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Balcioglu O, Ozgocmen C, Ozsahin DU, Yagdi T. The Role of Artificial Intelligence and Machine Learning in the Prediction of Right Heart Failure after Left Ventricular Assist Device Implantation: A Comprehensive Review. Diagnostics (Basel) 2024; 14:380. [PMID: 38396419 PMCID: PMC10888030 DOI: 10.3390/diagnostics14040380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
One of the most challenging and prevalent side effects of LVAD implantation is that of right heart failure (RHF) that may develop afterwards. The purpose of this study is to review and highlight recent advances in the uses of AI in evaluating RHF after LVAD implantation. The available literature was scanned using certain key words (artificial intelligence, machine learning, left ventricular assist device, prediction of right heart failure after LVAD) was scanned within Pubmed, Web of Science, and Google Scholar databases. Conventional risk scoring systems were also summarized, with their pros and cons being included in the results section of this study in order to provide a useful contrast with AI-based models. There are certain interesting and innovative ML approaches towards RHF prediction among the studies reviewed as well as more straightforward approaches that identified certain important predictive clinical parameters. Despite their accomplishments, the resulting AUC scores were far from ideal for these methods to be considered fully sufficient. The reasons for this include the low number of studies, standardized data availability, and lack of prospective studies. Another topic briefly discussed in this study is that relating to the ethical and legal considerations of using AI-based systems in healthcare. In the end, we believe that it would be beneficial for clinicians to not ignore these developments despite the current research indicating more time is needed for AI-based prediction models to achieve a better performance.
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Affiliation(s)
- Ozlem Balcioglu
- Department of Cardiovascular Surgery, Faculty of Medicine, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey;
- Operational Research Center in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey;
| | - Cemre Ozgocmen
- Department of Biomedical Engineering, Faculty of Engineering, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey;
| | - Dilber Uzun Ozsahin
- Operational Research Center in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey;
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Tahir Yagdi
- Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, Izmir 35100, Turkey
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Huang J, Mariyappa R, Byrne KR, Clifford SP. Right Ventricular Dysfunction During Left Ventricular Assist Device Implantation: Roles of Anesthesiologists. ASAIO J 2023; 69:915-917. [PMID: 37773148 PMCID: PMC10824595 DOI: 10.1097/mat.0000000000002049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023] Open
Affiliation(s)
- Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Ramesh Mariyappa
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Keith R. Byrne
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Sean P. Clifford
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
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Schurr JW, Sigal I, Usman A, Patel P, Lefebvre B, Kurcik K, Atluri P, Acker M, Bermudez C, Rame JE, Hanff T, Cevasco M, Wald J. Effect of Anesthesia Induction on Cardiac Hemodynamics in Patients Undergoing Durable Left Ventricular Assist Device Implantation: The EACH-LVAD Study. ASAIO J 2023; 69:907-914. [PMID: 37578995 DOI: 10.1097/mat.0000000000002010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Right ventricular (RV) dysfunction is common after left ventricular assist device (LVAD) implantation leading to clinical right heart failure (RHF) associated with worsened survival and quality of life. It is likely that intraoperative events such as anesthesia induction play a role in the development or unmasking of RV dysfunction in addition to known effects from hemodynamic changes that occur after LVAD implantation. The EACH-LVAD Study is a prospective, single-center, single-arm, observational cohort study of adult patients with advanced heart failure undergoing durable LVAD implantation with standard anesthesia induction. Intraoperative RV hemodynamics via central venous pressure, mean pulmonary artery pressure, pulmonary artery pulsatility index, and vasoactive-inotropic score (a simple weighted summation of standardized drug doses) and echocardiographic parameters (RV fractional area change, RV area in diastole, RV basal diameter, septum position, RV function, tricuspid regurgitation) were measured and compared at prespecified timepoints, including postinduction. Postoperative clinical RHF was determined based on published definitions. Forty-two patients receiving a first-time LVAD were included between September 2017 and March 2019. Propofol-based induction was used in 31 patients and etomidate-based induction in eight patients. A significant increase in central venous pressure (CVP; p < 0.001), mean pulmonary artery pressure (mPAP; p < 0.001), and vasoactive inotropic score (VIS; p < 0.001) with associated decrease in pulmonary artery pulsatility index (PAPi; p < 0.001) was observed. Right ventricular function worsened throughout. Right heart failure occurred in 70% of patients. Propofol-based induction was not associated with a higher risk of RHF (relative risk [RR], 1.01 [95% confidence interval {CI}, 0.64-1.61]). The EACH-LVAD study demonstrates an effect of anesthesia induction on worsened RV hemodynamics and echocardiographic changes which may have an effect on the development of RHF.
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Affiliation(s)
- James W Schurr
- From the Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ian Sigal
- From the Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Asad Usman
- Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Prakash Patel
- Department of Anesthesiology, Yale University, New Haven, Connecticut
| | - Benedicte Lefebvre
- Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kristy Kurcik
- Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Pavan Atluri
- Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael Acker
- Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christian Bermudez
- Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - J Eduardo Rame
- Division of Cardiovascular Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Thomas Hanff
- Division of Cardiovascular Medicine, University of Utah Hospital, Salt Lake City, Utah
| | - Marisa Cevasco
- Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joyce Wald
- Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Loforte A. Tricuspid valve repair and mechanical right ventricular support in rescue left ventricular assist device implantations: Still a relevant issue. J Card Surg 2022; 37:1118-1120. [DOI: 10.1111/jocs.16275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Antonio Loforte
- Division of Cardiac Surgery S. Orsola University Hospital, ALMA Mater Studiorum University of Bologna, IRCCS Bologna Bologna Italy
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Veenis JF, Radhoe SP, van Mieghem NM, Manintveld OC, Bekkers JA, Caliskan K, Bogers AJJC, Zijlstra F, Brugts JJ. Safety and feasibility of hemodynamic pulmonary artery pressure monitoring using the CardioMEMS device in LVAD management. J Card Surg 2021; 36:3271-3280. [PMID: 34159641 PMCID: PMC8453715 DOI: 10.1111/jocs.15767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a clinical need for additional remote tools to improve left ventricular assist device (LVAD) patient management. The aim of this pilot concept study was to assess the safety and feasibility of optimizing patient management with add-on remote hemodynamic monitoring using the CardioMEMS in LVAD patients during different treatment stages. METHODS Ten consecutive patients accepted and clinically ready for (semi-) elective HeartMate 3 LVAD surgery were included. All patients received a CardioMEMS to optimize filling pressure before surgery. Patients were categorized into those with normal mean pulmonary artery pressure (mPAP) (≤25 mmHg, n = 4) or elevated mPAP (>25 mmHg, n = 6), and compared to a historical cohort (n = 20). Endpoints were CardioMEMS device safety and a combined endpoint of all-cause mortality, acute kidney injury, renal replacement therapy and/or right ventricular failure at 1-year follow-up. Additionally, we investigated hospital-free survival and improvement in quality of life (QoL) and exercise tolerance. RESULTS No safety issues or signal interferences were observed. The combined endpoint occurred in 60% of historical controls, 0% in normal and 83% in elevated mPAP group. Post-discharge, the hospital-free survival was significantly better, and the QoL improved more in the normal compared to the elevated mPAP group. CONCLUSION Remote hemodynamic monitoring in LVAD patients is safe and feasible with the CardioMEMS, which could be used to identify patients at elevated risk of complications as well as optimize patient management remotely during the out-patient phase with less frequent hospitalizations. Larger pivotal studies are warranted to test the hypothesis generated from this concept study.
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Affiliation(s)
- Jesse F Veenis
- Department of Cardiology, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sumant P Radhoe
- Department of Cardiology, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nicolas M van Mieghem
- Department of Interventional Cardiology, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Olivier C Manintveld
- Department of Cardiology, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jos A Bekkers
- Department of Cardiothoracic Surgery, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Kadir Caliskan
- Department of Cardiology, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Felix Zijlstra
- Department of Interventional Cardiology, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jasper J Brugts
- Department of Cardiology, Erasmus MC, Thorax Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Veenis JF, Radhoe SP, van Mieghem NM, Manintveld OC, Caliskan K, Birim O, Bekkers JA, Boersma E, Lenzen MJ, Zijlstra F, Brugts JJ. Remote hemodynamic guidance before and after left ventricular assist device implantation: short-term results from the HEMO-VAD pilot study. Future Cardiol 2021; 17:885-898. [PMID: 33410726 DOI: 10.2217/fca-2020-0182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Aim: We aimed to assess the safety and feasibility of using CardioMEMS monitoring in patients before and after left ventricular assist device (LVAD) surgery. Patients & methods: Ten patients accepted for elective LVAD surgery were included, received a CardioMEMS at baseline and were categorized based on mean pulmonary artery pressure (mPAP) ≤25 mmHg (n = 4) or mPAP >25 mmHg [n = 6]) before LVAD surgery. Results: The combined end point of all-cause mortality, acute kidney injury and/or renal replacement therapy, and right ventricular failure occurred more often in patients with an mPAP >25 mmHg (83 vs 0%, p = 0.017). Conclusion: This pilot study demonstrates that combining CardioMEMS monitoring with LVAD therapy is safe and generates the hypothesis that patients with an mPAP >25 mmHg before LVAD surgery identify a very high-risk group for adverse clinical outcomes.
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Affiliation(s)
- Jesse F Veenis
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Sumant P Radhoe
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Nicolas M van Mieghem
- Department of Interventional Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Olivier C Manintveld
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Kadir Caliskan
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Ozcan Birim
- Department of Cardiothoracic Surgery, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Jos A Bekkers
- Department of Cardiothoracic Surgery, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Eric Boersma
- Department of Epidemiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Mattie J Lenzen
- Department of Epidemiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Felix Zijlstra
- Department of Interventional Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
| | - Jasper J Brugts
- Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam 3015GD, The Netherlands
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Calculation of the ALMA Risk of Right Ventricular Failure After Left Ventricular Assist Device Implantation. ASAIO J 2019; 64:e140-e147. [PMID: 29746312 DOI: 10.1097/mat.0000000000000800] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88). The final study patients were randomly divided into derivation (79.8%, n = 206) and validation (20.1%, n = 52) cohorts. Fifty-seven preoperative risk factors were compared between patients who were successfully managed with an LVAD and those who required a BVAD. Nineteen variables demonstrated statistical significance on univariable analysis. Multivariable logistic regression analysis identified destination therapy (odds ratio [OR] 2.0 [1.7-3.9], p = 0.003), a pulmonary artery pulsatility index <2 (OR 3.3 [1.7-6.1], p = 0.001), a right ventricle/left ventricle end-diastolic diameter ratio >0.75 (OR 2.7 [1.5-5.5], p = 0.001), an right ventricle stroke work index <300 mm Hg/ml/m (OR 4.3 [2.5-7.3], p < 0.001), and a United Network for Organ Sharing modified Model for End-Stage Liver Disease Excluding INR score >17 (OR 3.5 [1.9-6.9], p < 0.001) as the major predictors of the need for BVAD. Using these data, we propose a simple risk calculator to determine the suitability of patients for isolated LVAD support in the era of continuous-flow mechanical circulatory support devices.
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Aboud A, Liebing K, Abraham C, Reil JC, Turkistani Y, Eitz T, Ensminger S, Gummert J, Morshuis M. Defibrillator-Heart Pump: An Implantable Ventricular Assist Device With Integrated Defibrillator Component-The First In Vitro Testing. Surg Innov 2019; 26:720-724. [PMID: 31354072 DOI: 10.1177/1553350619862994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Left ventricular assist devices (LVADs) are an important therapeutic option for patients with end-stage heart failure waiting for heart transplantation or in older patients as definite therapy for heart failure. Interestingly, about 62% of patients receiving LVADs do not have an automatic implantable cardioverter-defibrillator (AICD) at the time of implantation, although these patients have increased risk of being confronted with dangerous arrhythmia. Therefore, an LVAD system including AICD function is a reasonable alternative for such heart failure patients thereby avoiding a second surgical intervention for AICD implantation. In this article, a newly developed system including LVAD and AICD function is introduced, and we also report its first in vitro testing.
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Affiliation(s)
- Anas Aboud
- University of Schleswig-Holstein, Lübeck Campus, Lübeck, Germany
| | - Kai Liebing
- Friedrich Schiller University, Jena, Germany
| | | | | | | | - Thomas Eitz
- Ruhr-University Bochum, Bad Oeynhausen, Germany
| | | | - Jan Gummert
- Ruhr-University Bochum, Bad Oeynhausen, Germany
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Shimada S, Nawata K, Kinoshita O, Ono M. Mechanical circulatory support for the right ventricle in combination with a left ventricular assist device. Expert Rev Med Devices 2019; 16:663-673. [PMID: 31216915 DOI: 10.1080/17434440.2019.1635006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Right heart failure (RHF) in patients with a left ventricular assist device (LVAD) carries a poor prognosis although the treatment strategy including mechanical circulatory support for the failing right ventricle (RV) has not been well established. Areas covered: In this review, we describe an overview of RHF post-LVAD implant including natural history, prevalence, pathophysiology, outcomes, and challenges to predict RHF post-LVAD implant. Then, we focus on right ventricular assist devices (RVADs) and their clinical outcomes. Recently developed percutaneous RVADs are the major advance in this field. Finally, we discuss future perspectives to overcome limitations of the current treatment options. Expert opinion: In the absence of dedicated RVAD system RHF post-LVAD implant may have been undertreated. Now that dedicated percutaneous RVADs have emerged, surgeons are encouraged to use these new devices to improve outcomes of LVAD therapy. As experience accumulates, we should be able to establish the best possible strategy to treat early RHF post-LVAD implant. Late RHF is another form of RHF post-LVAD implant and has been underappreciated. Further research is mandatory to clarify the mechanism and risk factors. There are still unmet needs for a dedicated implantable RVAD for a subset of patients who need long-term RV support.
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Affiliation(s)
- Shogo Shimada
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
| | - Kan Nawata
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
| | - Osamu Kinoshita
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
| | - Minoru Ono
- a Department of Cardiac Surgery, The University of Tokyo Hospital , Tokyo , Japan
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Approach to Complications of Ventricular Assist Devices: A Clinical Review for the Emergency Provider. J Emerg Med 2019; 56:611-623. [PMID: 31003823 DOI: 10.1016/j.jemermed.2019.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/25/2019] [Accepted: 03/06/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Heart failure is a major public health problem in the United States. Increasingly, patients with advanced heart failure that fail medical therapy are being treated with implanted ventricular assist devices (VADs). OBJECTIVE This review provides an evidence-based summary of the current data for the evaluation and management of implanted VAD complications in an emergency department context. DISCUSSION With a prevalence of >5.8 million individuals and >550,000 new cases diagnosed each year, heart failure is a major public health problem in the United States. Increasingly, patients with advanced heart failure that fail medical therapy are being treated with implanted VADs. As the prevalence of patients with VADs continues to grow, they will sporadically present to the emergency department, regardless of whether the facility is a designated VAD center. As a result, all emergency physicians must be familiar with the basic principles of VAD function, as well as the diagnosis and initial management of VAD-related complications. In this review, we address these topics, with a focus on contemporary third-generation continuous flow VADs. This review will help supplement the critical care skills of emergency physicians in managing this complex patient population. CONCLUSIONS The cornerstone of managing the unstable VAD patient is rapid initiation of high-quality supportive care and recognition of device-related complications, as well as the identification and use of specialist VAD teams and other resources for support. Emergency physicians must understand VADs so that they may optimally manage these complex patients.
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Veenis JF, Manintveld OC, Constantinescu AA, Caliskan K, Birim O, Bekkers JA, van Mieghem NM, den Uil CA, Boersma E, Lenzen MJ, Zijlstra F, Abraham WT, Adamson PB, Brugts JJ. Design and rationale of haemodynamic guidance with CardioMEMS in patients with a left ventricular assist device: the HEMO-VAD pilot study. ESC Heart Fail 2019; 6:194-201. [PMID: 30614639 PMCID: PMC6351888 DOI: 10.1002/ehf2.12392] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/16/2018] [Accepted: 11/05/2018] [Indexed: 12/28/2022] Open
Abstract
AIMS We aim to study the feasibility and clinical value of pulmonary artery pressure monitoring with the CardioMEMS™ device in order to optimize and guide treatment in patients with a HeartMate 3 left ventricular assist device (LVAD). METHODS AND RESULTS In this single-centre, prospective pilot study, we will include 10 consecutive patients with New York Heart Association Class IIIb or IV with Interagency Registry for Mechanically Assisted Circulatory Support Classes 2-5 scheduled for implantation of a HeartMate 3 LVAD. Prior to LVAD implantation, patients will receive a CardioMEMS sensor, for daily pulmonary pressure readings. The haemodynamic information provided by the CardioMEMS will be used to improve haemodynamic status prior to LVAD surgery and optimize the timing of LVAD implantation. Post-LVAD implantation, the haemodynamic changes will be assessed for additive value in detecting potential complications in an earlier stage (bleeding and tamponade). During the outpatient clinic phase, we will assess whether the haemodynamic feedback can optimize pump settings, detect potential complications, and further tailor the clinical management of these patients. CONCLUSIONS The HEMO-VAD study is the first prospective pilot study to explore the safety and feasibility of using CardioMEMS for optimization of LVAD therapy with additional (remote) haemodynamic information.
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Affiliation(s)
- Jesse F Veenis
- Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | | | | | - Kadir Caliskan
- Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | - Ozcan Birim
- Department of Cardiothoracic Surgery, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | - Jos A Bekkers
- Department of Cardiothoracic Surgery, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | | | - Corstiaan A den Uil
- Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands.,Department of Intensive Care Medicine, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | - Mattie J Lenzen
- Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | - Felix Zijlstra
- Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
| | - William T Abraham
- Division of Cardiovascular Medicine, The Ohio State University, Colombus, OH, USA
| | - Philip B Adamson
- Division of Cardiology, Oklahoma Foundation for Cardiovascular Research, Oklahoma City, OK, USA
| | - Jasper J Brugts
- Department of Cardiology, Erasmus MC Thoraxcenter, Rotterdam, The Netherlands
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