Multicenter clinical evaluation of the heartmate; vented electric left ventricular assist system in patients awaiting heart transplantation

Frazier, O.H.; Rose, Eric A.; Öz, Mehmet C.; Dembitsky, Walter P.; McCarthy, Patrick M.; Radovancevic, B.; Poirier, Victor L.; Dasse, Kurt A.

doi:10.1016/s1053-2498(00)00429-0

Cited by 130 publications

(170 citation statements)

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“…1,2 The use of LVADs, either as bridge to transplantation or as destination therapy, has resulted in marked improvement of morbidity and mortality in these patients. [3][4][5][6][7][8] Better outcomes observed over the past decade can be attributed to greater experience of LVAD teams in the management of these devices, as well as to the introduction of newer second and third generation continuous-flow LVADs (CF-LVADs), which are smaller, more reliable, and durable. [9][10][11][12][13] relationship between pulsatility and the risk of gastrointestinal (GI) bleeding from arteriovenous malformations (AVMs).…”

mentioning

confidence: 99%

Pulsatility and the Risk of Nonsurgical Bleeding in Patients Supported With the Continuous-Flow Left Ventricular Assist Device HeartMate II

Wever-Pinzon

Selzman

Drakos

et al. 2013

Circ: Heart Failure

214

111

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Background— Bleeding is an important cause of morbidity and mortality in patients with continuous-flow left ventricular assist devices (LVADs). Reduced pulsatility has been implicated as a contributing cause. The aim of this study was to assess the effects of different degrees of pulsatility on the incidence of nonsurgical bleeding. Methods and Results— The Utah Transplantation Affiliated Hospitals (U.T.A.H.) heart failure and transplant program databases were queried for patients with end-stage heart failure who required support with the continuous-flow LVAD HeartMate II (Thoratec Corp, Pleasanton, CA) between 2004 and 2012. Pulsatility was evaluated by means of the LVAD parameter pulsatility index (PI) and by the echocardiographic assessment of aortic valve opening during the first 3 months of LVAD support. PI was analyzed as a continuous variable and also stratified according to tertiles of all the PI measurements during the study period (low PI: <4.6, intermediate PI: 4.6–5.2, and high PI: >5.2). Major nonsurgical bleeding associated with a decrease in hemoglobin ≥2 g/dL (in the absence of hemolysis) was the primary end point. A total of 134 patients (median age of 60 [interquartile range: 49–68] years, 78% men) were included. Major bleeding occurred in 33 (25%) patients (70% gastrointestinal, 21% epistaxis, 3% genitourinary, and 6% intracranial). In multivariable analysis, PI examined either as a categorical variable, low versus high PI (hazard ratio, 4.06; 95% confidence interval, 1.35–12.21; P =0.04), or as a continuous variable (hazard ratio, 0.60; 95% confidence interval, 0.40–0.92; P =0.02) was associated with an increased risk of bleeding. Conclusions— Reduced pulsatility in patients supported with the continuous-flow LVAD HeartMate II is associated with an increased risk of nonsurgical bleeding, as evaluated by PI.

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mentioning

confidence: 99%

Pulsatility and the Risk of Nonsurgical Bleeding in Patients Supported With the Continuous-Flow Left Ventricular Assist Device HeartMate II

Wever-Pinzon

Selzman

Drakos

et al. 2013

Circ: Heart Failure

214

111

View full text Add to dashboard Cite

show abstract

“…Using the UNOS regions the following 4 geographic regions were defined; Northeast (UNOS regions 1,2,9,11), Midwest (10,7,8), South (regions 3,4) and West (regions 5,6). The rationale for choosing a UNOS based distribution was that it would allow us to align with the UNOS data.…”

Section: Definitions Of Variables and Outcomesmentioning

confidence: 99%

Regional Differences in Utilization and Outcomes of Left Ventricular Assist Devices: Insights from the INTERMACS Registry

Krim

Vivo

Campbell

et al. 2014

The Journal of Heart and Lung Transplantation

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“…However, in the majority of studies, the maximal support duration does not exceed 6 months, and in most studies mean support duration ranges only from 50 to 60 days. [17][18][19] Results in experienced high volume centers (>10 implants per year) tend to be better than in low-volume centers. Survival and quality of life has been closely related to adverse events such as bleeding, infections, thrombo-embolic events and technical failures.…”

Section: Outcomes Of First-generation Devicesmentioning

confidence: 99%

“…The ability of LVADs to support an acutely failing heart while it recovers function is well documented. 16,17,33 There are observations regarding the potential for myocardial recovery even in patients with chronic heart failure. Various studies have documented that the unloaded left ventricle undergoes a process of reverse remodeling, as categorized by multiple different indices e.g.…”

Section: Bridge To Recoverymentioning

confidence: 99%

Ventricular Assist Device: Emerging Modality for Long Term Cardiac Support

Shah¹,

Kommu²,

Bhuriya³

et al. 2011

New Aspects of Ventricular Assist Devices

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Multicenter clinical evaluation of the heartmate; vented electric left ventricular assist system in patients awaiting heart transplantation

Cited by 130 publications

References 0 publications

Pulsatility and the Risk of Nonsurgical Bleeding in Patients Supported With the Continuous-Flow Left Ventricular Assist Device HeartMate II

Pulsatility and the Risk of Nonsurgical Bleeding in Patients Supported With the Continuous-Flow Left Ventricular Assist Device HeartMate II

Regional Differences in Utilization and Outcomes of Left Ventricular Assist Devices: Insights from the INTERMACS Registry

Ventricular Assist Device: Emerging Modality for Long Term Cardiac Support

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