This single instutition study evaluated the impact of mechanical support in children awaiting heart transplant, comparing the pre-support era (1995-2005 and the post-support era (2005-2013); the latter era marked the transition to being able to provide support without concern for pt size. Support increased from 13% to 37%. Wait list mortality was d
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Mechanical circulatory assistance
Evolution and Impact of Ventricular Assist Device Program on Children Awaiting Heart Transplantation
February 2, 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.
Extracorporeal membrane oxygenation use has increased by 433% in adults in the United States from 2006 to 2011
January 14, 2015
The authors describe a "huge" increase in ECMO usage for pulmonay failure with a trend, though not statistically significant, towards improved outcomes.
December 15, 2014
The CardioWest Total Artificial Heart (CW-TAH) is a pneumatically driven pump that completely replaces the patient’s native ventricles orthotopically.
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.
Twenty-Four Hour In-Hospital Congenital Cardiac Surgical Coverage Improves Perioperative ECMO Support Outcomes
December 3, 2014
This single institution study evaluated the effects of 24-hr in hospital congenital cardiac surgery coverage on outcomes for perioperative congenital heart surgery ECMO. Institution of 24-hr coverage reduced hospital mortality from 68% to 43% as well as rates of cardiac arrhythmias and pneumonia. 24-hr coverage was independently associated with a r
Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program)
December 1, 2014
This is an excellent article on the feasibility of offering Veno Arterial ECMO in outlying community hospitals for Refractory Cardiogenic Shock (RCS). The Authors review a four year time period and describe assessing 104 patients of whom 87 were deemed eligible for V-A ECMO therapy.
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.