A sobering editorial, read last May at the AATS, that discusses at length the ethics of ventricular assist as a super expensive therapy seen from the principle of fairness.
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Mechanical Circulatory Assistance
October 12, 2017
Rajamiyer Venkateswaran of the Wythenshawe Hospital in Manchester, UK, asks whether it is possible to predict when a patient undergoing high-risk cardiac surgery will need postoperative mechanical circulatory support. He also discusses his institution's approach to transfering a patient to mechanical circulatory support.
October 12, 2017
The Impella RP device was approved by the FDA for use as a temporary percutaneous assist for the right ventricle, as announced by Abiomed. Use is approved for up to 14 days for a variety of indications including post MI, heart transplant, open heart surgery, or right heart failure after LVAD implant.
October 6, 2017
A stimulating editorial triggered by tri-species autopsy work on angiodysplasia potentially attributable to continuous-flow LVAD. Dr Birks discusses the findings and appears open to the suggestion that LVAD per se is a cause of gastrointestinal angiodysplasia and thence bleeding, as opposed to the anticoagulation for LVAD.
September 19, 2017
The authors queried the UNOS heart transplantation database to determine if LVAD device-related complications (DRCs) were associated with worse postoperative graft survival. The 5 categories of DRCs were as follows: device thrombosis, infection, device malfunction, life-threatening arrhythmias, and others.
Datascope Corp/MAQUET Issues Worldwide Voluntary Recall of IABPs for Potential Electrical Test Failure
June 24, 2017
Please make sure that you are aware of this recall for testing of System CS100, CS100i and CS300 Intra-aortic Balloon Pumps for electrical testing.
March 5, 2017
The authors report the use of ECMO in 8 pts who suffered ARDS after pneumonectomy. Predicted mortality was 80% prior to ECMO institution. ECMO was weaned in 7 pts and overall hospital survival was 50%.
Changes in End-Organ Function in Patients With Prolonged Continuous-Flow Left Ventricular Assist Device Support
March 5, 2017
Changes in end organ function were assessed in 59 pts having a continuous flow LVAD in place for more than 3 years. Renal and hepatic function improved initially, but renal function deteriorated to preoperative levels during the follow-up period.
Does Small Size Matter With Continuous Flow Devices? : Analysis of the INTERMACS Database of Adults With BSA ≤1.5 m2
February 15, 2017
The authors reviewed the retrospective INTERMACS database to assess whether outcomes after continuous-flow (CF) LVAD implantation varied with patient BSA. A total of over 10,000 CF LVAD patients were included. Of these, 231 (2%) had a BSA < 1.5 m².
February 8, 2017
Professor Stephen Westaby of John Radcliffe Hospital, Oxford, UK, gives an overview of the use of temporary mechanical support for postcardiotomy failure.