Patients with ventricular assist device and cerebral entrapment—Supporting skullcap reimplantation

Abstract

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

GMP-Compliant Radiosynthesis of [18F]GP1, a Novel PET Tracer for the Detection of Thrombi

“…Mechanical circulatory support (MCS) with left ventricular assist devices (LVAD) is a safe and efficacious treatment strategy for patients with end-stage heart failure (HF) that is refractory to medical therapy [ 18 , 19 ]. Unimproved, hemostatic complications are frequently observed and dreaded complications in patients with LVADs [ 20 , 21 ]. Despite ongoing efforts to engineer the LVAD surface less thrombogenic as well as the use of aggressive anticoagulation regimens, thrombotic complications continue to affect long-term outcomes post-implant with rates of 7% to 16% per year.…”

“…Despite ongoing efforts to engineer the LVAD surface less thrombogenic as well as the use of aggressive anticoagulation regimens, thrombotic complications continue to affect long-term outcomes post-implant with rates of 7% to 16% per year. Strokes, another debilitating complication post LVAD implantation, are a consequence of thrombus formation and embolic events, occur with an incidence ranging from 7% to 10% per year according to meta-analyses [ 21 ]. Studies consistently show that about 50% of strokes in this setting are embolic, and 50% are hemorrhagic.…”

Addition of levosimendan to overcome acute cardiogenic shock—Paving the way for later heart transplantation—A first case report

“…However, the addition of levosimendan to other ICU‐based therapies was associated with resolution of cardiogenic shock. Although hemodynamic stability might have been achieved using MCS, this invasive approach also carries significant risk (including bleeding, infection and thromboembolic complications), 6‐8 which were particularly relevant in our patient who had been listed for heart transplantation. Use of MCS might compromise the ability to perform heart transplant surgery, and it may not be possible to continue MCS for the length of time it takes to wait until a heart becomes available for transplantation 6,9 …”

Synergistic effects of levosimendan and convalescence plasma as bailout strategy in acute cardiogenic shock in COVID-19: A case report

“…We describe a novel treatment strategy for a complex clinicaly new disease pattern, with no verified therapy scheme known so far. During this life-threatening condition additional use of levosimendan resulted in potential synergistic effects resulting in hemodynamic stabilization and our strategy overcame CS not requiring invasive mechanical circulatory support (MCS), as MCS invasiveness in an 84-year-old carries notable risks such as bleeding, infection or thromboembolic complications [4,6]. Moreover, levosimendan is currently the subject of intense discussion too, as this novel drug promises positive inotropic effects, but large clinical trials failed to confirm these effects [7].…”

“…It has capabilities to prevent severe COVID-19 outbreak [3], but in COVID-19 associated CS many physicians are left blanked-faced because of widely lacking evidence. Utilization of catecholamines in CS is accompanied by side effects and the use of mechanical circulatory support in CS is associated with risk of infection, bleeding, vessel or nerve injury [4]. Therefore, substitute and new therapeutic options are warranted, especially to manage hypoperfusion and concomitant organ failure [5].…”