pump thrombosis. The aim of our study is to evaluate the clinical outcomes and functional capacity of patients with end-stage HF before and after the implantation of a third generation LVAD, the HeartMate 3™. Methods and results We evaluated eight patients with end-stage HF, followed to Cardiology Unit of Brotzu Hospital in Cagliari and consecutively implanted with the HeartMate 3™ LVAD in the Cardiac Surgery Unit from 12 May 2017 to 24 October 2019. For each patient we collected socio-demographic and clinical features, as well as laboratory tests, therapy, echocardiographic and haemodynamics parameters and any complication. Most of our patients were male (87.5%), with mean age 65.6 ± 5.7 years and higher prevalence of cardiovascular risk factors, like smoke (87.5%), hypertension (62.5%) and hypercholesterolaemia (62.5%). The etiology of HF was mainly due to idiopatic dilated cardiomyopathy (62.5%) and ischaemic heart disease (25%); the only female patient had a history of iatrogenic dilated cardiomyopathy, post-chemo and radiotherapy. Before the implantation most of our patients experienced severe symptoms, recurrent decompensations resulting in NYHA class IV (50%) and III (37.5%); the 100% was inotrope dependant and needed short-term support devices like IABP (75%) and ECMO (25%); the 62.5% underwent mechanical ventilation. The patients had severe left ventricular (LV) dysfunction, with low LV ejection fraction (18.6 ± 1.8%), cardiac output (3.08 ± 1.2 l/min) and cardiac index (1.81 ± 0.83 l/min/m2) and increasing filling pressure (26.5 ± 9.7 mmHg), central venous pression (12.7 ± 5 mmHg) and pulmonary arteries resistance (3.81 ± 1 μW). We also found important LV structural changes, with a severe dilatation and increased volumes (EDV 140.62 ± 67.1 ml/m2; ESV 113.7 ± 55.3 ml/m2). Mild right ventricle dysfunction was present only in 50% of patients with normal diameters. We observed few complications, mainly driveline infections (42.8%) and only one case of in-hospital mortality due to multiple organ failure. The seven patients presenting at FU shown a significant improvement in everyday symptoms and functional capacity compared to pre-operative features (P = 0.029). We also found a mild improvement of systolic LV function compared to pre-operatory values, with increase of CO (3.58 ± 0.65 l/min vs. 3.08 ± 1.2) and EF (21.2 ± 9.4% vs. 18.71 ± 97) even though not statistically significant. Conclusions Our study confirms that patients with end-stage HF are mostly male, older, experience severe symptoms and require frequent hospitalizations. The survival rate reached the 87.5% and remained stable even three years after implantation. On the whole our study showed that LVADs can significally improve clinical outcomes and survival rates, confirming the role as treatment of choice for many patients with end-stage HF who cannot undergo heart transplantation, which still remains the gold standard. The complications related to LVAD were few, thanks to careful patients selection, showing a favourable risk benefit ratio.

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.

scholarly journals Left Ventricular Assist Devices in Chronic Heart Failure

2013 ◽  
Vol 62 (23) ◽  
pp. 2257
Author(s):  
Antonino G.M. Marullo ◽  
Mariangela Peruzzi ◽  
Elena Cavarretta ◽  
Giuseppe Biondi-Zoccai ◽  
Giacomo Frati
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist

Chronic heart failure

2016 ◽  
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Patients With Heart Failure

The diagnosis and management of chronic heart failure are discussed. Medical therapy and indications for cardiac resynchronization therapy (CRT), implantable cardioverter-defibrillators (ICD), left ventricular assist devices (LVAD), and transplantation are presented. Recommendations by the ACC/AHA and ESC on the management of patients with heart failure have been summarized and tabulated.

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