100 long-term implantable left ventricular assist devices: the Columbia Presbyterian interim experience

Sun, Benjamin; Catanese, Katharine A.; Spanier, Talia B.; Flannery, M.; Gardocki, Michael; Marcus, Lee S.; Levin, Howard R.; Rose, Eric A.; Öz, Mehmet C.

doi:10.1016/s0003-4975(99)00539-1

Cited by 115 publications

(49 citation statements)

References 19 publications

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“…All of the current commercially available VADs require either anti-platelet (Heartmate) or anti-coagulant (Abiomed; Thoratec) therapy to prevent thrombus formation within the device components. Despite this, the incidence of thrombo-embolic events is approximately 6% in a series of 100 LVAD recipients at Columbia Presbyterian Medical Center (Sun et al, 1999), the single institution with the largest VAD experience. Furthermore, as a consequence of both iatrogenic over-anti-coagulation/ anti-platelet therapy and the implantation operation itself, there is a substantial early and late risk of bleeding complications (Graham, 2001).…”

Section: Ventricular Thrombosismentioning

confidence: 99%

A Model Incorporating Some of the Mechanical and Biochemical Factors Underlying Clot Formation and Dissolution in Flowing Blood

Mohan

Rajagopal

2003

Computational and Mathematical Methods in Medicine

140

121

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Multiple interacting mechanisms control the formation and dissolution of clots to maintain blood in a state of delicate balance. In addition to a myriad of biochemical reactions, rheological factors also play a crucial role in modulating the response of blood to external stimuli. To date, a comprehensive model for clot formation and dissolution, that takes into account the biochemical, medical and rheological factors, has not been put into place, the existing models emphasizing either one or the other of the factors. In this paper, after discussing the various biochemical, physiologic and rheological factors at some length, we develop a model for clot formation and dissolution that incorporates many of the relevant crucial factors that have a bearing on the problem. The model, though just a first step towards understanding a complex phenomenon, goes further than previous models in integrating the biochemical, physiologic and rheological factors that come into play.

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Section: Ventricular Thrombosismentioning

confidence: 99%

A Model Incorporating Some of the Mechanical and Biochemical Factors Underlying Clot Formation and Dissolution in Flowing Blood

Mohan

Rajagopal

2003

Computational and Mathematical Methods in Medicine

140

121

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“…The decision about possibility of successful weaning depends on integration of clinical, hemodynamic and echocardiographic factors [42,43] as documented by several studies reporting recovery and weaning protocols based on cardiopulmonary testing, hemodynamic and echocardiographic variables [44].…”

Section: Recovery and Weaningmentioning

confidence: 99%

Echocardiography and Hemodynamic Monitoring Tools for Clinical Assessment of Patients on Mechanical Circulatory Support

Scolletta¹,

Biagioli²,

Franchi³

et al. 2013

Recent Advances in the Field of Ventricular Assist Devices

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“…Ocurren entre 6% y 47% de los pacientes siendo en muchas ocasiones asintomáti-cas 3,4,[30][31][32] . Son más frecuentes en pacientes con falla multisistémica, cuando el flujo no es adecuado o si la anticoagulación es insuficiente.…”

Section: Emboliasunclassified

Estado actual de los sistemas de soporte circulatorio mecánico: State of the art

2006

Rev. méd. Chile

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Circulatory mechanical support. State of the artDespite advances in medical treatment, the prognosis of advanced heart failure remains poor. The number of hospitalizations for heart failure exacerbations continues to increase and most patients will ultimately die of complications related to heart failure. Implantable left ventricular assist devices (LVAD) are currently in use throughout the world with increasing frequency. This paper is a comprehensive review about mechanical support, focusing on a general description of the differents LVAD, complications and mortality (Rev Méd Chile 2006; 134: 1330-37 a insuficiencia cardíaca (IC) es una de las principales causas de mortalidad y hospitalización, se estima que su prevalencia se incrementará con el envejecimiento de la población. Pese al avance en la terapia farmacológica, el trasplante es una alternativa probada, pero restringida por la disponibilidad de donantes, observándose una elevada mortalidad en lista de espera de alrededor de 16% al año 1 . A lo anterior se suma el que en casos de IC aguda, muchas veces no se logra el trasplante dado lo crítico de la situación o a contraindicaciones. Es por estos motivos que los sistemas de soporte circulatorio mecánico (SSCM) han crecido en importancia, primordialmente como puente al trasplante, para lograr recuperación de una IC aguda, y en forma preliminar como terapia definitiva. Nuestro centro inició, a mediados de 2003, un programa de soporte circulatorio de corto plazo (ABIOMED BVS 5000). Este sistema ha sido utilizado en 4 pacientes, logrando el trasplante en tres de ellos. Esta experiencia inicial nos motivó a revisar el estado actual de los SSCM. CRITERIOS DE SELECCIÓN DE PACIENTESPARA ASISTENCIA VENTRICULAR Estos dispositivos son utilizados en pacientes con IC grave refractaria a terapia habitual y que no han tenido respuesta al uso del balón de contrapulsación (BCIA) y drogas vasoactivas (DVA). En general, se utilizan criterios similares a los usados para el ingreso a lista de trasplante cardíaco de urgencia. La presencia de disfunción hepática o renal, determinada por la IC y que potencialmente es reversible, no contraindica su uso. Del punto de vista hemodinámico, se utilizan valores referenciales para plantear el uso de SSCM como un índice cardíaco de 2 L/min/m 2 , presión arterial sistólica <90 mmHg y con capilares pulmonares mayores de 20 mmHg. INDICACIONES DEL USO DE SOPORTE VENTRICULAR1. Shock cardiogénico postcardiotomía: La necesidad de soporte circulatorio postcirugía cardíaca es relativamente baja (0,2 a 1%) 2 . Es más frecuente en cirugías de revascularización coronaria con disfunción ventricular significativa. El objetivo es

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100 long-term implantable left ventricular assist devices: the Columbia Presbyterian interim experience

Cited by 115 publications

References 19 publications

A Model Incorporating Some of the Mechanical and Biochemical Factors Underlying Clot Formation and Dissolution in Flowing Blood

A Model Incorporating Some of the Mechanical and Biochemical Factors Underlying Clot Formation and Dissolution in Flowing Blood

Echocardiography and Hemodynamic Monitoring Tools for Clinical Assessment of Patients on Mechanical Circulatory Support

Estado actual de los sistemas de soporte circulatorio mecánico: State of the art

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