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%.
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Mechanical circulatory assistance
November 25, 2014
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:
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.
Internet video of the week : Implantation of the HeartWare HVAD: from full sternotomy to less invasive techniques
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 Some had outdated statistics, some were written above a 3rd grade level, and most did not meet international standards.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
September 23, 2014
Pierre-Emmanuel Falcoz of Strasbourg University Hospital takes an in-depth look at extracorporeal membrane oxygenation (ECMO) and its use in thoracic surgery.
September 9, 2014
This video demonstrates a heart transplantation in a patient with an LVAD.
Survival on the Heart Transplant Waiting List: Impact of Continuous Flow Left Ventricular Assist Device as Bridge to Transplant
September 4, 2014
The impact of continuous flow VAD on survival among patients awaiting heart transplant is not well known. Pts on the UNOS list were propensity score matched 1:2 (HeartMate II vs no VAD). Wait list mortality was 10% during the 7.5 year study. Use of a VAD improved survival to transplant at 1 (91% vs 77%) and 2 years (85% vs 68%). Use of VAD as a br