Implantation of the HeartMate II and HeartWare Left Ventricular Assist Devices in Patients With Duchenne Muscular Dystrophy

Ryan, Thomas; Jefferies, John L.; Sawnani, Hemant; Wong, Brenda; Gardner, Aimee; Corral, Megan del; Lorts, Angela; Morales, David L.S.

doi:10.1097/mat.0000000000000050

Cited by 64 publications

(35 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[334][335][336][337][338][339] These reports acknowledge that perioperative risk is likely to be higher than in the general population because of concomitant skeletal muscle weakness or restrictive lung disease. [334][335][336][337][338][339] Before durable MCS placement, careful consideration must also be given to how atypical thoracic anatomy attributable to kyphoscoliosis in some NMDs might impact device selection and positioning, as well as the potential need for invasive pulmonary support with tracheostomy and reliable delivery of nutrition via permanent gastrostomy tube after durable MCS placement. Finally, the significant burden that outpatient MCS places on caregivers should be contemplated before placement.…”

Section: End-stage Hfmentioning

confidence: 96%

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Feingold¹,

Mahle²,

Auerbach³

et al. 2017

Circulation

Self Cite

211

195

View full text Add to dashboard Cite

For many neuromuscular diseases (NMDs), cardiac disease represents a major cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic. In this statement, we provide background on several NMDs in which there is cardiac involvement, highlighting unique features of NMD-associated myocardial disease that require clinicians to tailor their approach to prevention and treatment of heart failure. Undoubtedly, further investigations are required to best inform future guidelines on NMD-specific cardiovascular health risks, treatments, and outcomes. N euromuscular diseases (NMDs) encompass a broad spectrum of diagnoses with overlapping but distinct phenotypes. Common to many NMDs is cardiac involvement. Although the past 3 decades have seen marked advances in our understanding of many NMDs, significant gaps in knowledge remain on how best to approach cardiac care in these patients. For example, survival in Duchenne muscular dystrophy (DMD) has been extended through the use of glucocorticoid use and respiratory support, yet cardiac complications remain a significant cause of morbidity and mortality.1-3 To achieve further gains in care, we will need to improve our understanding of the pathophysiologies driving cardiac involvement in NMDs and advance treatments aimed at preventing the progression of heart failure (HF) and sudden death in NMDs. The recently published findings of an expert working group on cardiac involvement in DMD, which outlined key gaps in knowledge and made specific recommendations aimed at improving diagnosis and management, are a step toward this goal. 4 In this statement, we include a comprehensive overview of the major categories of NMDs with cardiac involvement. For each, a brief background of the gene defect(s), common clinical manifestations (particularly cardiac findings), and current therapies is summarized. Gaps in knowledge are highlighted, and where possible, clinical treatment suggestions are made by the expert writing group appointed by the American Heart Association to review the available literature. Selection of the writing group was performed in accordance with the American Heart Association's conflict-of-interest management policy. Participants volunteered to write sections relevant to their expertise and experience. CLINICAL STATEMENTS AND GUIDELINESconducted a general search of the literature, restricted to human subjects research published between 1980 and 2016. Drafts of each section were written and sent to the chair of the writing group for incorporation into a single document, which was then edited. The edited document was discussed electron...

show abstract

Section: End-stage Hfmentioning

confidence: 96%

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Feingold¹,

Mahle²,

Auerbach³

et al. 2017

Circulation

Self Cite

211

195

View full text Add to dashboard Cite

show abstract

“…A left ventricular assist device could be used as a destination therapy—ie, in individuals for whom a heart transplant is not considered appropriate. 59-61 The decision to proceed with a ventricular assist device is complex and involves a deep understanding of all the inherent risks and potential benefits. Risks include, but are not limited to, thromboembolism, bleeding, infection, device malfunction, and right heart failure.…”

Section: Cardiac Managementmentioning

confidence: 99%

Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management

Birnkrant

Bushby

Bann

et al. 2018

The Lancet Neurology

752

886

View full text Add to dashboard Cite

A coordinated, multidisciplinary approach to care is essential for optimum management of the primary manifestations and secondary complications of Duchenne muscular dystrophy (DMD). Contemporary care has been shaped by the availability of more sensitive diagnostic techniques and the earlier use of therapeutic interventions, which have the potential to improve patients’ duration and quality of life. In part 2 of this update of the DMD care considerations, we present the latest recommendations for respiratory, cardiac, bone health and osteoporosis, and orthopaedic and surgical management for boys and men with DMD. Additionally, we provide guidance on cardiac management for female carriers of a disease-causing mutation. The new care considerations acknowledge the effects of long-term glucocorticoid use on the natural history of DMD, and the need for care guidance across the lifespan as patients live longer. The management of DMD looks set to change substantially as new genetic and molecular therapies become available.

show abstract

“…3 Implantation of CF-LVADs is described with increasing frequency in both adolescents and those with muscular dystrophy, either as a bridge to transplant or DT. [4][5][6] For these patients, preservation of physical function is essential for their quality and longevity of life. As with other CF-LVAD recipients, significant weight loss may be difficult to achieve, despite a presumed improvement in heart failure symptoms.…”

Section: Discussionmentioning

confidence: 99%

Obesity and Premature Loss of Mobility in Two Adolescents with Becker Muscular Dystrophy After HeartMate II Implantation

et al. 2016

View full text Add to dashboard Cite

Weight gain is common after implantation of continuous-flow ventricular assist devices. Obesity can have a significant negative impact on mobility. For adolescents with Becker muscular dystrophy (BMD), for whom the ability to ambulate often persists into the mid-3rd decade, preservation of functional ability is critical. We report two cases of Thoratec HeartMate II left ventricular assist device (LVAD) implantation in adolescents with BMD for whom postoperative weight gain contributed significantly to an accelerated loss of ambulation and, in one case, driveline fracture in the context of repeated falls. As LVADs become an increasingly common therapy for endstage heart failure in adolescents with BMD, care must be focused not only on maintenance of device functionality, but also on management of aggressive weight, and preservation of ambulation, and skeletal muscle strength.

show abstract

Implantation of the HeartMate II and HeartWare Left Ventricular Assist Devices in Patients With Duchenne Muscular Dystrophy

Cited by 64 publications

References 4 publications

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management

Obesity and Premature Loss of Mobility in Two Adolescents with Becker Muscular Dystrophy After HeartMate II Implantation

Contact Info

Product

Resources

About