Thrombosis and cable damage in the HeartWare pump: clinical decisions and surgical technique.

Exchange of the HeartWare HVAD made necessary by thrombosis or cable damage is rare, but it is a complex procedure associated with morbidity. Less invasive exchange procedures may contribute to faster postoperative recovery and early mobilization. Between September 2009 and April 2012, 225 patients (median age 55.

Pump exchange for cable damage in patients supported with HeartMate II left ventricular assist device.

Implantable continuous flow pumps are a routine treatment for end-stage heart failure. The waiting time for heart transplantation is increasing, and more and more patients receive the pump for permanent support. We retrospectively analyzed our database of patients supported with the HeartMate II left ventricular assist device to identify instances of cable damage.

Gender differences during mechanical circulatory support.

Long-term mechanical circulatory support (MCS) with ventricular assist devices (VADs) is now an acceptable option for patients with end-stage heart failure (HF). There are growing numbers of reports identifying sex-related differences in the development and prognosis of HF and cardiac surgery. With the experience of 1,607 VAD implantations in our institution we are the first to analyze our data to determine gender distribution in our patient populations and the effect of gender on outcomes.

Incidence rates and predictors of major and minor depression in patients with heart failure.

Aims: Depression is common in heart failure (HF) and associated with adverse outcomes. This study aimed to investigate incidence rates and predictors of depression in patients sampled from four subprojects of the German Competence Network Heart Failure.

Methods: Eight hundred thirty nine symptomatic HF patients free of depression at baseline underwent repeat depression screening (Patient Health Questionnaire, PHQ-9) after 12 months.

Gender differences in health-related quality of life after coronary bypass surgery: results from a 1-year follow-up in propensity-matched men and women.

Objective: To examine whether the predictive value of gender for health-related quality of life (HRQoL) is independent of clinical health status and depression. Women undergoing coronary bypass surgery generally report a poorer HRQoL than men.

Methods: A total of 990 (20% women) patients completed study questionnaires 1 day before coronary bypass surgery and 1 year after surgery.

Causal attributions among patients undergoing coronary artery bypass surgery: gender aspects and relation to depressive symptomatology.

Causal attributions made by patients for their coronary heart disease may contribute to gender differences in emotional adjustment. The purpose of this study was to determine gender differences in causal attributions and to analyze the associations between causal attributions and depressive symptomatology in patients undergoing coronary artery bypass graft (CABG) surgery. Nine hundred and seventy-nine patients (mean age 66.

Predictive relationship between depression and physical functioning after coronary surgery.

Background: Depression is a prevalent condition in patients undergoing coronary artery bypass graft surgery (CABG) and is often associated with a less favorable health status. The aim of this study was to investigate the relationship between depression and physical functioning in patients undergoing CABG.

Methods: The analyses were based on a sample of 883 consecutive subjects (aged 35-93 years; 19.

Regression of myocardial hypertrophy after aortic valve replacement: faster in women?

Background: In patients with aortic stenosis, pressure overload induces cardiac hypertrophy and fibrosis. Female sex and estrogens influence cardiac remodeling and fibrosis in animal models and in men. Sex differences and their molecular mechanisms in hypertrophy regression after aortic valve replacement have not yet been studied.

Heart transplantation in women with dilated cardiomyopathy.

Background: Dilated cardiomyopathy (DCM) is responsible for over half of all heart transplants. Fewer women with DCM undergo heart transplants than men with DCM; the reasons for this state of affairs are unclear.

Methods And Results: We analyzed prospectively a cohort of 698 DCM patients who were referred to our heart transplant center.

A network against failing hearts--introducing the German "Competence Network Heart Failure".

Heart failure (HF) has been identified as one of the most threatening diseases for the western civilisation, posing a risk to health for a rising number of patients. Acknowledging the medical problem of HF to be both economically and socially threatening the German Federal Ministry of Research and Education (BMBF) initiated a nationwide research network aiming to find new ways in prevention, alleviation and treatment of the widespread disease. The "Competence Network Heart Failure" (CNHF), initiated in 2003, bundles the scientific expertise in a large-scale research network; its aims are the coordination of basic and applied clinical research as well as dissemination of findings into clinical practice in order to consolidate and perpetuate the achieved improvements.

Screening for depression: Rasch analysis of the dimensional structure of the PHQ-9 and the HADS-D.

Background: Both the depression modules of the Hospital Anxiety and Depression Scale (HADS-D) and the Patient Health Questionnaire (PHQ-9) are widely used for the screening of depression. We analyzed the dimensionality and the item fit of both scales individually and across the scales. Moreover, we sought to identify items which evidenced item response bias associated with age and gender.

Predictors of preoperative depressive risk in patients undergoing coronary artery bypass graft surgery.

Aims: Depression is highly prevalent among patients undergoing coronary artery bypass graft (CABG) surgery and represents a significant risk factor for longer hospitalization, increasing health costs and worse outcomes. Nonetheless, preoperative depression is rarely assessed in clinical practice, limiting the possibilities for effective prevention and care. Thus, we sought to develop risk models to determine the depressive risk before CABG based on sociodemographic, clinical and treatment variables.

Does time spent on household activities or housework stress complicate recovery following coronary artery bypass surgery?

Objectives: The purpose of the present study was to examine the role of household activities and housework stress as factors contributing to gender differences in recovery following coronary artery bypass graft (CABG) surgery. Therefore, the impact of time spent on household activities and housework stress on physical functioning (PF) was explored.

Methods: Psychosocial data were measured two months and again one year after CABG in a sample of 351 patients (23% women) recruited within one week before surgery.

The Biomaterialbank of the German Competence Network of Heart Failure (CNHF) is a valuable resource for biomedical and genetic research.

Genetic research on heart failure (HF) requires large cohorts of well-phenotyped patients. The German Competence Network of Heart Failure (CNHF) organized a biobank in 2004 to supply the necessary infrastructure and standard operating procedures (SOPs) for a centralized collection of blood specimen. We centralized data and collected serum, plasma and DNA of well characterized HF subjects all over Germany.

Gender aspects of the role of the metabolic syndrome as a risk factor for cardiovascular disease.

Background: The interaction of the risk factors of abdominal obesity, disturbed glucose homeostasis, dyslipidemia, and hypertension is believed to represent a distinct entity, termed the metabolic syndrome (MetS), that leads to a greater increase in cardiovascular risk than does the sum of its components.

Objective: We reviewed currently available information regarding gender differences in the role of the MetS as a risk factor for cardiovascular disease (CVD).

Methods: Using the search terms women, men, sex, gender, sex differences, and gender differences in combination with the metabolic syndrome, we conducted a systematic review of the available literature on sex differences in the MetS.

[Impact of gender and age on in-hospital mortality after coronary artery bypass graft].

Objective: The purpose of this study was to explore the association of gender and age on in-hospital mortality after coronary artery bypass graft (CABG) among the Chinese population.

Methods: A total of 2682 patients (male: 2316, female: 366) who underwent CABG surgery were retrospectively investigated between January 1st, 1997 and December 31st, 2001 for perioperative risk factors and in-hospital mortality rate after CABG.

Results: Preoperative comorbidity rate and postoperative complication rate were higher in women than that in men, although left ventricular ejection fraction was higher and the number of diseased vessels fewer in women than in men.

Heart failure and its treatment in women. Role of hypertension, diabetes, and estrogen.

Large differences exist between women and men in the syndrome of heart failure (HF). In contrast to men, hypertension and diabetes represent the major risk factors for development of HF in women and hypertension is also the major cause of left ventricular hypertrophy and stroke. Left ventricular hypertrophy in women increases the risk for mortality to a higher degree than it does in men.