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Artif Organs 2022 May 21. Epub 2022 May 21.

Fischell Department of Bioengineering, A. James Clark School of Engineering, University of Maryland, College Park, MD, USA.

Background: Left ventricular assist devices (LVADs) have been used as a standard treatment option for patients with advanced heart failure. However, these devices are prone to adverse events. Non-surgical bleeding (NSB) is the most common complication in patients with continuous flow (CF) LVADs. Read More

Artif Organs 2022 May 17. Epub 2022 May 17.

Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Introduction: Restrictive cardiomyopathy (RCM) and hypertrophic cardiomyopathy (HCM) are two disease processes that are known to progress to heart failure with preserved ejection fraction (HFpEF). Pharmacologic therapies for HFpEF have not improved patient outcomes or reduced mortality in this patient cohort; thus, there continues to be substantial interest in other treatment strategies, including surgical interventions and devices. In this article, we explore and report the current utility of percutaneous therapies and surgically implanted mechanical support in the treatment of patients with HFpEF. Read More

Artif Organs 2022 May 17. Epub 2022 May 17.

Medical Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar.

Background: Training is an essential aspect of providing high-quality treatment and ensuring patient safety in any medical practice. Because extracorporeal membrane oxygenation (ECMO) is a complicated operation with various elements, variables, and irregular situations, doctors must be experienced and knowledgeable about all conventional protocols and emergency procedures. The conventional simulation approach has a number of limitations. Read More

Artif Organs 2022 May 17. Epub 2022 May 17.

Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.

Objective: Cardiogenic shock (CS) often occurs in patients suffering from rapidly progressing end-stage heart failure or acute myocardial infarction. Mechanical circulatory support may be used for patients who do not respond to medication or revascularization to stabilize hemodynamics. Extracorporeal ventricular assist device (Extra-VAD) has been reported successful for patients with cardiogenic shock. Read More

Artif Organs 2022 May 16. Epub 2022 May 16.

Pharmacy Department, University of Kentucky Medical Center, Lexington, KY, USA.

Background: Gastrointestinal bleeding (GIB) is one of the most common bleeding complications associated with Left Ventricular Assist Devices (LVAD). Currently, there is no strong evidence or clear guidance for which secondary GIB prophylaxis strategy should be implemented after the discontinuation of aspirin.

Methods: Our single-center study describes the outcomes of 26 LVAD patients who experienced a total of 49 GIB events, these individuals were either in Group-1) lower INR target range or Group-2) lower INR target plus a hemostatic agent as the secondary prophylaxis strategy. Read More

Artif Organs 2022 May 12. Epub 2022 May 12.

Heart & Vascular Centre, Maastricht University Medical Centre (MUMC+), Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands.

Objectives: To highlight the role of percutaneous left ventricular assist device (LVAD) decommissioning as a safe procedure after myocardial recovery in patients with advanced heart failure.

Background: The HeartMate3 LVAD (Abbott, Chicago, IL, USA) is designed to provide circulatory support with enhanced hemocompatibility for patients with advanced heart failure. Most VADs are used as a bridge to heart transplantation; however, in certain cases, myocardial function recovers, and VADs can be explanted after the patient is weaned. Read More

Artif Organs 2022 May 12. Epub 2022 May 12.

Department of Anesthesiology, Critical Care Medicine and Pain Therapy, Sapienza University of Rome, Rome, Italy.

Background: Few studies explored the role of hypothermic machine perfusion (HMP) in the sub-group of non-standard renal grafts with a biopsy-proven advanced histological impairment. This study aimed to investigate the role of HMP in grafts with a Karpinski Score >3 in terms of the need for dialysis, creatinine reduction ratio at day-7 (CRR7), and 3-year graft survival.

Methods: Twenty-three perfused grafts with Karpinski Score >3 evaluated between November 2017 and December 2018 were retrospectively analyzed and compared with a control group of 32 non-perfused grafts transplanted between January 2014 and October 2017. Read More

Artif Organs 2022 May 12. Epub 2022 May 12.

Division of Thoracic Surgery, Department of Clinical Sciences, Lund University, Lund, Sweden.

Background: Existing working heart models for ex vivo functional evaluation of donor hearts often use cardiac afterloads made up of discrete resistive and compliant elements. This approach limits the practicality of independently controlling systolic and diastolic aortic pressure to safely test the heart under multiple loading conditions. We present and investigate a novel afterload concept designed to enable such control. Read More

Artif Organs 2022 May 12. Epub 2022 May 12.

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.

Introduction: Normothermic machine perfusion (NMP) provides a platform for drug-delivery. However, pharmacological considerations for therapeutics delivered during NMP are scarcely reported. We aimed to demonstrate the ability of NMP as a platform for pharmacological testing, using a drug which increases metabolism (2,4-dinitrophenol; DNP) as an example therapeutic. Read More

Artif Organs 2022 May 9. Epub 2022 May 9.

Department of Anaesthesia and Intensive Care, A.O.U. "Policlinico-San Marco", Catania, Italy.

Background: Extracorporeal membrane oxygenation (ECMO) represents an advanced option for supporting refractory respiratory and/or cardiac failure. Systemic anticoagulation with unfractionated heparin (UFH) is routinely used. However, patients with bleeding risk and/or heparin-related side effects may necessitate alternative strategies: among these, nafamostat mesilate (NM) has been reported. Read More

Artif Organs 2022 May 7. Epub 2022 May 7.

Escola Politécnica (EP), Universidade de São Paulo (USP), São Paulo, Brazil.

Background: Mechanical heart valves (MHV) and its fluid dynamics inside a pulsatile pediatric ventricular assist device (PVAD) can be associated with blood degradation. In this article, flow structures are analyzed and compared by an experimental investigation on the effect of bileaflet MHV positioned at varying angles in the inlet port orifice of a PVAD.

Methods: Time-resolved particle image velocimetry was applied to characterize the internal flow of the device. Read More

Artif Organs 2022 May 7. Epub 2022 May 7.

Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

Background: We previously proposed an accurate cup placement procedure using a portable navigation system (PNS) for total hip arthroplasty (THA) in the lateral decubitus position; however, the accuracy of our proposed procedure has not been shown, the aim of this study was to demonstrate the accuracy.

Methods: We prospectively analyzed 79 hips treated with primary THA; 40 hips treated until June 2020 were included in the conventional procedure (CP) group, and 39 hips treated from July 2020 were included in the modified procedure (MP) group. In the MP, pelvic orientation is considered to be the set coordinate axes in addition to the CP using the PNS. Read More

Artif Organs 2022 May 7. Epub 2022 May 7.

Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas, USA.

Background: Hyponatremia is associated with adverse outcomes in heart failure and after cardiac surgery. We hypothesized that hyponatremia is associated with poorer short-term and longer term survival in patients after continuous-flow left ventricular assist device (CF-LVAD) placement.

Methods: We reviewed a single-center database of patients who received a CF-LVAD during 2012-2017. Read More

Artif Organs 2022 May 6. Epub 2022 May 6.

Draper, Cambridge, Massachusetts, USA.

The increasing prevalence of chronic lung disease worldwide, combined with the emergence of multiple pandemics arising from respiratory viruses over the past century, highlights the need for safer and efficacious means for providing artificial lung support. Mechanical ventilation is currently used for the vast majority of patients suffering from acute and chronic lung failure, but risks further injury or infection to the patient's already compromised lung function. Extracorporeal membrane oxygenation (ECMO) has emerged as a means of providing direct gas exchange with the blood, but limited access to the technology and the complexity of the blood circuit have prevented the broader expansion of its use. Read More

Artif Organs 2022 May 3. Epub 2022 May 3.

Cardiovascular Department, UO of Cardiac Surgery of the IRCCS Humanitas Research Hospital, Rozzano, Italy.

Clinical pathway of an intracardiac hematoma treated by ECMO support. Read More

Artif Organs 2022 May 2. Epub 2022 May 2.

Department of Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China.

Objective: To evaluate whether septic shock patients with pulmonary infection and life-threatening hypoxemia can benefit from V-V ECMO.

Methods: Retrospective clinical data analysis on patients who suffered septic shock with pulmonary infection, categorized into V-V ECMO and control groups. The propensity score matching (PSM) method was used to screen patients matched for age, gender, and disease severity. Read More

Artif Organs 2022 May 1. Epub 2022 May 1.

Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.

Objective: Myocardial damage occurs in up to 25% of coronavirus disease 2019 (COVID-19) cases. While veno-venous extracorporeal life support (V-V ECLS) is used as respiratory support, mechanical circulatory support (MCS) may be required for severe cardiac dysfunction. This systematic review summarizes the available literature regarding MCS use rates, disease drivers for MCS initiation, and MCS outcomes in COVID-19 patients. Read More

Artif Organs 2022 May 1. Epub 2022 May 1.

Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University General Hospital, Nuremberg, Germany.

Artif Organs 2022 May 1. Epub 2022 May 1.

Department of Medicine IV, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Background: Severe COVID-19 can necessitate multiple organ support including veno-venous extracorporeal membrane oxygenation (vvECMO) and renal replacement therapy. The therapy can be complicated by venous thromboembolism due to COVID-19-related hypercoagulability, thus restricting vascular access beyond the vvECMO cannula. Although continuous renal replacement therapy can be performed via a vvECMO circuit, studies addressing sustained low-efficiency dialysis (SLED) integration into vvECMO circuits are scarce. Read More

Artif Organs 2022 Apr 25. Epub 2022 Apr 25.

Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany.

Background: Multiple organ failure is a common complication in patients undergoing ECLS significantly affecting patient outcomes. Gaining knowledge about the mechanisms of onset, clinical course, risk factors, and potential therapeutic targets is highly desirable.

Methods: Data of 354 patients undergoing ECLS with one-, two, three-, and four organ failures were retrospectively analyzed. Read More

Artif Organs 2022 Jun 25;46(6):985-986. Epub 2022 Apr 25.

Patients with amyotrophic lateral sclerosis may enter into a completely locked-in state without any capability for communication using neuromuscular output. Using an auditory-guided neurofeedback-based strategy with implantable sensors in the motor cortex, scientists were able to help a patient in this state produce intelligible sentences. Read More

Artif Organs 2022 Apr 24. Epub 2022 Apr 24.

Department of Intensive Care Medicine, Amsterdam University Medical Center (Location AMC), University of Amsterdam, Amsterdam, The Netherlands.

Background: Deep vein thrombosis (DVT) after decannulation of extracorporeal life support (ECLS) is not uncommon. Moreover, the impact of anticoagulation and potential risk factors is unclear. Furthermore, it is unclear if cannula-associated DVT is more common in ECLS patients compared to critically ill patients without ECLS. Read More

Artif Organs 2022 Apr 23. Epub 2022 Apr 23.

Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

In 1985, the surgical team led by Bjarne Semb implanted the first total artificial heart (TAH) in Europe, and the following year the first successful bridge to transplant in Europe using the Symbion J-7/100 TAH. Together with the clinical experiences of colleagues in the United States, these early cases preceded the subsequent development of scores of mechanical assist devices to treat advanced heart failure. Semb proved to have the pioneering spirit needed to use the early generation of a TAH, but these early implants also generated much controversy in the medical community as well as the general public. Read More

Artif Organs 2022 Jun 22;46(6):987-994. Epub 2022 Apr 22.

Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Scientific barriers that have prevented successful xenotransplantation are being breached, yet many ethical issues remain. Some are broad issues that accompany the adoption of novel and expensive technologies, and some are unique to xenotransplantation. Major ethical questions include areas such as: viral transmission; zoonoses and lifetime surveillance; interfering with nature; efficacy, access, and expense; treatment of animals; regulation and oversight. Read More

Artif Organs 2022 Jun 22;46(6):1209-1210. Epub 2022 Apr 22.

Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA.

Artif Organs 2022 Apr 22. Epub 2022 Apr 22.

Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Background: Despite increasing knowledge about the optimal treatment for patients with severe COVID-19, data from different cohorts suggested that survival of patients treated with ECMO seemed to decline over the course of the pandemic.

Methods: In this non-interventional retrospective single-center registry study we analyzed all consecutive patients tested positive for SARS-CoV-2 infection and supported with VV ECMO in our center during the first three waves of the pandemic. From March 2020 through June 2021, 59 patients have been included. Read More

Artif Organs 2022 Apr 22. Epub 2022 Apr 22.

Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.

Aims: To identify clinical and biochemical markers associated with nutrition adequacy and gastrointestinal and liver dysfunction in adults on extracorporeal membrane oxygenation (ECMO).

Methods: A retrospective, observational, study was conducted at 2 centres in Australia. Adult patients who received ECMO from July 2011 to June 2015 were included. Read More

Artif Organs 2022 Apr 22. Epub 2022 Apr 22.

Department of Nursing, Graduate Program in Health Science, Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Brazil.

Background: Failure to mature the fistula in patients undergoing hemodialysis leads to prolonged use of the central venous catheter (CVC) and can compromise the patency of the catheter and the arteriovenous fistula (AVF) due to thrombus development.

Objective: To evaluate hemostatic changes in patients undergoing hemodialysis with prolonged use of CVC or AVF.

Method: Cross-sectional study with a total of 200 adult participants who were divided into the following groups: I:control; II: patients who had 5-8 months of CVC insertion; III: patients who had 9-36 months of insertion; IV patients who had 5-8 months of AVF; and V: patients who had 9-36 months of AVF. Read More

Artif Organs 2022 Apr 22. Epub 2022 Apr 22.

Advanced Medical Emergency Department & Critical Care Center, Japanese Red Cross Maebashi Hospital, Maebashi, Japan.

Background: Bleeding complications during venovenous extracorporeal membrane oxygenation (V-V ECMO) can be critical. However, there is limited information on the associated risk factors. This study investigated the risk factors for bleeding complications during V-V ECMO as a bridge to recovery. Read More

Artif Organs 2022 Jun 20;46(6):995-996. Epub 2022 Apr 20.

Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA.