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Left Ventricular Assist Device

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1. Diagnosis and treatment of gastrointestinal bleeding in patients with left ventricular assist devices

Diagnosis and treatment of gastrointestinal bleeding in patients with left ventricular assist devices Diagnosis and treatment of gastrointestinal bleeding in patients with left ventricular assist devices Diagnosis and treatment of gastrointestinal bleeding in patients with left ventricular assist devices Mitchell MD, Fisher LR, Mehta S, Mull N. Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation Mitchell MD, Fisher LR, Mehta S, Mull N.. Diagnosis and treatment of gastrointestinal bleeding in patients with left ventricular assist devices. Philadelphia: Center for Evidence-based Practice (CEP). 2018 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Gastrointestinal Hemorrhage; Heart Failure; Heart-Assist Devices; Humans Language Published English Country of organisation United States English summary An English

2018 Health Technology Assessment (HTA) Database.

2. Subcutaneous implantable cardioverter defibrillator in patients awaiting cardiac transplantation or left ventricular assist device for refractory heart failure: a feasible alternative to transvenous device? Full Text available with Trip Pro

Subcutaneous implantable cardioverter defibrillator in patients awaiting cardiac transplantation or left ventricular assist device for refractory heart failure: a feasible alternative to transvenous device? 29377556 2018 12 17 2018 12 17 2055-5822 5 3 2018 06 ESC heart failure ESC Heart Fail Subcutaneous implantable cardioverter defibrillator in patients awaiting cardiac transplantation or left ventricular assist device for refractory heart failure: a feasible alternative to transvenous device (...) of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. Gerosa Gino G Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. Iliceto Sabino S Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. eng Editorial 2018 01 27 England ESC Heart Fail 101669191 2055-5822 IM Defibrillators, Implantable Feasibility Studies Heart Failure surgery Heart Transplantation Heart-Assist Devices Humans Subcutaneous Tissue Waiting

2018 ESC heart failure

3. Meta-Analysis of the Effect of Preoperative Atrial Fibrillation on Outcomes After Left Ventricular Assist Device Implantation (Abstract)

Meta-Analysis of the Effect of Preoperative Atrial Fibrillation on Outcomes After Left Ventricular Assist Device Implantation The effect of preoperative atrial fibrillation (AF) on clinical outcomes after left ventricular assist device (LVAD) implantation remains uncertain. We sought to conduct a meta-analysis to assess the safety and efficacy of LVAD implantation in AF patients. Medline and Scopus were searched for studies that assessed the effect of preoperative AF on clinical outcomes

2019 EvidenceUpdates

4. A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report. Full Text available with Trip Pro

A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report. In two interim analyses of this trial, patients with advanced heart failure who were treated with a fully magnetically levitated centrifugal-flow left ventricular assist device were less likely to have pump thrombosis or nondisabling stroke than were patients treated with a mechanical-bearing axial-flow left ventricular assist device.We randomly assigned patients with advanced heart failure to receive either (...) , 0.11 to 0.38; P<0.001). The numbers of events per patient-year for stroke of any severity, major bleeding, and gastrointestinal hemorrhage were lower in the centrifugal-flow pump group than in the axial-flow pump group.Among patients with advanced heart failure, a fully magnetically levitated centrifugal-flow left ventricular assist device was associated with less frequent need for pump replacement than an axial-flow device and was superior with respect to survival free of disabling stroke

2019 NEJM Controlled trial quality: predicted high

5. Meta-Analysis Comparing Risk for Adverse Outcomes After Left Ventricular Assist Device Implantation in Patients With Versus Without Diabetes Mellitus (Abstract)

Meta-Analysis Comparing Risk for Adverse Outcomes After Left Ventricular Assist Device Implantation in Patients With Versus Without Diabetes Mellitus Patients with diabetes mellitus (DM) are known to have reduced life expectancy and be at increased risk for multiple morbidities including serious infection. However, published data on DM outcomes after left ventricular assist device (LVAD) implantation are sparse, inconsistent and individual studies are small with limited power. We conducted (...) ). There was increased 30-day mortality (RR 1.57 [1.00, 2.47]; p = 0.05; I2 = 0%) among DM versus NDM. The DM and NDM groups did not differ significantly in terms of 1-year mortality (RR 1.15 [0.98, 1.35]; p = 0.08; I2 = 39%), device-related infection (RR 1.05 [0.92, 1.19]; p = 0.88; I2 = 0%), ischemic stroke (RR 1.29 [0.91, 1.83]; p = 0.69; I2 = 0%), hemorrhagic stroke (RR 1.10 [0.42, 2.83]; p = 0.85; I2 = 69%), or bleeding (RR 1.06 [0.80, 1.40]; p = 0.70; I2 = 27%). After LVAD implantation, patients with DM

2019 EvidenceUpdates

6. Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. Full Text available with Trip Pro

Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. Left ventricular assist device (LVAD) therapy improves myocardial function, but few patients recover sufficiently for explant, which has focused attention on stem cells to augment cardiac recovery.To assess efficacy and adverse effects of intramyocardial injections of mesenchymal precursor (...) failure, intramyocardial injections of mesenchymal precursor cells, compared with injections of a cryoprotective medium as sham treatment, did not improve successful temporary weaning from left ventricular assist device support at 6 months. The findings do not support the use of intramyocardial mesenchymal stem cells to promote cardiac recovery as measured by temporary weaning from device support.clinicaltrials.gov Identifier: NCT02362646.

2019 JAMA Controlled trial quality: predicted high

7. A Novel Toroidal-Flow Left Ventricular Assist Device Minimizes Blood Trauma: Implications of Improved Ventricular Assist Device Hemocompatibility. (Abstract)

A Novel Toroidal-Flow Left Ventricular Assist Device Minimizes Blood Trauma: Implications of Improved Ventricular Assist Device Hemocompatibility. Continuous-flow left ventricular assist devices (LVADs) cause blood trauma - von Willebrand factor degradation, platelet activation, and subclinical hemolysis. Blood trauma contributes to bleeding, thrombosis, and stroke, which cause significant morbidity and mortality. The TORVAD is a first-of-its kind, toroidal-flow LVAD designed to minimize blood

2018 Annals of Thoracic Surgery

8. Left Ventricular Assist Devices for Destination Therapy

Left Ventricular Assist Devices for Destination Therapy Health Quality Ontario ABOUT OHTAS Contact us: Evidence@hqontario.ca Left Ventricular Assist Devices for Destination Therapy: OHTAC Recommendation ONTARIO HEALTH TECHNOLOGY ADVISORY COMMITTEE RECOMMENDATIONS ? OHTAC recommends that continuous flow left ventricular assist devices (LVAD) be publicly funded as permanent therapy (also known as destination therapy) in patients with end-stage heart failure who are ineligible for heart (...) FOR THE RECOMMENDATION DECISION After a review of the evidence (1), OHTAC felt that the clinical benefit of LVADs as permanent therapy for patients with end-stage heart failure, who are ineligible for heart transplantation, outweighed its lack of cost-effectiveness. However, because there was uncertainty about this treatment’s effect on quality of life, OHTAC requested continued quality of life data collection to be reviewed by OHTAC in two years. Left Ventricular Assist Devices for Destination Therapy: OHTAC

2016 Health Quality Ontario

9. Comparison of continuous‐flow ventricular assist device therapy with intensive medical therapy in fixed pulmonary hypertension secondary to advanced left heart failure Full Text available with Trip Pro

Comparison of continuous‐flow ventricular assist device therapy with intensive medical therapy in fixed pulmonary hypertension secondary to advanced left heart failure Both ventricular assist device (VAD) and pulmonary vasodilator therapy have been shown in uncontrolled studies to improve pulmonary hypertension secondary to advanced left heart failure (Group 2 PH). This study aimed to compare haemodynamic benefits and survival in patients with fixed Group 2 PH treated with continuous-flow VAD

2018 ESC heart failure

10. Comment on: ‘Implantation of a left ventricular assist device to provide long term support for end‐stage Duchenne muscular dystrophy‐associated cardiomyopathy’ by Stoller et al. Full Text available with Trip Pro

Comment on: ‘Implantation of a left ventricular assist device to provide long term support for end‐stage Duchenne muscular dystrophy‐associated cardiomyopathy’ by Stoller et al. 29931760 2018 11 14 2018 11 14 2055-5822 5 4 2018 08 ESC heart failure ESC Heart Fail Comment on: 'Implantation of a left ventricular assist device to provide long term support for end-stage Duchenne muscular dystrophy-associated cardiomyopathy' by Stoller et al. 651-652 10.1002/ehf2.12286 Adorisio Rachele R

2018 ESC heart failure

11. HFSA/SAEM/ISHLT clinical expert consensus document on the emergency management of patients with ventricular assist devices

on ScienceDirect. Figures Figure 1 Components of a typical left ventricular assist device (LVAD). A continuous flow a (CF) LVAD consists of a pump connected to the cardiac apex and ascending aorta via an inflow cannula and outflow graft, respectively, a percutaneous driveline that exits the skin on the right, and a system controller that is typically worn on a belt. Power to the controller and pump is provided by external batteries or a power-based unit. Adapted from Mehra et al, 12 with permission. Figure 2 (...) Left ventricular assist device (LVAD) controllers with an alarm display. (A) HeartMate II pocket controller showing controller display/buttons (top) and driveline fault alarm with a yellow wrench (below). The patient is instructed to contact the ventricular assist device (VAD) team for further advice on troubleshooting and management. (B) HeartWare HVAD with controller display/buttons (top) and low battery alarm (below). The patient is instructed to replace the battery. (C) HeartMate 3 pocket

2019 International Society for Heart and Lung Transplantation

12. Outcomes of extra-corporeal right ventricular assist with durable left ventricular assist device. (Abstract)

Outcomes of extra-corporeal right ventricular assist with durable left ventricular assist device. Right heart failure occurs in 9-44% of left ventricular assist device (LVAD) implants of which less than 10% require a right ventricular assist device (RVAD) support either concurrently with the LVAD or staged, as a delayed procedure. We have reported our outcomes based on whether the RVAD was placed concurrently or staged.Clinical data were obtained from the Duke University Medical Center database

2018 Annals of Thoracic Surgery

13. Usefulness of a left ventricular assist device in patients with left ventricular noncompaction Full Text available with Trip Pro

Usefulness of a left ventricular assist device in patients with left ventricular noncompaction Left ventricular noncompaction (LVNC) is a multifactorial structural abnormality of the myocardial wall characterized by prominent trabeculae and deep trabecular recesses. LVNC may present as a congenital or acquired defect characterized by 2 distinct tissue layers: a spongy, noncompacted inner myocardium and a thin, compacted outer myocardium. Patients with LVNC are prone to thromboembolic events (...) , either due to deep trabeculations in the noncompacted myocardium or due to arrhythmias accompanying the defect. There are sparse data concerning treatment options for patients with LVNC who fail medical management. We present 2 such patients with LVNC who, following failed medical management, received a left ventricular assist device (LVAD): one for long-term management and one as a bridge to transplant. Both were managed successfully without thromboembolic events to date. The success of these cases

2018 Proceedings (Baylor University. Medical Center)

14. Left ventricular assist devices for destination therapy: OHTAC recommendation

Left ventricular assist devices for destination therapy: OHTAC recommendation Left ventricular assist devices for destination therapy: OHTAC recommendation Left ventricular assist devices for destination therapy: OHTAC recommendation Health Quality Ontario Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Health Quality Ontario. Left (...) ventricular assist devices for destination therapy: OHTAC recommendation. Toronto: Health Quality Ontario (HQO). 2016 Authors' conclusions After a review of the evidence (1), OHTAC felt that the clinical benefit of LVADs as permanent therapy for patients with end-stage heart failure, who are ineligible for heart transplantation, outweighed its lack of cost-effectiveness. However, because there was uncertainty about this treatment's effect on quality of life, OHTAC requested continued quality of life data

2016 Health Technology Assessment (HTA) Database.

15. Left ventricular assist devices for destination therapy: a health technology assessment

Left ventricular assist devices for destination therapy: a health technology assessment Left ventricular assist devices for destination therapy: a health technology assessment Left ventricular assist devices for destination therapy: a health technology assessment Health Quality Ontario Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation (...) Health Quality Ontario. Left ventricular assist devices for destination therapy: a health technology assessment. Toronto: Health Quality Ontario (HQO). Ontario Health Technology Assessment Series; 16(3). 2016 Authors' conclusions For patients with end-stage heart failure who are ineligible for heart transplantation, permanent treatment with continuous-flow LVADs is effective at improving survival and quality of life compared with drug therapy. However, permanent continuous-flow devices have higher

2016 Health Technology Assessment (HTA) Database.

16. Left ventricular assist devices in the treatment of end-stage heart failure

Left ventricular assist devices in the treatment of end-stage heart failure Left ventricular assist devices in the treatment of end-stage heart failure Left ventricular assist devices in the treatment of end-stage heart failure Neyt M, Leroy R, Devos C, Van Brabandt H Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Neyt M, Leroy R, Devos (...) C, Van Brabandt H. Left ventricular assist devices in the treatment of end-stage heart failure. Brussels: Belgian Health Care Knowledge Centre (KCE). KCE Reports 264. 2016 Authors' objectives A ventricular assist device is a medical device that supports the pumping function of the heart. This technique can be applied with different objectives: - as a "bridge to recovery" or "bridge to decision" to give a weakened heart muscle some time to recover and/or to give the opportunity to make a decision

2016 Health Technology Assessment (HTA) Database.

17. Left ventricular assist devices in the treatment of end-stage heart failure

Left ventricular assist devices in the treatment of end-stage heart failure 2016 www.kce.fgov.be KCE REPORT 264Cs SYNTHESIS LEFT VENTRICULAR ASSIST DEVICES IN THE TREATMENT OF END-STAGE HEART FAILURE 2016 www.kce.fgov.be KCE REPORT 264Cs HEALTH TECHNOLOGY ASSESSMENT SYNTHESIS LEFT VENTRICULAR ASSIST DEVICES IN THE TREATMENT OF END-STAGE HEART FAILURE MATTIAS NEYT, ROOS LEROY, CARL DEVOS, HANS VAN BRABANDT KCE Report 264Cs Left ventricular assist devices in the treatment of end-stage heart (...) Manager 2 Left ventricular assist devices in the treatment of end-stage heart failure KCE Report 264Cs ¦ SYNTHESIS Table of contents ¦ FOREWORD 1 ¦ SYNTHESIS 2 1. ASSIST DEVICES FOR TREATMENT OF HEART FAILURE 3 1.1. WHAT IS HEART FAILURE? 3 1.2. WHAT IS THE CAUSE OF HEART FAILURE? 3 1.3. DOES HEART FAILURE OCCUR OFTEN, AND IN WHOM? 3 1.4. HOW IS HEART FAILURE TREATED? 3 1.5. HEART TRANSPLANTATION: BETTER SURVIVAL AND QUALITY OF LIFE, BUT TOO FEW DONOR HEARTS 3 1.6. THE LVAD OR LEFT VENTRICULAR ASSIST

2016 Belgian Health Care Knowledge Centre

18. Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study. (Abstract)

Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study. Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes.We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients.Patients analyzed were those included (...) in the multicenter ASSIST-ICD observational study. ES was consensually defined as occurrence of ≥3 separate episodes of sustained VAs within a 24-hour interval.Of 652 patients with an LVAD, 61 (9.4%) presented ES during a median follow-up period of 9.1 (interquartile range [IQR] 2.5-22.1) months. The first ES occurred after 17 (IQR 4.0-56.2) days post LVAD implantation, most of them during the first month after the device implantation (62.9%). The incidence then tended to decrease during the initial years

2019 Heart Rhythm

19. Right ventricular function and residual mitral regurgitation after left ventricular assist device implantation determines the incidence of right heart failure. Full Text available with Trip Pro

Right ventricular function and residual mitral regurgitation after left ventricular assist device implantation determines the incidence of right heart failure. The effect of significant mitral regurgitation (MR) on outcomes after continuous flow left ventricular assist device (cfLVAD) implantation remains unclear.We performed a retrospective review of prospectively collected data from 159 patients with preoperative severe MR who underwent cfLVAD implantation (2003-2017). Two-step cluster (...) with mild RVD. Group 2 had the largest proportion with Interagency Registry for Mechanically Assisted Circulatory Support score of 1 (30.2%) and 2 (41.9%). They were more likely to undergo temporary mechanical circulatory support (18.6%) and tricuspid valve procedure (62.8%). Group 2 had the highest rate of stroke (30.2%; P = .02), hemolysis (39.5%; P = .01), device thrombosis (30%; P = .01), and worst survival (46.5%; P = .01). Survival at 5 years for groups 1, 2, and 3 were 56.0%, 17.6%, and 55.8

2019 Journal of Thoracic and Cardiovascular Surgery

20. Clinical impact of newly developed atrial fibrillation complicated with longstanding ventricular fibrillation during left ventricular assist device support: A case report. Full Text available with Trip Pro

Clinical impact of newly developed atrial fibrillation complicated with longstanding ventricular fibrillation during left ventricular assist device support: A case report. Continuous-flow left ventricular assist devices (LVADs) improve survival and morbidity in patients with stage D heart failure. Management of LVADs for longer durations is necessary in some clinical settings, and a better understanding of the hemodynamics of patients using LVADs is warranted. Arrhythmia, including atrial (AA (...) ) and ventricular (VAs) arrhythmias, is a modifying factor of hemodynamics that is highly prevalent among patients with LVADs. However, the clinical impact of arrhythmias in various clinical settings in patients with LVAD, in which the hemodynamic load is likely to present as worsening of right heart failure, remains to be completely elucidated.We describe the case of a patient under sustained ventricular fibrillation for extraordinarily long duration who was stabilized using LVAD support and in whom newly

2019 BMC Cardiovascular Disorders

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