In STEMI patients, IT was a better predictor than D2B time for 30-day mortality and infarct size. Our findings suggest that the focus of STEMI care should be directed at early initiation of therapy and minimizing IT rather than on D2B time alone. The potential impact of IT reporting in current STEMI registries merits further consideration. © 2015 Wiley Periodicals, Inc.

No abstract

This paper describes the stroke volume selection and operational design for the TORVAD™, a synchronous, positive-displacement ventricular assist device (VAD). A lumped parameter model was used to simulate hemodynamics with the TORVAD™ compared to those under continuous flow VAD support. Results from the simulation demonstrated that a TORVAD™ with a 30 mL stroke volume ejecting with an early diastolic counterpulse provides comparable systemic support to the HeartMate II® (HMII) (cardiac output 5.7 L/min up from 3.1 L/min in simulated heart failure). By taking advantage of synchronous pulsatility, the TORVAD™ delivers full hemodynamic support with nearly half the VAD flow rate (2.7 L/min compared to 5.3 L/min for the HMII) by allowing the left ventricle to eject during systole, thus preserving native aortic valve flow (3.0 L/min compared to 0.4 L/min for the HMII, down from 3.1 L/min at baseline). The TORVAD™ also preserves pulse pressure (26.7 mmHg compared to 12.8 mmHg for the HMII, down from 29.1 mmHg at baseline). Preservation of aortic valve flow with synchronous pulsatile support could reduce the high incidence of aortic insufficiency and valve cusp fusion reported in patients supported with continuous flow VADs.