Persistent Anemia After Implantation of the Total Artificial Heart

Mankad, Anit K.; Tang, Daniel; Clark, William; Flattery, Maureen; Harton, Suzanne; Katlaps, Gundars; Stribling, W. Kyle; Cooke, Richard H.; Heß, Michael; Kasirajan, Vigneshwar; Shah, Keyur B.

doi:10.1016/j.cardfail.2012.03.003

Cited by 25 publications

(13 citation statements)

References 13 publications

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“…Transcripts related to Heme Biosynthesis, including alpha hemoglobin stabilizing protein (AHSP) were also increased at 7 days. This was intriguing given that the majority of published work shows an association of anemia with implantation of a LVAD[23,24] (Table S2 in File S1, Table S5 in File S1). …”

Section: Resultsmentioning

confidence: 99%

Identification of Differentially Expressed Transcripts and Pathways in Blood One Week and Six Months Following Implant of Left Ventricular Assist Devices

et al. 2013

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IntroductionContinuous-flow left ventricular assist devices (LVADs) are an established therapy for patients with end-stage heart failure. The short- and long-term impact of these devices on peripheral blood gene expression has not been characterized, and may provide insight into the molecular pathways mediated in response to left ventricular remodeling and an improvement in overall systemic circulation. We performed RNA sequencing to identify genes and pathways influenced by these devices.MethodsRNA was extracted from blood of 9 heart failure patients (8 male) prior to LVAD implantation, and at 7 and 180 days postoperatively. Libraries were sequenced on an Illumina HiSeq2000 and sequences mapped to the human Ensembl GRCh37.67 genome assembly.ResultsA specific set of genes involved in regulating cellular immune response, antigen presentation, and T cell activation and survival were down-regulated 7 days after LVAD placement. 6 months following LVAD placement, the expression levels of these genes were significantly increased; yet importantly, remained significantly lower than age and sex-matched samples from healthy controls.ConclusionsIn summary, this genomic analysis identified a significant decrease in the expression of genes that promote a healthy immune response in patients with heart failure that was partially restored 6 months following LVAD implant.

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Section: Resultsmentioning

confidence: 99%

Identification of Differentially Expressed Transcripts and Pathways in Blood One Week and Six Months Following Implant of Left Ventricular Assist Devices

et al. 2013

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“…The two main choices are the total artificial heart (TAH) and the left ventricular assist device (LVAD), each of which has its own set of complications and limitations. For example, use of a TAH for support in biventricular heart failure has been associated with bleeding, neurologic events, infections, persistent anemia and other complications (11,40). Furthermore, because of the large size of TAHs, implantation of this device is restricted primarily to men.…”

Section: Whole Heart Replacementmentioning

confidence: 99%

Building New Hearts: A Review of Trends in Cardiac Tissue Engineering

Taylor¹,

Sampaio²,

Gobin³

2014

American Journal of Transplantation

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“…Aspirin, usually at 81 mg/day and titrated up to 325 mg/day, may be started when chest tube output is less than 30 mL/h for 4 hours. 106 TAH patients also exhibit abnormal hematopoiesis secondary to increased inflammatory markers impairing normal bone marrow response to anemia. Dipyridamole, at 50 mg every 8 hours and up to 400 mg every 6 hours, may be started immediately on arrival to the ICU.…”

Section: Hematologic Concernsmentioning

confidence: 99%

“…The aspirin dose may be increased as long as TEG ® platelet mapping indicates a maximum amplitude greater than 50 mm. 106 However, because TAH patients are being bridged to transplant, it is recommended to avoid transfusing blood products as much as possible to avoid foreign antigen exposure. Some protocols additionally recommend the use of pentoxifylline at 200 mg to 400 mg every 8 or 12 hours to help decrease blood viscosity, especially if there is a high amount of hemolysis.…”

Section: Hematologic Concernsmentioning

confidence: 99%

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Perioperative Care of the Patient With the Total Artificial Heart

Yaung

Arabía

Nurok

2017

Anesthesia &Amp; Analgesia

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Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns.

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Persistent Anemia After Implantation of the Total Artificial Heart

Cited by 25 publications

References 13 publications

Identification of Differentially Expressed Transcripts and Pathways in Blood One Week and Six Months Following Implant of Left Ventricular Assist Devices

Identification of Differentially Expressed Transcripts and Pathways in Blood One Week and Six Months Following Implant of Left Ventricular Assist Devices

Building New Hearts: A Review of Trends in Cardiac Tissue Engineering

Perioperative Care of the Patient With the Total Artificial Heart

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