CardioWest Total Artificial Heart in a Moribund Adolescent With Left Ventricular Thrombi

Smith, Margaret Cammack; Arabía, Francisco A.; Tsau, Pei H.; Smith, Richard G.; Bose, Raj; Woolley, Daniel S.; Rhenman, Birger; Sethi, Gulshan K.; Copeland, Jack G.

doi:10.1016/j.athoracsur.2004.04.094

Cited by 18 publications

(8 citation statements)

References 8 publications

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“…Our results may lead to the notion that early detection and treatment of pump thrombus might not result in a better outcome. The causes of thromboembolism in LVAS patients seem to be multifactorial and are usually attributable to: (i) a low flow state or an area of flow stagnation within the device; (ii) thrombogenic surface; (iii) hypercoagulable state; (iv) ineffective anticoagulation therapy; or (v) thrombus within the ventricular cavity , and thus, pump replacement alone does not seem to be appropriate treatment to resolve all these problems.…”

Section: Discussionmentioning

confidence: 99%

Impact of Pump Replacement on Outcome in Advanced Heart Failure Patients With Left Ventricular Assist System

et al. 2013

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Pump thrombosis is one of the major adverse events associated with the use of a left ventricular assist system (LVAS) in patients with advanced heart failure. We investigated the clinical implication of pump replacement because of thrombus formation. This study included 87 patients who underwent implantation of a Nipro (Toyobo) pulsatile extracorporeal LVAS intended as a bridge to transplantation and were alive more than 3 months after implantation. The pump of this device is translucent, and daily evaluation for signs of thrombus formation was performed. Pump replacement was performed for significant thrombus formation that became visible. Data collection including demographics as well as hematologic values were performed 1 day before (baseline) and 3 months after implantation, and all patients were followed for 2 years or until death. At 3 months after LVAS implantation, 41 patients (47.1%) had undergone pump replacement because of pump thrombus. Baseline body surface area <1.63 m(2) was a significant predictor of pump replacement (hazard ratio [HR] 2.15, P = 0.04). At 3 months after implantation, there was a significantly higher incidence of stroke (P < 0.05) as well as a significantly greater decrease in body weight (F = 4.92, P = 0.03) in patients who underwent pump replacement as compared to those without. The 2-year mortality after implantation was 26.4%. Multivariate Cox regression analysis showed that pump replacement within 3 months after implantation was an independent predictor of mortality (HR 2.50, P = 0.03). In conclusion, pump replacement for thrombus formation may have a strong association with worse outcome. Our results reconfirm the clinical importance of device thrombus in the management of LVAS.

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Section: Discussionmentioning

confidence: 99%

Impact of Pump Replacement on Outcome in Advanced Heart Failure Patients With Left Ventricular Assist System

et al. 2013

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“…Indications include: patients with heart failure and left ventricular thrombus [33], biventricular heart failure [34,35], allograft failure following heart transplantation [36 • ], congenitally corrected transposition with failing systemic ventricle [37], restrictive disease, and end-stage failing Fontan [38]. Use of the device has been limited in children due to the large footprint of the 70 cc device.…”

Section: Pulsatile Devicesmentioning

confidence: 99%

Children Are Not Small Adults: Options for Pediatric Ventricular Assist Devices

2015

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The number of children supported with ventricular assist devices (VADs) has grown rapidly over the last few years. VAD use in children holds the promise of improving the outcomes in pediatric end-stage heart failure; however, the risk-benefit profile inherent to VAD use is not uniform across all ages, sizes, and diagnoses. Device use in children has underscored a number of issues that distinguish pediatric and adult heart failure such as the high prevalence of complex congenital heart disease and the challenges inherent to supporting infants and small children. The use of VADs in children also raises a range of social, emotional, and logistic changes unique to children across the age spectrum.

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“…The Cardiowest TAH (28,29) was first implanted by Dr. DeVries in 1982. The patient, Barney Clark, survived for 112 days (30).…”

Section: Total Artificial Hearts (Tah)mentioning

confidence: 99%

Ventricular Assist Devices and Total Artificial Hearts

Blitz

Fang

2009

Device Therapy in Heart Failure

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CardioWest Total Artificial Heart in a Moribund Adolescent With Left Ventricular Thrombi

Cited by 18 publications

References 8 publications

Impact of Pump Replacement on Outcome in Advanced Heart Failure Patients With Left Ventricular Assist System

Impact of Pump Replacement on Outcome in Advanced Heart Failure Patients With Left Ventricular Assist System

Children Are Not Small Adults: Options for Pediatric Ventricular Assist Devices

Ventricular Assist Devices and Total Artificial Hearts

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