Chronic extra-aortic balloon counterpulsation: First-in-human pilot study in end-stage heart failure

Hayward, Christopher; Peters, Wolfgang; Merry, Alan; Ruygrok, Peter; Jansz, P.; O’Driscoll, Gerry; Larbalestier, Robert; Smith, Julian Anderson; Ho, Betty; Legget, Malcolm E.; Milsom, F. Paget

doi:10.1016/j.healun.2010.06.014

Cited by 33 publications

(23 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The implantation is achieved via midline sternotomy, without cardiopulmonary bypass. There is no any deterioration in the aortic valve and aortic regurgitation, no intimal disruption and only minor thickening of the adventitia on microscopy [61].…”

Section: Extraaortic Counterpulsatile Support (Eacps)mentioning

confidence: 86%

Invasive Treatment in Advanced (Stage-D) Heart Failure

Kırali¹,

Yerlikhan²,

Hançer³

2017

Cardiomyopathies - Types and Treatments

View full text Add to dashboard Cite

Heart failure is a complex, true pandemic clinical syndrome and is responsible for 5% of hospitalizations globally. Severe heart failure can manifest as two lethal clinical entities: (1) acute cardiac decompensation with cardiogenic shock after large acute myocardial infarction with mortality rates approaching 50% or after cardiac surgery with mortality rates higher than 65% and (2) chronic destructive cardiac remodeling or acute decompensative exacerbations of cardiomyopathies with one-year mortality of approximately 80% (worse than most types of cancer). Interventional therapies aim first to improve symptoms and life expectancy in patients with severe heart failure syndrome, second to prevent left ventricular remodeling, and third to bridge patients to long-term mechanical circulatory support or transplantation. Several treatment options can be used to stabilize patients. In particular, new percutaneous mitral valve interventions and short-term circulatory support devices open up a new temporary treatment area in symptomatic Stage-D heart failure. The durable or curable surgical destination treatment will be only permanent ventricular assist devices or heart transplantation. This chapter focuses on the treatment steps and new approaches in hospitalized Stage-D heart failure patients.Keywords: heart failure, heart transplantation, ventricular assist device, ECMO, ECLS At end-stage, any type of cardiomyopathy (CMP) causes a complex clinical heart failure (HF) syndrome, which results from structural and/or functional impairment of ventricular filling or ejection. This dire clinical situation can cause an adverse vicious cycle that is ultimately fatal if not treated by pharmacological or invasive mechanical support or heart transplantation (HTx). Left ventricular functional abnormalities range from normal-sized left ventricle (LV) with preserved left ventricular ejection fraction (LVEF) to severe left ventricular dilatation (LVD) with markedly reduced LVEF. Reduced LVEF is defined as the clinical diagnosis of HF and LVEF ≤40%, which means a clinic and functional association of systolic and/or diastolic LVD.© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Abnormal systolic and/or diastolic functions impair left ventricular contractile and relaxation functions that result in increasing left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV), as well as left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD), with the alteration of the left ventricular shape from conical form to spherical form. Adverse elevation of preload and afterload results in increasing left ventricular end-diastolic pressure (LVEDP) and left ventricular end-systolic pressure (LVESP). Inadequate unloading is the pr...

show abstract

Section: Extraaortic Counterpulsatile Support (Eacps)mentioning

confidence: 86%

Invasive Treatment in Advanced (Stage-D) Heart Failure

Kırali¹,

Yerlikhan²,

Hançer³

2017

Cardiomyopathies - Types and Treatments

View full text Add to dashboard Cite

show abstract

“…Device-based approaches for the treatment of HF or its comorbidities currently under investigation include cardiac contractility modulation (CCM), 168,169 percutaneous ventricular partitioning, 170 transvenous phrenic nerve stimulation for central sleep apnoea in HF, 171 chronic extra-aortic counterpulsation, 172 and a variety of noninvasive and implantable telemonitoring devices. 173 Some of these devices will be briefly described, but detailed discussion is beyond the scope of this Review.…”

Section: Future Directionsmentioning

confidence: 99%

Devices in the management of advanced, chronic heart failure

Abraham

Smith

2012

Nat Rev Cardiol

View full text Add to dashboard Cite

Heart failure (HF) is a global phenomenon, and the overall incidence and prevalence of the condition are steadily increasing. Medical therapies have proven efficacious, but only a small number of pharmacological options are in development. When patients cease to respond adequately to optimal medical therapy, cardiac resynchronization therapy has been shown to improve symptoms, reduce hospitalizations, promote reverse remodelling, and decrease mortality. However, challenges remain in identifying the ideal recipients for this therapy. The field of mechanical circulatory support has seen immense growth since the early 2000s, and left ventricular assist devices (LVADs) have transitioned over the past decade from large, pulsatile devices to smaller, more-compact, continuous-flow devices. Infections and haematological issues are still important areas that need to be addressed. Whereas LVADs were once approved only for ‘bridge to transplantation’, these devices are now used as destination therapy for critically ill patients with HF, allowing these individuals to return to the community. A host of novel strategies, including cardiac contractility modulation, implantable haemodynamic-monitoring devices, and phrenic and vagus nerve stimulation, are under investigation and might have an impact on the future care of patients with chronic HF.

show abstract

“…It has been speculated that partial unloading of the failing left ventricle will interrupt the progressive hemodynamic deterioration observed in heart failure 7 as well as increase functional capacity, improve quality of life, and promote myocardial recovery. Although there is limited data to support this hypothesis, initial clinical results with partial-support devices are encouraging 7,17,19,20 .…”

Section: Introductionmentioning

confidence: 99%

The Future of Adult Cardiac Assist Devices: Novel Systems and Mechanical Circulatory Support Strategies

Bartoli

Dowling

2011

Cardiology Clinics

View full text Add to dashboard Cite

Synopsis The recent, widespread success of mechanical circulatory support has ushered in a new era of cardiovascular medicine in which numerous implantable devices exist to treat advanced heart failure. As cardiac assist devices gain prevalence in the clinical management of cardiovascular disease, it is increasingly important to raise awareness of novel device systems, the unique mechanisms by which they function, and implications for patient management. In this article, we present state-of-the-art devices that are currently under development or in clinical trials. Devices are categorized as Standard Full-Support (HeartMate III, CorAide, Evaheart LVAS), Less-Invasive Full-Support (MVAD), Partial-Support (CircuLite Synergy Pocket Micro-Pump, Reitan Catheter Pump, Procyrion CAD, C-Pulse, Symphony Counterpulsation Device) Right Ventricular Assist Device (RVAD; DexAide, Impella RD Recover, Impella RP), and Total Artificial Heart (TAH; CardioWest, AbioCor II, Continuous-Flow TAH, Continuous-Flow BiVAD). Implantation strategy, mechanism of action, durability, efficacy, hemocompatibility, and human factors such as quality of life during device support are considered. The feasibility of novel strategies for unloading the failing heart is examined.

show abstract

Chronic extra-aortic balloon counterpulsation: First-in-human pilot study in end-stage heart failure

Cited by 33 publications

References 10 publications

Invasive Treatment in Advanced (Stage-D) Heart Failure

Invasive Treatment in Advanced (Stage-D) Heart Failure

Devices in the management of advanced, chronic heart failure

The Future of Adult Cardiac Assist Devices: Novel Systems and Mechanical Circulatory Support Strategies

Contact Info

Product

Resources

About