<b>Clinical Differences Between Continuous Flow Ventricular Assist Devices:</b>
 A Comparison Between HeartMate II and HeartWare HVAD

Lalonde, S.; Alba, Ana C.; Rigobon, Alanna; Ross, Heather J.; Delgado, Diego; Billia, Filio; McDonald, Michael; Cusimano, Robert J.; Yau, Terrence M.; Rao, Vivek

doi:10.1111/jocs.12158

Cited by 103 publications

(63 citation statements)

References 17 publications

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“…They found no difference between the two devices in any of the investigated parameters. This study supports other investigations from the past demonstrating close similarity of the two devices with respect to clinical outcome [63,64].…”

Section: Tricuspid Valve Surgerysupporting

confidence: 92%

Cardiac surgery 2014 reviewed

et al. 2015

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For the year 2014, more than 17,000 published references can be found in Pubmed when entering the search term "cardiac surgery". The last year has been characterized by a vivid discussion in the fields where classic cardiac surgery and modern interventional techniques overlap. Specifically, there have been important contributions in the field of coronary revascularization with either percutaneous coronary intervention or bypass surgery as well as in the fields of interventional valve therapy. Here, the US core valve trial with the first demonstration of a survival advantage at 1 year with transcatheter valves compared to surgical aortic valve replacement or the 5-year outcome of the SYNTAX trial with significant advantages for bypass surgery has been the landmark. However, in addition to these most visible publications, there have been several highly relevant and interesting contributions. This review article will summarize the most pertinent publications in the fields of coronary revascularization, surgical treatment of valve disease, heart failure (i.e., transplantation and ventricular assist devices) and aortic surgery. This condensed summary will provide the reader with "solid ground" for up-to-date decision-making in cardiac surgery.

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Section: Tricuspid Valve Surgerysupporting

confidence: 92%

Cardiac surgery 2014 reviewed

et al. 2015

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“…The relationship between device types and GI bleeding remains controversial, 24 but this should be analyzed in larger-scale studies, particularly including the most recently introduced HeartMate 3. 2 …”

Section: Discussionmentioning

confidence: 99%

Long-Acting Octreotide Reduces the Recurrence of Gastrointestinal Bleeding in Patients With a Continuous-Flow Left Ventricular Assist Device

Juricek

Imamura

Nguyen

et al. 2018

Journal of Cardiac Failure

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Background Recurrent gastrointestinal bleeding is one of the most significant adverse events in patients with left ventricular assist devices (LVAD). Methods We enrolled LVAD patients who had received an intramuscular injection of 20 mg of octreotide LR every 4 weeks as secondary prevention for recurrent gastrointestinal bleeding despite conventional medical therapies and repeated transfusions. The frequency of gastrointestinal bleeding and other associated clinical outcomes before and during octreotide therapy were compared. Results Thirty LVAD patients (66.4 ± 8.8 years old and 16 male [53%]) received octreotide therapy for 498.8 ± 356.0 days without any octreotide-associated adverse events. The frequency of gastrointestinal bleeding was decreased significantly during octreotide therapy (from 3.4 ± 3.1 to 0.7 ± 1.3 events/year, p <0.001), accompanied by significant reductions in red blood cell and flesh frozen plasma transfusions, days in hospital, and need for endoscopic procedures (p <0.05 for all). Conclusions Octreotide therapy reduced the frequency of recurrent gastrointestinal bleeding and may be considered for secondary prevention.

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“…Lalonde et al reported a 10% incidence of stroke at 1 year in 33 HMII patients, with the majority in INTERMACS 3-4 at the time of surgery (8). The critical condition of many of these patients is probably a significant risk factor.…”

Section: Discussionmentioning

confidence: 99%

Use of Left Ventricular Assist Device (HeartMate II): A Singapore Experience

et al. 2014

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Recent advances in medical and device therapies in heart failure have improved the survival of patients with heart failure. However, due to the limited availability of suitable heart donors, left ventricular assist devices (LVADs) have become an important tool as a bridge-to-heart transplantation for patients with refractory heart failure in Singapore. We report our experience with the HeartMate II (HMII) LVAD (Thoratec Corporation, Pleasanton, CA, USA) as a bridge-to-heart transplant in our center from 2009 to 2012. This was a retrospective review of 23 consecutive patients who underwent HMII LVAD implantation in our center between May 2009 and December 2012. All patients were classified as Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 to 3 and underwent LVAD implantation as a bridge-to-heart transplant. There were 17 male and 6 female patients. The mean age was 43.6 years old (range 14 to 64). The etiologies of heart failure included ischemic heart disease [8], idiopathic dilated cardiomyopathy [11], viral myocarditis [2], and chemotherapy-induced cardiomyopathy [2]. Nine patients were INTERMACS level 1, 12 patients level 2, and two patients level 3. All patients successfully underwent HMII LVAD implantation. There was no mortality within the first 30 postoperative days. Postoperative complications included stroke with full neurological recovery (21.7%), mediastinal infection (21.7%), cardiac tamponade or mediastinal collection requiring reopening of the chest (39.1%), cardiac arrhythmia (13.0%), and pump thrombosis with pump replacement (4.3%). All patients were discharged from hospital after LVAD implantation. Three patients experienced driveline infections during outpatient follow-up. There were 19 readmissions due to the following conditions: sub-therapeutic anticoagulation (13.0%), gastrointestinal bleeding (13.0%), suspected pump thrombosis (13.0%), transient ischemic attack (8.7%), arrhythmia (8.7%), congestive cardiac failure due to severe aortic regurgitation (8.7%), right ventricular failure (4.3%), rhabdomyolysis (4.3%), and hematuria (4.3%). Post-LVAD implantation, 20 patients were functionally New York Heart Association (NYHA) class I, while 3 reported NYHA III symptoms. Three patients were successfully bridged to heart transplantation. One patient was successfully explanted 11 months after LVAD implantation. There were two mortalities during the follow-up period. The average duration of LVAD support was 522 days (range 47 to 1316 days). The HeartMate II LVAD has proven to be effective in our Asian population. Driveline infection rate remains low even in the tropical hot, humid climate in Singapore. With more patients ending up on extended periods of LVAD support, increased emphasis in the detection and management of long-term complications of ventricular assist devices will be needed.

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Clinical Differences Between Continuous Flow Ventricular Assist Devices: A Comparison Between HeartMate II and HeartWare HVAD

Abstract: While device complications were comparable, patients with HVAD experienced a significantly higher incidence of stroke and GI bleeding and therefore refinement in patients' management may decrease incidence of these complications.

Cited by 103 publications

References 17 publications

Cardiac surgery 2014 reviewed

Cardiac surgery 2014 reviewed

Long-Acting Octreotide Reduces the Recurrence of Gastrointestinal Bleeding in Patients With a Continuous-Flow Left Ventricular Assist Device

Use of Left Ventricular Assist Device (HeartMate II): A Singapore Experience

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