Extracorporeal membrane oxygenation (EMCO) offers a therapeutic option for moribund patients of all ages with acute pumonary or cardiac failure. The authors present a retrospective analysis of the largest single institution experience with ECMO support, and present their perspective on the evolving use of ECMO supported by four decades of clinical r
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Mechanical Circulatory Assistance
February 5, 2015
January 25, 2015
This study from the University of Texas Southwestern sought to analyze the effects of mechanical unloading during prolonged LVAD support on mitochondrial mass, DNA damage response (DDR), and cardiomyocyte proliferation. Ten matched human samples of LV myocardium were analyzed before and after mechanical circulatory support.
Impact of Tricuspid Valve Surgery at the Time of Left Ventricular Assist Device Insertion on Postoperative Outcomes
January 17, 2015
The authors perform a meta-analysis of the limited studies available on the utility of tricuspid valve surgery in patients with significant TR at the time of LVAD implantation. No RCTs are available on this issue; however, six observational studies were analyzed by the group.
Comparison of continuous-flow and pulsatile-flow left ventricular assist devices: is there an advantage to pulsatility?
December 13, 2014
This publication by the University of Louisville group provides an excellent comparative analysis of the outcomes after continuous-flow (CF) vs. pulsatile flow (PF) LVADs. Although the outcomes after CF LVAD implantation are clearly superior than those of PF LVADs, there are certainly unique morbidities after CF LVAD implantation.
Improved Early Survival With a Nonsternotomy Approach for Continuous-Flow Left Ventricular Assist Device Replacement
December 11, 2014
In this Duke study, all CF LVAD implantations during the 2005 to 2013 era were analyzed, and those patients who underwent CF LVAD implantation and later replacement were reviewed.
November 27, 2014
Abrams and colleagues provide a comprehensive review of the topic of recirculation during VV ECMO. Specifically, the authors discuss the factors contributing to recirculation, how to calculate the extent of recirculation, and what interventions can be applied to correct the issue.
November 25, 2014
In a retrospective review of 45 cases where patients were placed on VV ECMO, investigators from Seoul performed a multivariate analysis of pre-ECMO risk factors that might be predictive of an unsuccessful ECMO wean. Notably, successful weaning from ECMO was only 46%, and overall survival was only 18%.
November 15, 2014
Selzman and colleagues provide an outstanding overview of the state of the art of bridge to recovery, describing a paradigm shift that has been occurring. A consistent theme over the years is that recovery likelihood is enhanced in younger patients, those with non-ischemic cardiomyopathy, and those who have had HF for shorter durations.
Alternative Right Ventricular Assist Device Implantation Technique for Patients with Perioperative Right Ventricular Failure
November 13, 2014
The authors describe an alternative technique for insertion of a temporary RVAD so as to allow minimally invasive removal without sternotomy after RV recovery. An elongated graft is sewn to the PA and exited in the subxyphoid area at a site that is separate from the sternotomy incision. After exiting, the graft is attached to an outflow cannula.
Effect of Exercise and Pump Speed Modulation on Invasive Hemodynamics in Patients with Centrifugal Continuous Flow Left Ventricular Assist Devices
November 10, 2014
The effects of exercise, increasing pump speed, or both on invasive hemodynamics in centrifugal flow LVAD patients were analyzed in this small study. Findings included: