Search Our Scientific Publications & Authors

ASAIO J 2019 Feb 26. Epub 2019 Feb 26.

University of Washington, Seattle, Washington.

ASAIO J 2019 Feb 26. Epub 2019 Feb 26.

From the Réanimation Médico-chirurgicale, Centre Hospitalier René Dubos, Pontoise, France.

Venovenous and venoarterial extracorporeal membrane oxygenation (ECMO) are lifesaving supports that are more and more frequently used in critically ill patients. Despite of major technological improvements observed during the last 20 years, ECMO-associated hemolysis is still a complication that may arise during such therapy. Hemolysis severity, directly appreciated by plasma free hemoglobin concentration, may be present with various intensity, from a nonalarming and tolerable hemolysis to a highly toxic one. Read More

ASAIO J 2019 Feb 26. Epub 2019 Feb 26.

University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, United Kingdom University College London, London, United Kingdom.

ASAIO J 2019 Feb 26. Epub 2019 Feb 26.

Division of Cardiology, University of Chicago Medical Center, Chicago, Illinois.

ASAIO J 2019 Apr 10. Epub 2019 Apr 10.

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

There are conflicting data regarding whether concomitant mitral valve surgery (MVS) at left ventricular assist device (LVAD) implantation is beneficial. This study aimed to assess the hemodynamic effects of concomitant MVS. Of all 73 enrolled patients, 44 patients had undergone concomitant MVS and 29 patients had not. Read More

ASAIO J 2019 Mar 27. Epub 2019 Mar 27.

ANSYS, Inc., Evanston, Illinois.

Medical device manufacturers using computational modeling to support their device designs have traditionally been guided by internally developed modeling best practices. A lack of consensus on the evidentiary bar for model validation has hindered broader acceptance, particularly in regulatory areas. This has motivated the Food and Drug Administration and the American Society of Mechanical Engineers (ASME), in partnership with medical device companies and software providers, to develop a structured approach for establishing the credibility of computational models for a specific use. Read More

ASAIO J 2019 Mar 27. Epub 2019 Mar 27.

From the Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Fibrinogen is a clotting factor and a major determinant of platelet aggregation. Albumin, on the other hand, inhibits platelet function and thrombus formation. Taken together, an elevated fibrinogen albumin ratio (FAR) has been described as a marker of disease severity during prothrombotic conditions. Read More

ASAIO J 2019 Mar 27. Epub 2019 Mar 27.

Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.

Extracorporeal membrane oxygenation (ECMO) is a low-volume, high-risk modality of care. Clinical specialists (CS) who manage ECMO circuit emergencies vary in background and approach to circuit emergencies based on institutional training standards, leading to variation that may impact the quality of care. Validated checklists to assess CS performance are crucial to eliminate disparities and improve efficiency. Read More

ASAIO J 2019 Apr 4. Epub 2019 Apr 4.

From the Division of Cardiothoracic Transplantation and Circulatory Support, Baylor College of Medicine, Houston, Texas.

The number of patients on destination therapy is increasing as long-term survival on continuous-flow left ventricular assist device (CF-LVAD) therapy has improved. Gastrointestinal bleeding (GIB) is a common complication after CF-LVAD implantation, and its risk correlates with longer support time, emphasizing the importance of GIB management. The lower pulsatility of CF-LVADs may promote arteriovenous malformations, that amplify the bleeding risk. Read More

ASAIO J 2019 Apr 4. Epub 2019 Apr 4.

From the Department of Nutrition and Integrative Physiology.

Current continuous-flow left ventricular assist devices (LVADs) decrease peripheral vascular pulsatility, which may contribute to side effects such as bleeding and thrombotic events. However, the actual impact of manipulating LVAD pump speed, revolutions per minute (rpm), on peripheral (brachial) pulsatility index (brachial PI), in patients with heart failure implanted with a HeartWare (HVAD) or HeartMateII (HMII) LVAD is unknown. Therefore, blood velocities (Doppler ultrasound) in the brachial artery were recorded and brachial PI calculated across rpm manipulations which spanned the acceptable clinical outpatient range: 360 rpm (HVAD, n = 10) and 1200 rpm (HMII, n = 10). Read More

ASAIO J 2019 Apr 2. Epub 2019 Apr 2.

European ECMO Advisory Board.

Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy for severe respiratory and circulatory failure. It is best performed in high-volume centers to optimize resource utilization and outcomes. Regionalization of ECMO might require the implementation of therapy before and during transfer to the high-volume center. Read More

ASAIO J 2019 Mar 21. Epub 2019 Mar 21.

Department of Laboratory Medicine, University of Washington, Seattle, Washington.

To balance the risk of bleeding versus circuit thrombosis during extracorporeal life support (ECLS), it is important to monitor anticoagulants and hemostasis. We evaluated the prothrombin time (PT), partial thromboplastin time (PTT), activated clotting time (ACT), and antifactor Xa heparin activity (aXa) correlation with changes in coagulation factor and heparin levels using in vitro and in vivo samples. aXa correlated with heparin (r = 0. Read More

ASAIO J 2018 Dec 20. Epub 2018 Dec 20.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.

We retrospectively reviewed all pertinent extracorporeal membrane oxygenation (ECMO) studies (January 1995 to September 2017) of adults with sepsis as a primary indication for intervention and its association with morbidity and mortality. Collected data included study type, ECMO configuration, outcomes, effect size, and other features. Advanced age was a risk factor for death. Read More

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, Department of Medicine and Interdepartmental Division of Critical Care Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada Department of Medicine and Interdepartmental Division of Critical Care Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada Department of Medicine and Interdepartmental Division of Critical Care Medicine, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada.

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom.

Left ventricular assist devices (LVADs) have become an established treatment for advanced heart failure, although with long-term support these patients are potentially exposed to serious complications. Our purpose was to assess the role of the neutrophil to lymphocyte ratio (NLR) in LVAD complications and to evaluate if higher values of NLR after 4-6 months on LVAD support (NLR 4_6m) are associated with worse prognosis. All consecutive patients who received a HeartWare LVAD (N = 188, age 50 ± 13 years), as bridge to transplant from December 2009 to January 2018 were included. Read More

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

From the Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Volume status assessment in left ventricular assist device (LVAD) patients remains challenging. Cardiac resynchronization therapy (CRT) devices are common in LVAD patients, and the impedance across the CRT leads may be associated with hemodynamics and serve as a tool for noninvasive estimation of volume status. Ninety-one sets of measurements including cardiac filling pressures and lead impedances were prospectively obtained during ramp tests from 11 LVAD patients (65. Read More

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

From the Department of Pediatric Surgery, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas.

The use of the resuscitative endovascular balloon occlusion of the aorta (REBOA) device is expanding in adult trauma. Reports of its use in pediatric patients have been published, but no guidelines currently exist nor has it been Food and Drug Administration approved in pediatrics. This project develops a model to determine appropriate balloon inflation volumes in pediatric patients to guide potential use. Read More

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

DermaPort, Inc., Grayslake, Illinois.

Safe, percutaneous access to the body for hemodialysis and other medical uses is increasingly necessary for modern medical therapy. Long-term hemodialysis offers unique challenges with its requirements for high blood flow, chronic implantation, and risks of infection. Although widely used, the polyester, cuffed, and hemodialysis catheter is far from ideal, and there is a need for an improved vascular access system to allow catheter adjustment and replacement, to reduce infections and to reduce medical costs. Read More

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

From the Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Although a correlation between the nutritional status and the prognosis of patients with heart failure has been suggested, a correlation between the nutritional status and outcomes after the left ventricular assist device (LVAD) implantation remains unclear. We aimed to investigate the efficacy of the Controlling Nutritional Status (CONUT) score (range 0-12, including serum albumin, total cholesterol, and lymphocytes) as a nutritional index in speculating the prognosis of patients undergoing LVAD implantation. We examined 63 consecutive patients who underwent the continuous-flow LVAD implantation. Read More

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

From the Heart Failure and Transplant Unit, St Vincent's Hospital, Sydney, New South Wales, Australia.

At fixed speed, the spontaneous increase in pump flow accompanying exercise in patients with continuous flow left ventricular assist devices (cfLVADs) is slight in comparison to normal physiologic response, limiting exercise capacity. We systematically exercised 14 patients implanted with an isolated HeartWare HVAD undergoing routine right heart catheterization at baseline and at maximal safe pump speed. In addition to hemodynamics, mixed venous oxygen saturation (SvO2), echocardiography and noninvasive mean arterial pressure, and heart rate were measured. Read More

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia, Critical Care Research Group and Centre of Research Excellence for Advanced Cardio-respiratory Therapies Improving OrgaN Support (ACTIONS), Brisbane, Queensland, Australia, University of Queensland, Brisbane, Queensland, Australia, Bond University, Gold Coast, Queensland, Australia Royal Brisbane and Women's hospital, Brisbane, Queensland, Australia Critical Care Research Group and Centre of Research Excellence for Advanced Cardio-respiratory Therapies Improving OrgaN Support (ACTIONS), Brisbane, Queensland, Australia, University of Queensland, Brisbane, Queensland, Australia, Speech and Language Therapy, St. Bartholomew's Hospital, Barts NHS Trust, London, United Kingdom Critical Care Research Group and Centre of Research Excellence for Advanced Cardio-respiratory Therapies Improving OrgaN Support (ACTIONS), Brisbane, Queensland, Australia, University of Queensland, Brisbane, Queensland, Australia.

ASAIO J 2019 Feb 21. Epub 2019 Feb 21.

From the Center for Advanced Heart Failure, University of Texas Health Science Center at Houston/Memorial Hermann Hospital - Texas Medical Center, Houston, Texas.

Rescuing heterotopic heart transplantation (HHT) patients remains a challenge in the field. When a 41 year old patient was transferred to our service, we chose a novel approach that is reported herein. The HHT had been performed over 20 years ago, and in 2016, because of complications, the patient was listed for transplant with a 1A status. Read More

ASAIO J 2019 Mar 19. Epub 2019 Mar 19.

From the Johns Hopkins University School of Medicine, Baltimore, Maryland.

Since the first successful case report in 1972, extracorporeal life support or extracorporeal membrane oxygenation (ECMO) has become a standard approach for severe respiratory failure unresponsive to other therapy. In the past, if there was no recovery by approximately 30 days or if right ventricular heart failure occurred, ECMO was discontinued and the patient died. More recently patients with severe lung disease have been maintained for months, as opposed to days, with eventual decannulation and recovery. Read More

ASAIO J 2019 Mar 19. Epub 2019 Mar 19.

From the Department of Cardiothoracic, Transplantation and Vascular Surgery, S. Orsola Hospital, Bologna University, Bologna, Italy.

Peripheral extracorporeal membrane oxygenation (ECMO) setting remains a valid option to treat cardiogenic shock (CS). We investigated a percutaneous approach to unload the left ventricle (LV) while on veno-arterial (v-a) peripheral ECMO support. Between 2017 and 2018, eight patients (three females, mean age: 49. Read More

ASAIO J 2019 Jan 11. Epub 2019 Jan 11.

Division of Cardiovascular Medicine, University of Miami Miller School of Medicine, Miami, Florida.

ASAIO J 2019 Jan 11. Epub 2019 Jan 11.

Department of Cardiovascular Surgery, University Health Network, Canada.

This article presents a primed left ventricle heart perfusion method to generate physiologic aortic pressure (AoP) and perform functional assessment. Isolated hearts of male Yorkshire pigs were used to study the hemodynamic behaviors of AoPs generated in the primed left ventricle heart perfusion (n = 6) and conventional (zero-loaded left ventricle) Langendorff perfusion (n = 6). The measurement results show that left ventricular pressure generated in the primed left ventricle heart perfusion is a determinant of physiologic AoP (i. Read More

ASAIO J 2019 Mar 13. Epub 2019 Mar 13.

Department of Pediatrics, Duke University Hospital, Durham, North Carolina.

Anticoagulation is essential during extracorporeal membrane oxygenation (ECMO) to prevent catastrophic circuit clotting. Several assays exist to monitor unfractionated heparin (UFH), the most commonly used anticoagulant during ECMO, but no single test or combination of tests has consistently been proven to be superior. This retrospective observational study examines the correlation among antifactor Xa level, activated partial thromboplastin time (aPTT), and UFH dose and the association between antifactor Xa level and aPTT with survival and hemorrhagic and thrombotic complications. Read More

ASAIO J 2019 Mar 13. Epub 2019 Mar 13.

From the Department of Neurology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

Although heart transplantation remains the gold standard for management of heart failure, ventricular assist devices (VAD) have emerged as viable alternatives. VAD implantation improves kidney function. However, whether the improvement is sustained or associated with improved outcomes is unclear. Read More

ASAIO J 2019 Mar 13. Epub 2019 Mar 13.

From the Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland.

Flow fields in rotary blood pumps (RBPs) have a significant influence on hemocompatibility. Because flow characteristics vary with flow rate, different operating conditions play a role. Furthermore, turbulence is crucial in the evaluation of blood damage potential, but the level of turbulence in implantable RBPs is still unknown. Read More

ASAIO J 2019 Mar 13. Epub 2019 Mar 13.

From the University of Washington/Seattle Children's Hospital, Seattle, Washington.

We describe the use of extracorporeal life support (ECLS) for Legionellosis in the pediatric and adult populations and report complications, morbidity, and mortality by conducting a retrospective review of patients from the Extracorporeal Life Support Organization registry, including two cases at our pediatric institution. A total of 194 patients with ECLS for Legionella pneumophila infection who received ECLS were included in the analysis. Overall survival was 71%. Read More

ASAIO J 2019 Mar 6. Epub 2019 Mar 6.

Department of Cardiothoracic Surgery, Stanford University, Palo Alto, California.

Ventricular assist device (VAD) support for children with single ventricle (SV) heart disease remains challenging. We performed a single-center retrospective review of SV patients on VAD support and examined survival to transplant using the Kaplan-Meier method. Patients transplanted were compared with those who died on support. Read More

ASAIO J 2019 Mar 6. Epub 2019 Mar 6.

From the National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore.

The aim of this study is to examine factors that can predict mortality in patients that have veno-arterial extracorporeal membrane oxygenation (VA-ECMO) instituted for cardiogenic shock. A single-center, retrospective study of 127 patients who underwent VA-ECMO for cardiogenic shock between January 2003 and December 2017 was conducted. Eighty-three (65%) patients survived to weaning or bridging therapy. Read More

ASAIO J 2019 Mar 6. Epub 2019 Mar 6.

Medicine-Cardiology, University of Washington, Seattle, Washington.

ASAIO J 2019 Apr 2. Epub 2019 Apr 2.

From Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York.

Transcatheter aortic valve replacement (TAVR) has emerged as an effective therapy for the unmet clinical need of inoperable patients with severe aortic stenosis (AS). Current clinically used tissue TAVR valves suffer from limited durability that hampers TAVR's rapid expansion to younger, lower risk patients. Polymeric TAVR valves optimized for hemodynamic performance, hemocompatibility, extended durability, and resistance to calcific degeneration offer a viable solution to this challenge. Read More

ASAIO J 2019 Mar 19. Epub 2019 Mar 19.

Department of Medicine, Division of Cardiology, Montefiore Medical Center - Albert Einstein College of Medicine, Bronx, New York.

ASAIO J 2019 Mar/Apr;65(3):226

ASAIO J 2019 Mar/Apr;65(3):205-206

From the Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, North Carolina.

ASAIO J 2019 Feb 20. Epub 2019 Feb 20.

From the Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.

Several studies have investigated early outcomes with a surgical short-term ventricular assist device (VAD), but little is known about adverse event profile during prolonged support with a surgical short-term VAD. This is a retrospective analysis of 161 patients who received a CentriMag ventricular assist system (Abbott Laboratories, Abbott Park, IL) at our institution between January 2007 and June 2014. Device-related adverse events include major bleeding, infection, and stroke incidents occurring during CentriMag support. Read More

ASAIO J 2019 Feb 19. Epub 2019 Feb 19.

From the U.S. Food and Drug Administration, Silver Spring, Maryland.

A reliable in vitro dynamic test method to evaluate device thrombogenicity is very important for the improvement of the design and safety of blood-contacting medical devices, while reducing the use of animal studies. In this study, a recirculating flow loop system was developed for thrombogenicity testing, using donor sheep blood anticoagulated with Anticoagulant Citrate Dextrose Solution A (ACDA) and used within 24-36 hr postdraw. Immediately before testing, the blood was recalcified and heparinized to a donor-specific target concentration. Read More

ASAIO J 2019 Feb 19. Epub 2019 Feb 19.

Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Pediatric heart transplant candidates have the highest wait-list mortality of all organ candidates. Mechanical circulatory support has improved survival for many patients awaiting transplant. Biventricular mechanical circulatory support remains a particular challenge for pediatric patients. Read More

ASAIO J 2019 Feb 19. Epub 2019 Feb 19.

From the Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

ASAIO J 2019 Feb 11. Epub 2019 Feb 11.

From the St Vincent's Hospital, Sydney, New South Wales, Australia.

We evaluated mean, peak, and instantaneous pressure gradients across the outflow conduit in a pulsatile mock circulation loop which incorporated Heartware HVADs for left ventricular (LV) and right ventricular (RV) support. Steady-state 50 Hz measurements of left ventricular assist device (LVAD) flow (Q) and pressures within the proximal and distal outflow conduit were obtained at varying pump speed, LV contractility, hematocrit (HCT), heart rate (HR), and conduit diameter and length. Experiments were conducted using polyvinyl chloride (PVC) tubing and results confirmed in HVAD Gelweave conduit. Read More

ASAIO J 2019 Jan 29. Epub 2019 Jan 29.

From the Department of Cardiothoracic Surgery.

Pulmonary Embolism (PE) is a common illness in western countries. The purpose of this study is to report the institutional experience with massive PE and Extracorporeal Membrane Oxygenation (ECMO) in inoperable patients on admission. A retrospective analysis using the institutional ECMO-registry including the time between 2006 and 2017 was performed. Read More

ASAIO J 2019 Feb;65(2):122

ASAIO J 2019 Feb;65(2):101-103

From the Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

ASAIO J 2019 Jan 24. Epub 2019 Jan 24.

Division of Cardiac Surgery, Seattle Children's Hospital, Seattle, Washington.

Patients on extracorporeal life support (ECLS) are at risk for central nervous system (CNS) injury. One potentially modifiable risk factor is site of arterial cannulation in venoarterial (VA) ECLS, as in most cases one can choose the femoral or carotid artery. There is acute alteration in cerebral blood flow with carotid cannulation, potentially increasing the risk of stroke. Read More

ASAIO J 2019 Jan 24. Epub 2019 Jan 24.

School of Biomedical Engineering, Cornell University, New York.

Current risk stratification models to predict outcomes after a left ventricular assist device (LVAD) are limited in scope. We assessed the performance of Bayesian models to stratify post-LVAD mortality across various International Registry for Mechanically Assisted Circulatory Support (INTERMACS or IM) Profiles, device types, and implant strategies. We performed a retrospective analysis of 10,206 LVAD patients recorded in the IM registry from 2012 to 2016. Read More

ASAIO J 2019 Jan 24. Epub 2019 Jan 24.

Department of Radiology, MedStar Medical Group Radiology, Baltimore, Maryland.

Various congenital heart defects (CHDs) are characterized by the existence of a single functional ventricle, which perfuses both the systemic and pulmonary circulation. A three-stage palliation procedure, including the final Fontan completion, is often adopted by surgeons to treat patients with such CHDs. The completion Fontan involves the creation of a total cavopulmonary connection (TCPC), commonly accomplished with an extracardiac conduit. Read More

ASAIO J 2019 Jan 24. Epub 2019 Jan 24.

Department of Surgery, High-ranking Medical Service Center, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Attempts have been made to observe the tissue repair of neo-esophagus after esophageal muscularis resection and to investigate possibility of the regeneration repair of esophageal muscularis resection in neo-esophagus. Sixteen pigs were divided into two groups: group A and group B. Pigs in group A were performed with the partial resection of mere esophageal muscularis propria reserved mucosa muscle layer in a segment of thoracic esophagus. Read More

ASAIO J 2019 Jan 24. Epub 2019 Jan 24.

From the Intervention Centre, Oslo University Hospital, Oslo, Norway.

We have recently demonstrated that accelerometer-based pump thrombosis and thromboembolic events detection is feasible in vitro. This article focuses on detection of these conditions in vivo. In an open-chest porcine model (n = 7), an accelerometer was attached to the pump casing of an implanted HeartWare HVAD. Read More