Cardiogenic shock: collaboration between cardiac surgery and cardiology subspecialties to bridge to recovery.

Acute cardiogenic shock is a lethal condition that results in death from myocardial failure, arrhythmia, or combinations of both. Aggressive medical, surgical, and interventional maneuvers have helped reduce the mortality. For the most advanced cases, ventricular assist devices have been used for persistent shock states.

Incorporation of an in-line filter for ultrafiltration or hemodialysis to the Abiomed BVS5000 ventricular assist device.

Multiple organ system dysfunction is an associated finding in patients requiring acute ventricular assist device (VAD) support. In the setting of acute renal failure, percutaneous catheters are placed for hemodialysis and/or ultrafiltration. Incorporation of an ultrafiltration or hemodialysis system in the Abiomed BVS5000 VAD circuit is a simple maneuver that eliminates the need for an additional catheter, thereby reducing the vascular and infectious complications associated with these catheters.

The Thoratec Implantable Ventricular Assist Device (IVAD): initial clinical experience.

Background: The Thoratec Implantable Ventricular Assist Device (IVAD) is the only FDA-approved intracorporeal biventricular cardiac assist device. It is a titanium-coated version of its predecessor, the Paracorporeal Ventricular Assist Device (PVAD). The blood pump is compatible with the portable TLC-II driver, making home discharge feasible.

Cognitive dysfunction in advanced heart failure and prospective cardiac assist device patients.

Background: Extended periods of hypoperfusion in an advanced heart failure (HF) places patients at high risk for neurobehavioral compromise, which has not been studied systematically. It is also not clear how intravenous inotropic therapy and mechanical cardiac assist devices (MCAD) affect cognitive function.

Methods: This prospective cross-sectional cognitive preliminary study evaluated 252 potential heart transplant candidates assessing functions in memory, motor, and processing speed.

Initial experience with the Abiomed AB5000 ventricular assist device system.

Purpose: We describe our initial experience with the Abiomed AB5000 ventricular assist device (VAD).

Description: The Abiomed AB5000 VAD is a system recently approved by the Food and Drug Administration that consists of a fully automatic, vacuum-assisted console and a paracorporeal, pneumatically driven blood pump. The VAD is designed for short or intermediate term use.

Transmyocardial laser revascularization as sole reoperative therapy following late anginal recurrence: case report.

A case of recurrent angina 3 years following sole therapy transmyocardial laser revascularization (TMR) is described. Repeat sole therapy TMR with the Holmium:YAG system was performed and resulted in complete and immediate angina relief. Repeat TMR should be considered in patients with angina recurrence who underwent primary TMR.

Selective use of amiodarone and early cardioversion for postoperative atrial fibrillation.

Background: Postoperative atrial fibrillation (AF) occurs in 20%-40% of patients undergoing open-heart surgery. Numerous pharmacological and electrical therapies have been used as a prophylaxis to prevent this dysrhythmia. The purpose of this study was to examine the selective use of amiodarone and early cardioversion (CVN) postoperatively to restore normal sinus rhythm (NSR).

Complications following placement or extraction of endovascular pacemaker and defibrillator leads--cardiothoracic surgical intervention: case reports.

Complications related to the insertion or removal of permanent pacemakers and implantable cardiac defibrillators are rare events. However, when adverse events occur, their severity may be life threatening. Rapid recognition of a problem followed by prompt consultation with a cardiothoracic surgeon is necessary to stabilize potentially catastrophic events.

Psychosocial and sexual concerns of patients with implantable left ventricular assist devices: a pilot study.

Objective: We sought to determine the psychosocial and sexual concerns of patients discharged from the hospital with implantable left ventricular assist devices.

Methods: Bridge-to-transplant patients with the Heartmate left ventricular assist device received a psychosocial and sexual survey at 1 month after discharge from the hospital. The survey consisted of 3 parts, with 5 questions in each category.

Outpatient management of long-term assist devices.

Current VAD technology has enabled patients to be safely discharged from hospital, awaiting transplantation in the setting of their home. The results of recent studies have proven that patients on LVADs as destination therapy fare better than their medical counterparts and enjoy a higher quality of life. The lessons learned thus far in the outpatient management of LVADs has convinced the medical and non-medical communities that this form of therapy is more than feasible in addressing the epidemic of heart failure.

The AbioCor totally implantable replacement heart.

An artificial heart with adequate circulatory support and an acceptable quality of life remains one of the holy grails of heart failure medicine and surgery. The totally implantable AbioCor is powered electrically via an external power source and has no skin-piercing cables. To date, seven critically ill patients with end-stage heart failure have been implanted with it.

Ventricular assist device support for management of sustained ventricular arrhythmias.

We describe herein the cases of 2 patients who had ventricular arrhythmias. In one, a short-term biventricular assist device, the ABIOMED BVS 5000, was placed because the patient had sustained ventricular tachycardia and could not be weaned from cardiopulmonary bypass. Excellent hemodynamic support was maintained for several days while the antiarrhythmic therapy was maximized.