Pulsatility and the Risk of Nonsurgical Bleeding in Patients Supported With the Continuous-Flow Left Ventricular Assist Device HeartMate II
Omar Wever-Pinzon,Craig H. Selzman,Stavros G. Drakos,Abdulfattah Saidi,Gregory J. Stoddard,Edward M. Gilbert,Mohamed Labedi,Bruce B. Reid,Erin Davis,Abdallah G. Kfoury,Dean Y. Li,Josef Stehlik,Feras Bader +12 more
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In this paper, the effects of different degrees of pulsatility on the incidence of nonsurgical bleeding were assessed by means of the LVAD parameter pulsatility index (PI) and by the echocardiographic assessment of aortic valve opening during the first 3 months of LVAD support.Abstract:
Background—Bleeding is an important cause of morbidity and mortality in patients with continuous-flow left ventricular assist devices (LVADs). Reduced pulsatility has been implicated as a contributing cause. The aim of this study was to assess the effects of different degrees of pulsatility on the incidence of nonsurgical bleeding. Methods and Results—The Utah Transplantation Affiliated Hospitals (U.T.A.H.) heart failure and transplant program databases were queried for patients with end-stage heart failure who required support with the continuous-flow LVAD HeartMate II (Thoratec Corp, Pleasanton, CA) between 2004 and 2012. Pulsatility was evaluated by means of the LVAD parameter pulsatility index (PI) and by the echocardiographic assessment of aortic valve opening during the first 3 months of LVAD support. PI was analyzed as a continuous variable and also stratified according to tertiles of all the PI measurements during the study period (low PI: 5.2). Major ...read more
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The vexing problem of thrombosis in long-term mechanical circulatory support.
TL;DR: The magnitude and implications of pump thrombosis are described, secular and management trends in this unique population are discussed, guidance on surveillance and therapeutic principles are offered, and issues that deserve immediate and collaborative attention are outlined.
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GI bleeding in patients with continuous-flow left ventricular assist devices: a systematic review and meta-analysis
TL;DR: The prevalence of GIB is increased in patients with continuous-flow LVADs, primarily secondary to the presence of GIAD, according to a meta-analysis of the medical literature.
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Cardiac Recovery During Long-Term Left Ventricular Assist Device Support
Omar Wever-Pinzon,Stavros G. Drakos,Stephen H. McKellar,Benjamin D. Horne,William T. Caine,Abdallah G. Kfoury,Dean Y. Li,James C. Fang,Josef Stehlik,Craig H. Selzman +9 more
TL;DR: The incidence of cardiac recovery is higher in patients implanted with an a priori LVAD implantation strategy of bridge-to-recovery (BTR) and a recovery predictive model, I-CARS, suggests a 24% probability of successful LVAD explantation.
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Hospital Readmissions After Continuous-Flow Left Ventricular Assist Device Implantation: Incidence, Causes, and Cost Analysis
Shahab A. Akhter,Abbasali Badami,Margaret Murray,Takushi Kohmoto,Lucian Lozonschi,Satoru Osaki,Entela B. Lushaj +6 more
TL;DR: Gastrointestinal bleeding and CF-LVAD-related infections were the leading causes of readmission, and readmissions did not have a negative impact on long-term survival.
Journal ArticleDOI
Elevated Angiopoietin-2 Level in Patients With Continuous-Flow Left Ventricular Assist Devices Leads to Altered Angiogenesis and Is Associated With Higher Nonsurgical Bleeding.
Corey E. Tabit,Phetcharat Chen,Gene Kim,Savitri Fedson,Gabriel Sayer,Mitchell J. Coplan,Valluvan Jeevanandam,Nir Uriel,James K. Liao +8 more
TL;DR: The findings indicate that thrombin-induced Ang-2 expression in LVAD patients leads to increased angiogenesis in vitro and may be associated with higher nonsurgical bleeding events.
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