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ASAIO J 2020 May 21. Epub 2020 May 21.

Columbia University College of Physicians and Surgeons, New York, NY, USA.

ASAIO J 2020 May 18. Epub 2020 May 18.

Division of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

The current study aims to investigate the impact of left ventricular assist device (LVAD) implantation on weight loss and functional status in obese patients bridged to transplantation (BTT). The United Network for Organ Sharing (UNOS) database was queried to identify patients with body mass index (BMI) ≥ 30 who underwent LVAD implantation as BTT from 2008 to 2018. Patients were divided into three groups based the World Health Organization classification of obesity: obesity class I (BMI, 30. Read More

ASAIO J 2020 May 18. Epub 2020 May 18.

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine and Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York.

ASAIO J 2020 May 19. Epub 2020 May 19.

From the Section of Cardiology, University of Chicago Medical Center, Chicago, Illinois.

Neurohormonal blockade (NHB) is the mainstay of therapy for patients with systolic heart failure (HF). However, the efficacy in patients with left ventricular assist devices (LVADs) remains unknown. Of all, 114 LVAD patients (57 [48, 65] years old and 78% male) were enrolled and followed during the early period (6 months after index discharge), and 98 were followed during the late period (6-12 months following index discharge). Read More

ASAIO J 2020 May 19. Epub 2020 May 19.

Department of Pediatrics, Divisions of Critical Care and Nephrology, University of Texas Health Science Center Houston, Houston, Texas.

Purpose of this study was to evaluate the impact of early fluid accumulation and renal dysfunction on mortality in children receiving extracorporeal membrane oxygenation (ECMO). Retrospective cohort study of neonatal and pediatric patients who received ECMO between January 2010 and December 2012 in a tertiary level multidisciplinary pediatric intensive care unit (ICU). Ninety-six patients were included, and forty-six (48%) of them received continuous renal replacement therapy (CRRT) during ECMO. Read More

ASAIO J 2020 May 13. Epub 2020 May 13.

Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC.

Patients with left ventricular assist device (LVAD) have poor exercise tolerance. We aimed to characterize relationship between right ventricular (RV) afterload and exercise capacity, RV reserve, and adaptation to load. Twelve well-compensated LVAD subjects underwent right heart catheterization at rest and during symptom-limited exercise. Read More

ASAIO J 2020 May 11. Epub 2020 May 11.

From the Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria.

Despite increasing popularity and multiple postulated benefits, less invasive (LIS) left ventricular assist device (LVAD) implantation has not been sufficiently compared with standard full sternotomy (FS). We report the outcomes of a propensity score analysis designed to compare LIS and FS LVAD implantation, with perioperative blood product use, adverse event rates, and mortality as primary objective. From September 2010 to August 2016, 159 consecutive patients received a Medtronic HVAD or Abbott HeartMate 3 LVAD via a FS or LIS approach. Read More

ASAIO J 2020 May 11. Epub 2020 May 11.

From the Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

ASAIO J 2020 May 11. Epub 2020 May 11.

From the Department of Cardiovascular Surgery, Children's National Heart Institute, Children's National Hospital, The George Washington University School of Medicine, Washington, DC.

Extracorporeal membrane oxygenation (ECMO) is the most common mechanical circulatory support strategy used to treat pediatric patients presenting with low cardiac output or cardiogenic shock. While transthoracic central cannulation is feasible and mostly utilized for early postoperative support, peripheral cannulation is preferred as a primary strategy in the late postoperative period. Redo-sternotomy and venous cannulation are difficult to achieve in patients with occluded peripheral veins or complex venous anatomy like Glenn circulation. Read More

ASAIO J 2020 May 11. Epub 2020 May 11.

Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Ex vivo lung perfusion (EVLP) is increasingly used to treat and assess lungs before transplant. Minimizing ventilator induced lung injury (VILI) during EVLP is an important clinical need, and negative pressure ventilation (NPV) may reduce VILI compared with conventional positive pressure ventilation (PPV). However, it is not clear if NPV is intrinsically lung protective or if differences in respiratory pressure-flow waveforms are responsible for reduced VILI during NPV. Read More

ASAIO J 2020 May 11. Epub 2020 May 11.

School of Architecture, Design and Planning, The University of Sydney, Sydney, Australia.

Through the examination of digital channels, this study explores the determinants impacting the quality of life (QoL) of ventricular assist devices (VAD) stakeholders. Using nonparticipant online ethnography and qualitative content analysis, data were collected from 56 digital channels (Facebook, blogs, Forum, Instagram, YouTube, and podcasts) designed for VAD stakeholders. Data were classified across existing domains of QoL determinants to identify 12 new QoL determinants which address VAD stakeholders' specific needs. Read More

ASAIO J 2020 May 11. Epub 2020 May 11.

From the Interventional cardiology, Henri Mondor Hospital, Créteil, France.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) initiation for patients with cardiogenic shock or cardiac arrest is an attractive strategy since it provides a quick restoration of organ perfusion. One major limitation of VA-ECMO is left ventricle (LV) distension which is associated with poor prognosis. To prevent or treat LV distension, LV decompression may be required. Read More

ASAIO J 2020 May 11. Epub 2020 May 11.

From the II Department of Anesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.

Extracorporeal membrane oxygenation (ECMO) requires constant management of coagulation. Whereas unfractionated heparin remains the anticoagulant of choice, experienced centers report high bleeding rates. Biocompatibility of the extracorporeal circuit enables management of anticoagulation with subcutaneous low-molecular-weight heparins only. Read More

ASAIO J 2020 May 7. Epub 2020 May 7.

Department of Emergency and Organ Transplant (D.E.T.O.), University of Bari Aldo Moro, Bari, Italy.

ASAIO J 2020 04 29. Epub 2020 Apr 29.

University of Texas Southwestern Medical Center, USA.

ASAIO J 2020 Apr 30. Epub 2020 Apr 30.

Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine and Jewish Hospital, Louisville, KY.

The severe acute respiratory syndrome (SARS)-CoV-2 is an emerging viral pathogen responsible for the global coronavirus disease 2019 (COVID)-19 pandemic resulting in significant human morbidity and mortality. Based on preliminary clinical reports, hypoxic respiratory failure complicated by acute respiratory distress syndrome is the leading cause of death. Further, septic shock, late-onset cardiac dysfunction, and multiorgan system failure are also described as contributors to overall mortality. Read More

ASAIO J 2020 Apr 23. Epub 2020 Apr 23.

Department of Critical Care Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada.

ASAIO J 2020 May;66(5):e68-e69

From The Pauley Heart Center, Divisions of Cardiovascular Medicine and Cardiothorasic Surgery, Virginia Commonwealth University Health Systems, Richmond, Virginia.

ASAIO J 2020 May;66(5):571

ASAIO J 2020 May;66(5):504-506

From the Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany.

ASAIO J 2020 05;66(5):471

Department Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY.

ASAIO J 2020 Apr 22. Epub 2020 Apr 22.

Department Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY.

ASAIO J 2020 Apr 17. Epub 2020 Apr 17.

Departments of Medicine and Biomedical Engineering, Sarver Heart Center, University of Arizona, Tucson, Arizona.

As COVID-19 cases surge worldwide, an urgent need exists to enhance our understanding of the role of extracorporeal membrane oxygenation (ECMO) in the management of severely ill patients with COVID-19 who develop acute respiratory and cardiac compromise refractory to conventional therapy. The purpose of this manuscript is to review our initial clinical experience in 32 patients with confirmed COVID-19 treated with ECMO.A multi-institutional registry and database was created and utilized to assess all patients who were supported with ECMO provided by SpecialtyCare. Read More

ASAIO J 2020 Apr 17. Epub 2020 Apr 17.

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

ASAIO J 2020 Apr 16. Epub 2020 Apr 16.

Division of Cardiology, Swedish Medical Center and Altius Institute for Biomedical Sciences Division of Cardiac Surgery, Swedish Medical Center Division of Hematology and Oncology, Swedish Cancer Institute Division of Pulmonary and Critical Care Medicine, Swedish Medical Center Division of Infectious Disease, Swedish Medical Center and the Polyclinic Division of Pulmonary and Critical Care Medicine, Swedish Medical Center Division of Critical Care Medicine, Evergreen Health Division of Critical Care Medicine, and Department of Anesthesiology, Swedish Medical Center; US Anesthesia Partners, WA Division of Hematology and Oncology, Swedish Cancer Institute Division of Cardiac Surgery, Swedish Medical Center Division of Cardiology, Swedish Medical Center.

The outbreak of novel coronavirus (SARS-CoV-2) which causes the respiratory illness COVID-19 has led to unprecedented efforts at containment due to its rapid community spread, associated mortality, and lack of immunization and treatment. We herein detail a case of a young patient who suffered life-threatening disease and multi-organ failure. His clinical course involved rapid and profound respiratory decompensation such that he required support with veno-venous extracorporeal membrane oxygenation (VV-ECMO). Read More

ASAIO J 2020 Apr 16. Epub 2020 Apr 16.

Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany.

The novel coronavirus SARS-CoV-2 is infecting hundreds of thousands of humans around the globe. The coronavirus disease COVID-19 is known to generate mild as well as critical courses. Complications on the intensive care units include acute respiratory distress syndrome, acute cardiac- and kidney injury as well as shock. Read More

ASAIO J 2020 Apr 16. Epub 2020 Apr 16.

Cardio-Thorac-Vascular Department, Cardiac Surgery Unit, S. Orsola Hospital, ALMA Mater Studiorum University of Bologna, Bologna, Italy.

We report on the role of fluorine 18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) scan examinations to contribute in the diagnosis of COVID-19 respiratory syndrome even in the case of asymptomatic left ventricular assist device (LVAD) recipients. Thus, warm caution and thoughtful approaches for timely detection should be taken for our delicate LVAD population expecially if patients are currently living in a high density COVID-19 infected area and the pontential intention for LVAD treatment is bridge to transplantation. Read More

ASAIO J 2020 May;66(5):463-470

University of Texas Southwestern Medical Center.

ASAIO J 2020 05;66(5):471

Department Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY.

ASAIO J 2020 05;66(5):472-474

Division of Paediatric Critical Care, Emory University, Atlanta, Georgia.

ASAIO J 2020 05;66(5):475-481

Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, Kentucky.

Severe cases of coronavirus disease 2019 (COVID-19) cannot be adequately managed with mechanical ventilation alone. The role and outcome of extracorporeal membrane oxygenation (ECMO) in the management of COVID-19 is currently unclear. Eight COVID-19 patients have received ECMO support in Shanghai with seven with venovenous (VV) ECMO support and one veno arterial (VA) ECMO during cardiopulmonary resuscitation. Read More

ASAIO J 2020 Apr 1. Epub 2020 Apr 1.

From the Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York.

Computational fluid dynamics has become a dynamic tool in the development of ventricular assist devices (VADs) and as a predictor of thrombosis within these pumps. The genesis of thrombi could be in loco, due to deposition within the VAD, or upstream such as the left atrial appendage or inside the left ventricle. To calibrate our group's computational model, a retrospective analysis of 29 explanted HeartMate II (HMII) VADs due to suspected pump thrombosis (PT) from the University of Michigan was conducted. Read More

ASAIO J 2020 Apr 1. Epub 2020 Apr 1.

Division of Cardiology, Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland.

ASAIO J 2020 Apr;66(4):441-446

Division of Cardiology, Stanford University School of Medicine, Palo Alto, California.

Improving the outcomes of pediatric patients with congenital heart disease with end-stage heart failure depends on the collaboration of all stakeholders; this includes providers, patients and families, and industry representatives. Because of the rarity of this condition and the heterogeneity of heart failure etiologies that occur at pediatric centers, learnings must be shared between institutions and all disciplines to move the field forward. To foster collaboration, excel discovery, and bring data to the bedside, a new, collaborative quality improvement science network-ACTION (Advanced Cardiac Therapies Improving Outcomes Network)-was developed to meet the needs of the field. Read More

ASAIO J 2020 Mar 27. Epub 2020 Mar 27.

Division of Cardiology, Columbia University, New York, NY.

Ventricular arrhythmias are common following left ventricular assist device implantation (LVAD), and the effects of ventricular tachycardia (VT) ablation on thrombosis and embolic events are unknown. We aimed to assess LVAD thrombosis, stroke, and embolic event rates after VT ablation. Left ventricular assist device implantation patients from two academic centers who underwent endocardial VT ablation between 2009 and 2016 were compared to a control group with VT who were not ablated and followed for one year. Read More

ASAIO J 2020 Mar 27. Epub 2020 Mar 27.

Department of Anaesthetics and Intensive Care, Royal Papworth Hospital, Cambridge, United Kingdom.

Pulsatile flow has been used during cardiopulmonary bypass (CPB) for decades and its use is increasing with advancing extracorporeal technology. Pulsatile flow generates higher circuit pressures and shear forces than nonpulsatile flow at comparable pump flow and patient mean arterial pressure. Very little is known about the effect this has on erythrocytes. Read More

ASAIO J 2020 Mar 27. Epub 2020 Mar 27.

From the Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.

Extracorporeal circulation (ECC) support using intraoperative extracorporeal membrane oxygenation (ECMO) during lung transplantation (LTx) is now a routine practice for many high volume centers. Circuits that are dedicated to ECMO alone can be expensive and do not allow full cardiopulmonary bypass (CPB) to be performed. We describe our technique of instituting venoarterial ECMO during LTx using a less-expensive hybrid circuit that facilitates easy and immediate conversion to full CPB if needed, without interruption of ECC. Read More

ASAIO J 2020 Mar 27. Epub 2020 Mar 27.

From the Department of Cardiovascular Diseases.

There is a paucity of data describing the invasive assessment of afterload and influence on cardiac output in patients supported on left ventricular assist device (LVAD) therapy. From 2015 to 2018, patients on LVAD therapy were evaluated with simultaneous left/right heart catheterization ramp study for speed optimization. Hemodynamic parameters from 31 patients without significant aortic insufficiency were analyzed. Read More

ASAIO J 2020 Apr;66(4):399-400

From the Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota.

ASAIO J 2020 Apr;66(4):362

From the Division of Cardiothoracic Surgery, Department of Surgery, Emory University Hospital, Atlanta, Georgia.

ASAIO J 2020 Apr;66(4):339-342

Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

ASAIO J 2020 Apr 1. Epub 2020 Apr 1.

From the Division of Cardiac Surgery.

ASAIO J 2020 Mar 24. Epub 2020 Mar 24.

Division of Critical Care, Department of Pediatrics, Children's Hospital of Michigan/Wayne State University, Detroit, Michigan.

Risk factors for mortality in children with refractory pediatric septic shock who are supported with extracorporeal life support (ECLS) are largely unknown. Therefore, we performed univariable and multivariable analyses to determine risk factors for mortality among children (<19 years) who underwent an ECLS run between January 2012 and September 2014 at eight tertiary pediatric hospitals, and who had septic shock based on 2005 International Consensus Criteria. Of the 514 children treated with ECLS during the study period, 70 were identified with septic shock. Read More

ASAIO J 2020 Mar 24. Epub 2020 Mar 24.

From the Advanced Heart Failure and Pulmonary Hypertension Program, Hackensack University Medical Center, Hackensack, New Jersey.

Ventricular assist devices (VAD) complications including stroke, device failure, gastrointestinal bleeding, and infection all can manifest in the outpatient environment. Often, first responders do not have the knowledge base to respond appropriately. This study conducted an assessment of first responders generalized knowledge and self-reported competency regarding VAD use, provided an education course, and tested for improvement immediately after and 1 month postintervention. Read More

ASAIO J 2020 Mar 24. Epub 2020 Mar 24.

From the Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

Mechanical assist devices in refractory cardiac arrest are increasingly employed. We compared the hemodynamics and organ perfusion during cardiac arrest with either veno-arterial extracorporeal membrane oxygenation (ECMO) or biventricular assisted circulation combining left- and right-sided impeller devices (BiPella) in an acute experimental setting. Twenty pigs were randomized in two equal groups receiving circulatory support either by ECMO or by BiPella during 40 minutes of ventricular fibrillation (VF) followed by three attempts of cardioversion, and if successful, 60 minute observation with spontaneous, unsupported circulation. Read More

ASAIO J 2020 Mar 3. Epub 2020 Mar 3.

Georgetown School of Medicine, Washington, DC.

Continuous bedside pulse oximetry (SpO2) is universally used to monitor oxygenation for patients supported on veno-venous extracorporeal membrane oxygenation (VV-ECMO). Yet, elevated carboxyhemoglobin (COHb), a known event in VV-ECMO, diminishes the reliability of SpO2. This retrospective cohort study aims to assess the accuracy of SpO2 compared with oxyhemoglobin (SaO2) and quantify COHb levels by co-oximetry in the VV-ECMO population. Read More

ASAIO J 2020 Mar 3. Epub 2020 Mar 3.

From the Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.

Microchannel artificial lungs may provide highly efficient, long-term respiratory support, but a robust predictive oxygen transfer (VO2) model is needed to better design them. To meet this need, we first investigated the predictive accuracy of Mikic, Benn, and Drinker's advancing front (AF) oxygen transfer theory by applying it to previous microchannel lung studies. Here, the model that included membrane resistance showed no bias toward overprediction or underprediction of VO2 (median error: -1. Read More

ASAIO J 2020 Feb 25. Epub 2020 Feb 25.

Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Only a very small portion of end-stage organ failures can be treated by transplantation because of the shortage of donor organs. Although artificial long-term organ support such as ventricular assist devices provide therapeutic options serving as a bridge-to-transplantation or destination therapy for end-stage heart failure, suitable long-term artificial lung systems are still at an early stage of development. Although a short-term use of an extracorporeal lung support is feasible today, the currently available technical solutions do not permit the long-term use of lung replacement systems in terms of an implantable artificial lung. Read More

ASAIO J 2020 Mar 3. Epub 2020 Mar 3.

From the Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania.

Extracorporeal CO2 removal (ECCO2R) can permit lung protective or noninvasive ventilation strategies in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS). With evidence supporting ECCO2R growing, investigating factors which affect CO2 removal is necessary. Multiple factors are known to affect the CO2 removal rate (vCO2) which can complicate the interpretation of changes in vCO2; however, the effect of hematocrit on the vCO2 of artificial lungs has not been investigated. Read More

ASAIO J 2020 Mar 3. Epub 2020 Mar 3.

The Heart Center, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington.

Patients with adult congenital heart disease (ACHD) who undergo cardiac surgery may require extracorporeal life support (ECLS) for cardiopulmonary support, but outcomes after ECLS support have not been well described. This study aimed to identify risk factors for ECLS mortality in this population. We identified 368 ACHD patients who received ECLS after cardiac surgery between 1994 and 2016 in the Extracorporeal Life Support Organization (ELSO) database, a multicenter international registry of ECLS centers. Read More