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Mechanical Circulatory Assistance

January 2, 2018
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.
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.  
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%.  
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.
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.

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