共查询到20条相似文献,搜索用时 15 毫秒
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Ellie J. Coromilas Koji Takeda Masahiko Ando Marisa Cevasco Phillip Green Dimitri Karmpaliotis Ajay Kirtane Veli K. Topkara Melana Yuzefpolskaya Hiroo Takayama Yoshifumi Naka Daniel Burkhoff Paolo C. Colombo A. Reshad Garan 《Journal of cardiac failure》2019,25(2):105-113
Background
Early right ventricular (RV) failure after left ventricular assist device (LVAD) implantation increases morbidity and mortality. Percutaneous right ventricular assist device (pRVAD) support is an alternative to more invasive surgical RVAD (sRVAD).Methods and Results
We retrospectively reviewed patients receiving isolated pRVAD or sRVAD after durable LVAD at our center in the years 2007–2018. Hemodynamic parameters before and after implantation and survival outcomes were compared among groups. Nineteen patients received pRVAD and 21 sRVAD. Hemodynamic parameters improved immediately with the use of pRVAD; central venous pressure decreased (from 15.9 ± 2.4 to 12.3 ± 3.2 mm Hg; P<.001) and cardiac index increased (from 2.4 ± 0.5 to 3.5 ± 0.8 L·min?1·m?2; P<.001). These were sustained after device removal and were similar to those with the use of sRVAD. Patients with pRVAD required fewer blood transfusions and mechanically ventilated days than those with sRVAD. Among survivors, intensive care unit and hospital days were fewer with the use of pRVAD: 21 (16–27) versus 34 (27–46) ICU days (P?=?.01); 43.5 (30–66) versus 91 (62–111) hospital days (P?=?.03). There was no significant difference in 30-day mortality with the use of pRVAD compared with sRVAD (21.1% vs 42.9%; P?=?.14), but there was a trend toward a higher rate of discharge free from hemodialysis (73.7% vs 47.6%; P?=?.09).Conclusions
Novel pRVAD systems for RV failure provide hemodynamic benefits similar to sRVAD, are associated with less morbidity, and should be considered as an alternative to sRVAD. 相似文献2.
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《Journal of cardiac failure》2014,20(6):387-391
BackgroundThe purpose of this study was to define the prevalence and clinical ramifications of anemia in patients implanted with a continuous-flow left ventricular assist device (CF-LVAD).Methods and ResultsPatients implanted with a CF-LVAD from January 1, 2008, to April 30, 2012, were included in this retrospective cohort study. The primary outcome was the prevalence of anemia throughout the 1st year of device support. Secondary end points included the impact of anemia on rates of readmission to hospital and mortality. Ninety-one patients were included; the prevalence of anemia 360 days after implantation was significantly reduced compared with baseline (61.4% vs 79.1%, respectively; P = .032); 65.4% of anemic patients and 34.6% of nonanemic patients were readmitted at least once (P = .067). The median number of readmissions in the anemic compared with the nonanemic group was 4 (interquartile range [IQR] 2-6) versus 1.5 (IQR 1-3), respectively (P < .001). Furthermore, among those who experienced >3 readmissions during the 1st year, 19 were anemic compared with 1 patient who was not anemic (P < .001).ConclusionsAnemia remains a prevalent condition while on CF-LVAD support and is associated with a significant increase in the number of hospital readmissions. 相似文献
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Lamees I. El Nihum Nina Manian Priya Arunachalam Qasim Al Abri Ashrith Guha 《Methodist DeBakey Cardiovascular Journal》2022,18(4):19
Late-stage heart failure and renal dysfunction are often seen in conjunction. Cardiorenal syndrome (CRS) describes the complex interaction between the two disease states. Early literature described the pathophysiology of CRS as related only to reduced cardiac output and decreased renal perfusion. Recent literature suggests a more multifaceted mechanism. Left ventricular assist devices (LVAD), used as bridge-to-transplant and destination therapy in patients with heart failure, impact not only cardiac function but also renal function, especially in those patients with preoperative renal dysfunction. The mechanism by which LVAD implantation affects renal function is complex and understated in early literature. In this review, we discuss the pathogenesis of CRS, the impact of preoperative renal dysfunction in patients undergoing LVAD implantation, and the effect of LVAD implantation on postoperative renal function. 相似文献
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心脏移植是终末期心力衰竭治疗的金标准,但面临着供体短缺的问题。左心室辅助装置已成为目前终末期心力衰竭患者的重要治疗手段。出血、泵血栓形成、卒中、右心衰竭和溶血是限制左心室辅助装置治疗的关键因素,第三代全磁悬浮离心式连续流左心室辅助装置的研发,旨在克服这些并发症。近年来我国心室辅助装置发展迅速,多款设备已进入临床试验阶段。本文结合国际前沿研究进展,介绍国内外以磁悬浮为技术特点的左心室辅助装置的研究与应用现状。 相似文献
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Liza Grosman-Rimon Prabjit Ajrawat Jocelyn Lioe Laura C. Tumiati Vivek Rao Filio Billia Andrzej Chruscinski 《Journal of cardiac failure》2019,25(4):301-306
Background
Left ventricular assist devices (LVADs) can serve as a bridge to transplant or destination therapy for patients with advanced heart failure. Implantation of LVADs is known to be associated with increases in anti-HLA antibodies, but less is known about how autoantibody levels change with the use of these devices.Methods and Results
Autoantibody levels were quantified with the use of customized antigen microarrays in 22 patients both before and after LVAD. We observed an increase (1.5- to 2-fold) in 14 IgG autoantibodies in the serum of patients after LVAD, including autoantibodies against cardiac proteins (myosin, troponin I, tropomyosin), DNA, and structural proteins (collagen, laminin). There was also a small but significant rise in total serum IgG after LVAD. Increases in autoantibodies after LVAD were positively associated with increases in calculated panel-reactive antibody class II (P?=?.05) and negatively correlated with age (r?=??0.45; P < .05). Cytokines were evaluated to gain insights into the mechanism of antibody generation, and we observed a positive correlation between total IgG levels after LVAD and the level of monocyte chemoattractant protein 1 (r?=?0.60; P < .05).Conclusions
LVAD implantation is associated with increases in IgG autoantibodies, anti-HLA antibodies, and total IgG. Increases in IgG after LVAD implantation may relate to an inflammatory response triggered by these devices. 相似文献12.
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Moursi M Nanda NC Holman W McGiffin D Samal A de Sousa JB 《Echocardiography (Mount Kisco, N.Y.)》1998,15(7):703-707
In this case report, we present the utility of transesophageal echocardiography in the detection of two uncommon complications of left ventricular assist devices: regurgitation of the bioprosthetic valve in the inflow conduit and a tear of a Dacron conduit with hematoma formation and compression of the right ventricular free wall. 相似文献
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Alan D. Enriquez Brandon Calenda Parul U. Gandhi Ajith P. Nair Anelechi C. Anyanwu Sean P. Pinney 《Journal of the American College of Cardiology》2014