Severe Hemolytic Anemia and Acute Kidney Injury After Percutaneous Continuous-Flow Ventricular Assistance

Kummerfeldt, Carlos E.; Toma, Andrew; Badheka, Apurva; Azzam, Iyad; Andrews, David; Alfonso, Carlos; Chaparro, Sandra

doi:10.1161/circheartfailure.111.964023

Cited by 8 publications

(4 citation statements)

References 4 publications

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“…Hemolysis resolved after device removal, but renal dysfunction did not improve and he required continued hemodialysis. 11 A second case described a patient who presented with ST-segment elevation myocardial infarction and acute cardiogenic shock. Oliguria with dark urine developed after Impella placement with laboratory markers of hemolysis.…”

Section: Discussionmentioning

confidence: 99%

“…1,[7][8][9] Two cases of severe hemolysis leading to acute renal failure have been reported. 10,11 Here we describe a third case of pigment-induced nephropathy resulting from an Impella CP mechanical assist device used for procedural hemodynamic support during VT ablation, which is unique as it occurred despite early withdrawal of the therapy in an effort to reduce complications.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pigment nephropathy associated with percutaneous hemodynamic support during ventricular tachycardia ablation

Payne

Hodskins

Gold

et al. 2020

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pigment nephropathy associated with percutaneous hemodynamic support during ventricular tachycardia ablation

Payne

Hodskins

Gold

et al. 2020

HeartRhythm Case Reports

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“…In contrast, Badiye et al reported a significantly higher frequency of hemolysis, which occurred in the majority of patients on Impella support (62.5% of 118 devices), with an average duration of support of 86 h [ 33 ]. Severe hemolysis resulting in acute renal failure has also been described [ 34 ]. Less common Impella-related complications include device failure due to kinking of the driveline (device failure) [ 35 ] and iatrogenic mitral regurgitation related to the positioning of the Impella in the mitral valve apparatus [ 36 , 37 ].…”

Section: Complications Of Combined Impella and Va-ecmo Supportmentioning

confidence: 99%

The Physiologic Basis and Clinical Outcomes of Combined Impella and Veno-Arterial Extracorporeal Membrane Oxygenation Support in Cardiogenic Shock

Lim

2020

Cardiol Ther

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Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides effective hemodynamic support in cardiogenic shock, but in some cases may be complicated by left ventricular (LV) distension and pulmonary edema. The Impella, a catheter-mounted microaxial pump has been used to unload the LV. Recent studies have compared the clinical outcomes of VA-ECMO to the combination of Impella and VA-ECMO. The purpose of this review is threefold: firstly, to discuss the physiological effects of Impella support in addition to VA-ECMO, secondly to review published studies on the outcome of this combined support, and thirdly to provide a practical overview of the approach to combining Impella and VA-ECMO. Electronic supplementary material The online version of this article (10.1007/s40119-020-00175-6) contains supplementary material, which is available to authorized users.

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“…Mild hemolysis is common due to mechanical cause after LVAD, with a case of severe hemolytic uremic syndrome being reported. 64 Calcification Finally, the association between CKD and calcification and CV disease has been established. It is believed that phosphate plays a direct role in promoting vascular calcification, however, there is now some evidence that the increased level of FGF23 that occurs in CKD may lead to left ventricular hypertrophy and CCF, independent of klotho.…”

Section: Left Ventricular Assist Devicementioning

confidence: 99%

Cardiorenal syndrome

Pai

2015

Hong Kong Journal of Nephrology

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Patients with cardiorenal syndrome (CRS) suffer from extremely high levels of morbidity and mortality. The pathophysiology of the CRS involves inter-related hemodynamic and neurohormonal mechanisms including the renineangiotensinealdosterone system (RAAS), endothelin, and arginineevasopressin system activation. The management of CRS remains a challenge despite extensive research into the pathophysiology, discovery of new biomarkers, and ongoing drug trials. This article reviews some of the most important trials for patients with acute decompensated heart failure and CRS using diuretics, vasodilator, levosimendan (a calcium sensitizer), vasoactive and neurohormonal therapies, and finally ultrafiltration for refractory cases. In addition, the trials of a new agent that combines angiotensin-receptor blockade with neprilysin inhibition (enhancing endogenous natriuretic peptide action), and of a new recombinant human relaxin-2 called serelaxin are discussed. For chronic CRS, the blockade of the RAAS and levosimendan given in repetitive dosing is discussed. Finally, some data on how the newer generation devices such as left ventricular assist device may improve outcome of CRS are presented; additionally, some new ideas about prevention and treatment of calcification-induced congestive cardiac failure in renal patients are presented. 心腎綜合症(CRS, cardiorenal syndrome)是嚴重的疾病，死亡率極高，其致病過程涉及一系列血行動力-神經內分泌機轉的變化，包括腎素-血管緊縮素-醛固酮系統(RAAS, renineangiotensin ealdosterone system)、內皮素(endothelin)及抗利尿素(arginineevasopressin)系統的活化。至今，即使已有大量關於病理生理學、生物標識物、及藥物治療的研究問世，然而CRS仍然是臨床上的一大挑戰。本文將針對合併有CRS的急性失代償性心衰竭 (ADHF)患者，回顧利尿劑、血管擴張劑、levosimendan (鈣增敏劑)、血管活性及神經內分泌療法的相關重要研究，更會回顧超過濾(UF, ultrafiltration)在頑抗性個案間的治療表現。此外，我們亦會探討利鈉肽(NPs, natriuretic peptides)或神經荷爾蒙藥物的潛在效用，包括一種兼具血管緊縮素受體阻斷(ARB)與neprilysin抑制作用(促進內源性NP活動)的新藥物、及一種新的重組人類relaxin-2 (稱為serelaxin)。至於慢性 CRS，我們主要著眼於RAAS阻斷劑與levosimendan的重複給藥、及腹膜透析(PD)療法。最後，我們將回顧新世代裝置例如左心室輔助裝置(LVAD)對CRS的潛在效用，更會對腎病患者間，鈣化誘發鬱血性心衰竭(CCF)的預防與治療作出探討。

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Severe Hemolytic Anemia and Acute Kidney Injury After Percutaneous Continuous-Flow Ventricular Assistance

Cited by 8 publications

References 4 publications

Pigment nephropathy associated with percutaneous hemodynamic support during ventricular tachycardia ablation

Pigment nephropathy associated with percutaneous hemodynamic support during ventricular tachycardia ablation

The Physiologic Basis and Clinical Outcomes of Combined Impella and Veno-Arterial Extracorporeal Membrane Oxygenation Support in Cardiogenic Shock

Cardiorenal syndrome

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