Left ventricular assist devices (LVADs) are carefully designed, but the significance of the implantation configuration and interaction with the vasculature is complex and not fully determined. The present study employs computational fluid dynamics to investigate the importance of applying a realistic LVAD profile when evaluating assisted aortic flow fields and subsequently compares a number of potential anastomosis locations in a patient-specific aortic geometry. The outflow profile of the Berlin Heart INCOR® device was provided by Berlin Heart GmbH (Berlin, Germany) and the cannula was attached at a number of locations on the aorta. Simulations were conducted to compare a flat profile against the real LVAD profile. The results illustrate the importance of applying an LVAD profile. It not only affects the magnitude and distribution of oscillatory shear index, but also the distribution of flow to the great arteries. The ascending aorta was identified as the optimal location for the anastomosis.
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http://dx.doi.org/10.1080/10255842.2011.556628 | DOI Listing |
Circ Heart Fail
January 2025
Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. (S.R.P., M.A.V.).
Background: Patients with end-stage heart failure and low pulmonary capillary wedge pressure are referred to as cold and dry and represent an understudied minority in whom the benefit of left ventricular assist device (LVAD) therapy is unclear.
Methods: Adults receiving LVADs between 2006 and 2017 in the Interagency Registry for Mechanically Assisted Circulatory Support database were classified as cold and wet (pulmonary capillary wedge pressure >15 mm Hg) and cold and dry (pulmonary capillary wedge pressure ≤15 mm Hg) based on pre-LVAD hemodynamics obtained via right heart catheterization. The primary outcome was 1-year survival.
Ann Thorac Surg
December 2024
Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville Tennessee.
Background: Predicted heart mass ratio (PHMr) has become the standard donor-recipient size matching method in heart transplantation. While utilization of small PHMr hearts is associated with increased one-year mortality, the underlying mechanisms and time horizon of mortality remain uncertain.
Methods: A single institution analysis of isolated heart transplant recipients (01/2019-7/2022) was performed (N=334).
Clin Infect Dis
December 2024
Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
A distinction between infections of left ventricular assist devices (LVADs) and cardiac implantable electronic devices (CIEDs) is warranted as they differ markedly in incidence, microbiologic profiles, clinical presentations, and extraction feasibility. These differences necessitate tailored suppressive antibiotic therapy (SAT) strategies. This commentary highlights the need for device-specific SAT approaches.
View Article and Find Full Text PDFEur Heart J Case Rep
December 2024
Department of Anesthesiology, Center for Clinical and Translational Research, Helios University Hospital Wuppertal, Heusnerstraße 40, 42283 Wuppertal, Germany.
Background: Initially conceptualized as a bridge to heart transplantation, the left ventricular assist device (LVAD) has become an important option for improving survival in patients with severe heart failure and poor prognosis.
Case Summary: We report the case of a patient suffering from severe chronic heart failure, complicated by ST-elevation myocardial infarction due to left main coronary artery stenosis (NYHA IV, INTERMACS profile 1). Despite support with veno-arterial extracorporeal membrane oxygenation, inotropes, and catecholamine therapy, the patient's cardiac function did not recover sufficiently.
J Cardiovasc Dev Dis
November 2024
Cardiovascular and Thoracic Department, Division of Cardiology, Città della Salute e della Scienza Hospital, 10126 Turin, Italy.
Background: Heart transplantation and left ventricular assist device (LVAD) implementation are effective treatments for advanced heart failure (HF), although their use is limited by organ availability and the high incidence of adverse events. The efficacy of mitral transcatheter edge-to-edge repair (TEER) as a bridge to transplantation or as a destination therapy in advanced HF is still debated.
Methods: A total of 63 patients with INTERMACS class 3 or 4 with contraindications for LVAD and severe functional mitral regurgitation (FMR) were evaluated for TEER implantation eligibility.
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