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Mechanical Circulatory Assistance

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.
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.
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.
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:
November 5, 2014
This video presents the options available when a patient has greater-than-mild aortic insufficiency at the time of LVAD placement, and demonstrates the performance of a Parks’ stitch.
November 3, 2014
Left ventricular assist devices (LVADs) are increasingly used for the treatment of end-stage congestive heart failure, both as a bridge to transplantation and as destination therapy (1).
October 22, 2014
This survey of publicly available information on LVAD for patients considering such therapy identified numerous flaws in the materials.  All discussed benefits, few discussed surgical issues, quality of life, and complications.  Some had outdated statistics, some were written above a 3rd grade level, and most did not meet international standards.  Th

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