Mechanical circulatory support devices such as ventricular assist devices have become the approved and accepted treatment option to improve survival and quality of life in patients with advanced heart failure refractory to medical therapy. Patients as a result are living longer and presenting to emergency medical services, primary care facilities, emergency departments, and critical care units more frequently. Currently, health care providers have limited experience in managing this complex patient population. Thus, we created a standardized method of initial evaluation and algorithmic approach of management to help in the management of emergencies in this unique patient population. We present a comprehensive overview of the types of mechanical assist devices, their complications, and an algorithmic approach to the emergency management in the patients with mechanical circulatory support. A systematic method is crucial in prompt and early recognition of emergencies to ensure appropriate management of these patients.
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http://dx.doi.org/10.7182/pit2013848 | DOI Listing |
Sci Rep
January 2025
University of Ulsan, 93 Daehak-ro, Nam-gu, Ulsan, 680-749, Republic of Korea.
This study employed large eddy simulation (LES) with the wall-adapting local eddy-viscosity (WALE) model to investigate transitional flow characteristics in an idealized model of a healthy thoracic aorta. The OpenFOAM solver pimpleFoam was used to simulate blood flow as an incompressible Newtonian fluid, with the aortic walls treated as rigid boundaries. Simulations were conducted for 30 cardiac cycles and ensemble averaging was employed to ensure statistically reliable results.
View Article and Find Full Text PDFAm J Cardiol
January 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address:
Background: The benefit of mechanical circulatory support (MCS) with Impella (Abiomed, Inc, Danvers, MA) for patients undergoing non-emergent, high-risk percutaneous coronary intervention (HR-PCI) is unclear and currently the subject of a large randomized clinical trial (RCT), PROTECT IV. While contemporary registry data from PROTECT III demonstrated improvement of outcomes with Impella when compared with historical data (PROTECT II), there is lack of direct comparison to the HR-PCI cohort that did not receive Impella support.
Methods: We retrospectively identified patients from our institution meeting PROTECT III inclusion criteria (left ventricular ejection fraction [LVEF] <35% with unprotected left main or last remaining vessel or LVEF <30% undergoing multivessel PCI), and compared this group (NonIMP) to the published outcomes data from the PROTECT III registry (IMP).
Rev Esp Anestesiol Reanim (Engl Ed)
January 2025
Departamento de ECMO, Fundación Cardiovascular de Colombia, Floridablanca, Colombia. Electronic address:
Heart failure is a complication that may develop in patients diagnosed with acromegaly. This complication can progress to cardiogenic shock, which in cases like the one described, may be refractory to optimal medical management, necessitating the use of mechanical circulatory support as a bridge to decision. Given the specific morphology of this patient's heart, the likelihood of finding a suitable donor in our environment was very low.
View Article and Find Full Text PDFBioelectrochemistry
January 2025
Graduate School of Engineering, Chiba University, 1-33 Yayoi, Inage, Chiba 263-8522 Japan.
Heparin concentration c in a blood extracorporeal circulation has been real-timely predicted based on the relaxation strength Δε at relaxation frequency f extracted by relaxation time distribution (RTD). The simulated extracorporeal circulation was conducted to optimize the number of Δε for the prediction of c using the porcine whole blood (WB) and low-leukocyte and -platelet blood (LLPB) under the condition of the gradual increment of c from 0 to 8 U/mL with constant flow rate and blood temperature. The experimental results show that among the three relaxation strengths Δε, Δε and Δε (in ascending order of frequency), Δε at f = 5.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany.
Emerging evidence suggests the role of mechanical circulatory support (MCS) devices in the therapy of refractory cardiogenic shock (CS). However, largerandomized trials addressing the role of Impella in the therapy of infarct-associated CS are sparse. As such, evidence coming from comprehensive retrospective studies or meta-analyses is of major importance in order to clarify the role of the Impella device in this setting.
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