International Coordinator Survey Results on the Outpatient Management of Patients with the Heartware® Ventricular Assist System

Schlöglhofer, Thomas; Robson, D.; Bancroft, J.; Sørensen, Gro; Kaufmann, Friedrich; Sweet, L.; Wrightson, Neil

doi:10.5301/ijao.5000538

Cited by 17 publications

(16 citation statements)

References 18 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Currently, only 25.7% of VAD centers require their patients to measure blood pressure at home. 16 The results of this study are a step toward a system to measure blood pressure noninvasively in out-of-hospital RBP recipients even in the case of low pulsatility and/or arrhythmic events. This would have a great benefit for the monitoring and subsequently the treatment of this patient population.…”

Section: Discussionmentioning

confidence: 87%

Noninvasive assessment of blood pressure in rotary blood pump recipients using a novel ultrasonic Doppler method

et al. 2019

Self Cite

View full text Add to dashboard Cite

In rotary blood pump recipients with low blood pressure pulsatility, current oscillometric methods to measure blood pressure are not applicable. The aim of this study was to use ultrasonic Doppler flow measurements to determine blood pressure in this patient population noninvasively. In 28 rotary blood pump recipients, blood pressure was measured three times with the developed Doppler method and compared to the invasive arterial line (n = 15) or to the oscillometric Terumo Elemano BP monitor (n = 13). Blood velocities in the radial artery were recorded by the new Doppler sensor during cuff deflation. A sigmoid curve was fitted to a preprocessed velocity signal and the systolic and mean arterial pressures were determined. A total of 84 measurements were performed, and 17 recordings were visually excluded from further analysis due to obvious artifacts. Both the systolic and mean pressures derived by the Doppler method were in good accordance with the invasively measured pressure (3.7 ± 6.6 mmHg for the systolic and −2.1 ± 7.3 mmHg for the mean pressure). A good agreement between the oscillometric monitor and the Doppler method for the systolic (0.0 ± 6.0 mmHg) and mean (1.0 ± 5.9 mmHg) pressures was observed. In this study, a new Doppler blood pressure measurement system was developed and clinically validated. The novel sensor allows easier placement above the radial artery compared to commercial probes. An algorithm was developed which processes the Doppler signal robustly and is able to determine the systolic as well as the mean arterial blood pressure.

show abstract

Section: Discussionmentioning

confidence: 87%

Noninvasive assessment of blood pressure in rotary blood pump recipients using a novel ultrasonic Doppler method

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…The periodic alternation between open and closed conditions will allow gradual training of heart muscle and thus reduce the risk of aortic atrophy. In the future, this can be used to establish methods for myocardial recovery [32, 33] as there is a need for advanced control strategies and consistent outpatient management [34].…”

Section: Discussionmentioning

confidence: 99%

A Novel Control Method for Rotary Blood Pumps as Left Ventricular Assist Device Utilizing Aortic Valve State Detection

Petukhov

Korn

Walter

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

A novel control method for rotary blood pumps is proposed relying on two different objectives: regulation of pump flow in accordance with desired value and the maintenance of partial support with an open aortic valve by the variation of pump speed. The estimation of pump flow and detection of aortic valve state was performed with mathematical models describing the first- and second generation of Sputnik rotary blood pumps. The control method was validated using a cardiovascular system model. The state of the aortic valve was detected with a mean accuracy of 91% for Sputnik 1 and 96.2% for Sputnik 2 when contractility, heart rate, and systemic vascular resistance was changed. In silico results for both pumps showed that the proposed control method can achieve the desired pump flow level and maintain the open state of the aortic valve by periodically switching between two objectives under contractility, heart rate, and systemic vascular resistance changes. The proposed method showed its potential for safe operation without adverse events and for the improvement of chances for myocardial recovery.

show abstract

“…Another possible contribution to improved survival in the TI group is better adherence to institutional guidelines for anticoagulation and hypertension management: Previous studies revealed that VAD patients spent only 50–60% of their TTR and only 11.4% of patients transmit their INR readings telemetrically to the VAD center , suggesting room for improvement. In this study, patients in the TI cohort reported a mean INR of 2.4 ± 0.4 and spent 72.2% of the TTR, possibly contributing to the reduced readmission rates based on major bleeding of 20.8% (TI) versus 36.4% in the UC group.…”

Section: Discussionmentioning

confidence: 99%

A Standardized Telephone Intervention Algorithm Improves the Survival of Ventricular Assist Device Outpatients

et al. 2018

Self Cite

View full text Add to dashboard Cite

Ventricular assist devices (VADs) are an established therapeutic option for patients with chronic heart failure. Continuous monitoring of VAD parameters and their adherence to guidelines are crucial to detect problems in an early stage to optimize outcomes. A telephone intervention algorithm for VAD outpatients was developed, clinically implemented and evaluated. During the phone calls, a structured inquiry of pump parameters, alarms, blood pressure, INR, body weight and temperature, exit‐site status and heart failure symptoms was performed and electronically categorized by an algorithm into 5 levels of severity. VAD outpatient outcomes without (n = 71) and with bi‐weekly telephone interviews in their usual care (n = 25) were conducted using proportional hazard Cox regression, with risk adjustment based on a propensity score model computed from demographics and risk factors. From February 2015 through October 2017, 25 patients (n = 3 HeartMate II, n = 4 HeartMate 3 and n = 18 HeartWare HVAD) underwent 637 telephone interventions. In 57.5% of the calls no problems were identified, 3.9% were recalled on the next day because of alarms. In 26.5% (n = 169), the VAD Coordinator had to refer to the physician due to elevated blood pressure (n = 125, >85 mm Hg), INR < 2.0 or > 4.0 (n = 24) or edema (n = 10), 11.9% of the calls led to a follow‐up because of equipment or exit‐site problems. Propensity‐adjusted 2‐year survival (89% vs. 57%, P = 0.027) was significantly higher for the telephone intervention group. Continuous, standardized communication with VAD outpatients is important for early detection of upcoming problems and leads to significantly improved survival.

show abstract

International Coordinator Survey Results on the Outpatient Management of Patients with the Heartware® Ventricular Assist System

Abstract: This survey showed specific differences in outpatient management strategies that were previously unreported. However, further studies with correlations to patient outcomes are necessary to determine optimal patient management recommendations.

Cited by 17 publications

References 18 publications

Noninvasive assessment of blood pressure in rotary blood pump recipients using a novel ultrasonic Doppler method

Noninvasive assessment of blood pressure in rotary blood pump recipients using a novel ultrasonic Doppler method

A Novel Control Method for Rotary Blood Pumps as Left Ventricular Assist Device Utilizing Aortic Valve State Detection

A Standardized Telephone Intervention Algorithm Improves the Survival of Ventricular Assist Device Outpatients

Contact Info

Product

Resources

About