1
|
Semenova Y, Shaisultanova S, Beyembetova A, Asanova A, Sailybayeva A, Novikova S, Myrzakhmetova G, Pya Y. Examining a 12-year experience within Kazakhstan's national heart transplantation program. Sci Rep 2024; 14:10291. [PMID: 38704426 PMCID: PMC11069499 DOI: 10.1038/s41598-024-61131-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/02/2024] [Indexed: 05/06/2024] Open
Abstract
Kazakhstan has one of the lowest heart transplantation (HTx) rates globally, but there are no studies evaluating the outcomes of HTx. This study aimed to provide a comprehensive analysis of the national HTx program over a 12-year period (2012-2023). Survival analysis of the national HTx cohort was conducted using life tables, Kaplan‒Meier curves, and Cox regression methods. Time series analysis was applied to analyze historical trends in HTx per million population (pmp) and to make future projections until 2030. The number of patients awaiting HTx in Kazakhstan was evaluated with a regional breakdown. The pmp rates of HTx ranged from 0.06 to 1.08, with no discernible increasing trend. Survival analysis revealed a rapid decrease in the first year after HTx, reaching 77.0% at 379 days, with an overall survival rate of 58.1% at the end of the follow-up period. Among the various factors analyzed, recipient blood levels of creatinine and total bilirubin before surgery, as well as the presence of infection or sepsis and the use of ECMO after surgery, were found to be significant contributors to the survival of HTx patients. There is a need for public health action to improve the HTx programme.
Collapse
Affiliation(s)
- Yuliya Semenova
- School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan.
| | | | - Altynay Beyembetova
- RSE on PCV "Republican Center for Coordination of Transplantation and High-Tech Medical Services" of the Ministry of Health, Astana, 010000, Kazakhstan
| | - Aruzhan Asanova
- Corporate Fund "University Medical Center", Astana, 010000, Kazakhstan
| | - Aliya Sailybayeva
- Corporate Fund "University Medical Center", Astana, 010000, Kazakhstan
| | - Svetlana Novikova
- Corporate Fund "University Medical Center", Astana, 010000, Kazakhstan
| | | | - Yuriy Pya
- Corporate Fund "University Medical Center", Astana, 010000, Kazakhstan
| |
Collapse
|
2
|
Semenova Y, Beyembetova A, Shaisultanova S, Asanova A, Sailybayeva A, Altynova S, Pya Y. Evaluation of liver transplantation services in Kazakhstan from 2012 to 2023. Sci Rep 2024; 14:9304. [PMID: 38654041 DOI: 10.1038/s41598-024-60086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
There is a scarcity of publications evaluating the performance of the national liver transplantation (LTx) program in Kazakhstan. Spanning from 2012 to 2023, it delves into historical trends in LTx surgeries, liver transplant centers, and the national cohort of patients awaiting LTx. Survival analysis for those awaiting LTx, using life tables and Kaplan-Meier, is complemented by time series analysis projecting developments until 2030. The overall per million population (pmp) LTx rate varied from 0.35 to 3.77, predominantly favoring living donor LTx. Liver transplant center rates ranged from 0.06 to 0.40. Of 474 LTx patients, 364 on the waiting list did not receive transplantation. The 30-day and 1-year survival rates on the waiting list were 87.0% and 68.0%, respectively. Viral hepatitis and cirrhosis prevalence steadily rose from 2015 to 2023, with projections indicating a persistent trend until 2030. Absent targeted interventions, stable pmp rates of LTx and liver transplant centers may exacerbate the backlog of unoperated patients. This study sheds light on critical aspects of the LTx landscape in Kazakhstan, emphasizing the urgency of strategic interventions to alleviate the burden on patients awaiting transplantation.
Collapse
Affiliation(s)
- Yuliya Semenova
- School of Medicine, Nazarbayev University, 010000, Astana, Kazakhstan
| | - Altynay Beyembetova
- RSE on PCV "Republican Center for Coordination of Transplantation and High-Tech Medical Services", Ministry of Health, 010000, Astana, Kazakhstan.
| | - Saule Shaisultanova
- RSE on PCV "Republican Center for Coordination of Transplantation and High-Tech Medical Services", Ministry of Health, 010000, Astana, Kazakhstan
| | - Aruzhan Asanova
- Corporate Fund "University Medical Center", 010000, Astana, Kazakhstan
| | - Aliya Sailybayeva
- Corporate Fund "University Medical Center", 010000, Astana, Kazakhstan
| | - Sholpan Altynova
- Corporate Fund "University Medical Center", 010000, Astana, Kazakhstan
| | - Yuriy Pya
- Corporate Fund "University Medical Center", 010000, Astana, Kazakhstan
| |
Collapse
|
3
|
Nurmykhametova Z, Lesbekov T, Kaliyev R, Bekishev B, Jabayeva N, Novikova S, Faizov L, Vakhrushev I, Pya Y. Preliminary report of extracorporeal blood purification therapy in patients receiving LVAD: Cytosorb or Jafron HA330. J Extra Corpor Technol 2024; 56:10-15. [PMID: 38488713 PMCID: PMC10941830 DOI: 10.1051/ject/2023048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/09/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND Left ventricular assist device (LVAD) candidates are at increased risk of immune dysregulation and infectious complications. To attenuate the elevated proinflammatory cytokine levels and associated adverse clinical outcomes, it has been postulated that extracorporeal blood purification could improve the overall survival rate and morbidity of patients undergoing LVAD implantation. METHODS We retrospectively reviewed prospectively collected data of 15 patients who underwent LVAD implantation at our center between January 2021 and March 2022. Of these, 15 (100%) who received HeartMate 3™ (St. Jude Medical, Abbott, MN, USA) device were eligible. Intraoperatively, patients were single randomized 1:1:1 to three groups: group 1, patients who received Cytosorb therapy (n = 5; installed in the CPB circuit); group 2, patients who received Jafron HA330 (n = 5; installed in the CPB circuit); and control group 3, patients who did not receive filter (n = 5; usual care, neither Cytosorb nor Jafron during CPB). Baseline patient characteristics and intraoperative data were compared between the groups. Blood sample analyses were performed to assess the levels of inflammatory markers (IL-1, 6, 8; CRP, Leukocyte, Lactate, PCT, NT-proBNP, TNF-α) in both preoperative and postoperative data. RESULTS Baseline patient characteristics were similar in all three groups. We found that IL1α; IL 6; IL8; Lactatedehydrogenase, PCT, pro-BNP, CRP; Leukocyte, and TNFα levels significantly increased with LVAD implantation and that neither Cytosorb nor Jafron influenced this response. In-hospital mortality and overall survival during follow-up were similar among the groups. CONCLUSION Our preliminary results showed that hemoadsorption therapy using Cytosorb or Jafron hemoadsorption (HA) 330 may not be clinically beneficial for patients with advanced heart failure undergoing LVAD implantation. Large prospective studies are needed to evaluate the potential role of HA therapy in improving outcomes in patients undergoing LVAD implantation.
Collapse
Affiliation(s)
- Zhuldyz Nurmykhametova
-
Department of Perfusiology and Assisted Circulation Laboratory, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Timur Lesbekov
-
Department of Adult Cardiac Surgery, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Rymbay Kaliyev
-
Department of Perfusiology and Assisted Circulation Laboratory, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Bolat Bekishev
-
Department of Anesthesiology and Intensive Care, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Nilufar Jabayeva
-
Department of Anesthesiology and Intensive Care, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Svetlana Novikova
-
Department of Adult Cardiac Surgery, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Linar Faizov
-
Department of Perfusiology and Assisted Circulation Laboratory, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Ivan Vakhrushev
-
Department of Anesthesiology and Intensive Care, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| | - Yuriy Pya
-
Department of Adult Cardiac Surgery, National Research Cardiac Surgery Center Astana 010000 Kazakhstan
| |
Collapse
|
4
|
Schmitto JD, Shaw S, Garbade J, Gustafsson F, Morshuis M, Zimpfer D, Lavee J, Pya Y, Berchtold-Herz M, Wang A, Gazzola C, Potapov E, Saeed D. Fully magnetically centrifugal left ventricular assist device and long-term outcomes: the ELEVATE registry. Eur Heart J 2024; 45:613-625. [PMID: 38036414 PMCID: PMC10959573 DOI: 10.1093/eurheartj/ehad658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 07/06/2023] [Accepted: 08/17/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND AND AIMS HeartMate 3 (HM3) is a fully magnetically levitated continuous flow left ventricular assist device, which received CE marking in 2015. The ELEVATE Registry was initiated to collect real-world outcomes in patients treated with HM3 post-CE Mark approval. METHODS A total of 540 subjects implanted at 26 centres between March 2015 and February 2017 were included in this registry. Of these, 463 received the device as a primary implant (primary implant cohort, PIC), 19 as a pump exchange (pump exchange cohort), and in 58 patients, only anonymized survival data were collected (anonymized cohort, AC). Patients in the PIC contributed to the baseline demographics, survival, adverse events, quality of life (QoL) (EuroQoL-5 Dimensions-5 Levels visual analogue scale), and functional capacity (6 min walk distance) assessments, while patients in the AC contributed only to survival. RESULTS Primary implant cohort patients had a mean age of 56 years and were predominantly male (89%) with 48% ischaemic aetiology. The majority of subjects was designated bridge to transplant (66%) and had INTERMACS Profiles 1-3 (70%). At baseline, the subjects had poor functional capacity (104 ± 140 m) and impaired QoL (35 ± 19 points). The overall survival rate of the PIC was 63.3% and survival free of stroke was 58.1% at 5 years. Significant improvements in functional capacity and QoL were observed and maintained for 5 years (301 ± 131 m and 64 ± 20 points, respectively). CONCLUSIONS Real-world data from the ELEVATE registry demonstrate an overall survival rate for primary implants of 63.3%. In the PIC, reductions in adverse events for patients in the extended follow-up and improved QoL and functional capacity were observed at 5 years in this patient population with advanced heart failure.
Collapse
Affiliation(s)
- Jan D Schmitto
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, OE 6210, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Steven Shaw
- The Transplant Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | - Jens Garbade
- Department of Cardiothoracic Surgery, Klinikum Links der Weser, Bremen, Germany
| | - Finn Gustafsson
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Michiel Morshuis
- Department of Cardiothoracic Surgery, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
| | - Daniel Zimpfer
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Jacob Lavee
- Heart Transplantation Unit, Leviev Heart Center, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuriy Pya
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | | | | | | | | | - Diyar Saeed
- Department for Cardiac Surgery, Heart Center, Leipzig, Germany
| |
Collapse
|
5
|
Mehra MR, Netuka I, Uriel N, Katz JN, Pagani FD, Jorde UP, Gustafsson F, Connors JM, Ivak P, Cowger J, Ransom J, Bansal A, Takeda K, Agarwal R, Byku M, Givertz MM, Bitar A, Hall S, Zimpfer D, Vega JD, Kanwar MK, Saeed O, Goldstein DJ, Cogswell R, Sheikh FH, Danter M, Pya Y, Phancao A, Henderson J, Crandall DL, Sundareswaran K, Soltesz E, Estep JD. Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial. JAMA 2023; 330:2171-2181. [PMID: 37950897 PMCID: PMC10640705 DOI: 10.1001/jama.2023.23204] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/24/2023] [Indexed: 11/13/2023]
Abstract
IMPORTANCE Left ventricular assist devices (LVADs) enhance quality and duration of life in advanced heart failure. The burden of nonsurgical bleeding events is a leading morbidity. Aspirin as an antiplatelet agent is mandated along with vitamin K antagonists (VKAs) with continuous-flow LVADs without conclusive evidence of efficacy and safety. OBJECTIVE To determine whether excluding aspirin as part of the antithrombotic regimen with a fully magnetically levitated LVAD is safe and decreases bleeding. DESIGN, SETTING, and PARTICIPANTS This international, randomized, double-blind, placebo-controlled study of aspirin (100 mg/d) vs placebo with VKA therapy in patients with advanced heart failure with an LVAD was conducted across 51 centers with expertise in treating patients with advanced heart failure across 9 countries. The randomized population included 628 patients with advanced heart failure implanted with a fully magnetically levitated LVAD (314 in the placebo group and 314 in the aspirin group), of whom 296 patients in the placebo group and 293 in the aspirin group were in the primary analysis population, which informed the primary end point analysis. The study enrolled patients from July 2020 to September 2022; median follow-up was 14 months. Intervention Patients were randomized in a 1:1 ratio to receive aspirin (100 mg/d) or placebo in addition to an antithrombotic regimen. MAIN OUTCOMES AND MEASURES The composite primary end point, assessed for noninferiority (-10% margin) of placebo, was survival free of a major nonsurgical (>14 days after implant) hemocompatibility-related adverse events (including stroke, pump thrombosis, major bleeding, or arterial peripheral thromboembolism) at 12 months. The principal secondary end point was nonsurgical bleeding events. RESULTS Of the 589 analyzed patients, 77% were men; one-third were Black and 61% were White. More patients were alive and free of hemocompatibility events at 12 months in the placebo group (74%) vs those taking aspirin (68%). Noninferiority of placebo was demonstrated (absolute between-group difference, 6.0% improvement in event-free survival with placebo [lower 1-sided 97.5% CI, -1.6%]; P < .001). Aspirin avoidance was associated with reduced nonsurgical bleeding events (relative risk, 0.66 [95% confidence limit, 0.51-0.85]; P = .002) with no increase in stroke or other thromboembolic events, a finding consistent among diverse subgroups of patient characteristics. CONCLUSIONS AND RELEVANCE In patients with advanced heart failure treated with a fully magnetically levitated LVAD, avoidance of aspirin as part of an antithrombotic regimen, which includes VKA, is not inferior to a regimen containing aspirin, does not increase thromboembolism risk, and is associated with a reduction in bleeding events. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04069156.
Collapse
Affiliation(s)
- Mandeep R. Mehra
- Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ivan Netuka
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Nir Uriel
- Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York
| | - Jason N. Katz
- Duke University Medical Center, Durham, North Carolina
| | | | - Ulrich P. Jorde
- Montefiore Einstein Center for Heart and Vascular Care, New York, New York
| | - Finn Gustafsson
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jean M. Connors
- Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter Ivak
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - John Ransom
- Baptist Health Medical Center, Little Rock, Arkansas
| | | | - Koji Takeda
- Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York
| | - Richa Agarwal
- Duke University Medical Center, Durham, North Carolina
| | - Mirnela Byku
- University of North Carolina at Chapel Hill, Chapel Hill
| | - Michael M. Givertz
- Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | | - Omar Saeed
- Montefiore Einstein Center for Heart and Vascular Care, New York, New York
| | | | | | | | | | - Yuriy Pya
- National Research Center for Cardiac Surgery, Kazakhstan
| | - Anita Phancao
- Miami Transplant Institute—Jackson Memorial, Miami, Florida
| | | | | | | | | | | |
Collapse
|
6
|
Mussayev A, Alimbayev S, Tanaliev N, Kuanyshbek A, Marat A, Lesbekov T, Raissov Y, Sadykova A, Kamila AK, Mukarov M, Pya Y. Case report: Transcatheter tricuspid valve-in-valve implantation using novel balloon-expandable aortic valve with 1 year follow-up. Front Cardiovasc Med 2023; 10:1152280. [PMID: 37485262 PMCID: PMC10361752 DOI: 10.3389/fcvm.2023.1152280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Generally, the dysfunction or failure of bioprosthetic heart valves (BHVs) is managed by replacement surgery. In the case of tricuspid valve dysfunction, re-do surgery is rarely attempted because of the critically high risk of developing pulmonary hypertension, pulmonary embolism, and intraoperative mortality. Hence, transcatheter tricuspid repair and replacement procedures are preferred. More recently, transcatheter valve-in-valve (ViV) treatments have gained importance because of their less invasiveness, especially for patients with prior surgeries. Encouraging evidence of the safety and effectiveness of a novel balloon-expandable (BE) transcatheter heart valve (THV)-the Myval THV-has been reported for ViV procedures. Here, we present a case-series of 5 patients, in whom tricuspid ViV procedure was performed using BE Myval THV, implanted supra-annularly by anchoring onto the deteriorated BHV. This case-series details the procedural steps to prevent in-hospital adverse events and early (30-day) mortality and the challenges during tricuspid ViV interventions.
Collapse
Affiliation(s)
- Abdurashid Mussayev
- Head of Cathlab, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Serik Alimbayev
- Head of Structural Heart Diseases, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Nursultan Tanaliev
- Department of Interventional Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Aidyn Kuanyshbek
- Head of the Department of Anesthesiology, Resuscitation and Intensive Care, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Aripov Marat
- Head of Department of Interventional Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Timur Lesbekov
- Head of the Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Yerkezhan Raissov
- Resident of Interventional Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Aigerim Sadykova
- Chief Nurse of Cathlab, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Askarovna Kenzhebayeva Kamila
- Clinical Cardiologist, Central Hospital with a Polyclinic of the Ministry of Internal Affairs, Astana, Republic of Kazakhstan
| | - Murat Mukarov
- Head of the Department of Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Yuriy Pya
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| |
Collapse
|
7
|
Pya Y, Mussayev A, Novikova S, Bekbossynova M, Alimbayev S, Khissamutdinov N, Kapyshev T, Kuanyshbek A, Lesbekov T. Case report: A novel surgical technique for rapid valve-in-ring implantation into the native aortic annulus during left ventricular assist device implantation. Front Cardiovasc Med 2023; 10:1091420. [PMID: 37089890 PMCID: PMC10117784 DOI: 10.3389/fcvm.2023.1091420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/17/2023] [Indexed: 04/08/2023] Open
Abstract
The implantation of a left ventricular assist device (LVAD) has become an essential requirement for managing patients with end-stage heart failure. However, aortic valve insufficiency is a contraindication for LVAD implantation in patients with end-stage heart failure, partly because of the decreasing efficiency of mechanical circulatory support and the eventual development of right ventricular failure. Herein, we present the first case of performing transcatheter aortic valve replacement in valve-in-ring along with LVAD implantation for the treatment of a 60-year-old male suffering from refractory heart failure due to dilated cardiomyopathy and pure aortic insufficiency in need of a new aortic bioprosthesis. A balloon-expandable bioprosthetic transcatheter heart valve was implanted into a previously sewn annulus ring into the aortic root via transaortic access. Subsequently, a centrifugal-flow LVAD was implanted. Postoperatively, the patient was in New York Heart Association Functional Class (NYHA) II with 6-min walk test of 310 m. The patient has completed 6 months of follow-up with no events. This novel and feasible surgical technique reduced the cardiopulmonary bypass time and duration of surgery. Furthermore, it avoids the risk of redo sternotomy and decreases the chances of paravalvular leakage and worsening of aortic regurgitation.
Collapse
Affiliation(s)
- Yuriy Pya
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Abdurashid Mussayev
- Department of Interventional Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Svetlana Novikova
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | | | - Serik Alimbayev
- Department of Interventional Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Nail Khissamutdinov
- Department of Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Timur Kapyshev
- Department of Anesthesiology, Resuscitation and Intensive Care(Adult), Astana, Kazakhstan
| | - Aidyn Kuanyshbek
- Department of Anesthesiology, Resuscitation and Intensive Care(Adult), Astana, Kazakhstan
| | - Timur Lesbekov
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| |
Collapse
|
8
|
Lesbekov T, Nurmykhametova Z, Kaliyev R, Kuanyshbek A, Faizov L, Bekishev B, Jabayeva N, Samalavicius R, Pya Y. Hemadsorption in patients requiring V-A ECMO support: Comparison of Cytosorb versus Jafron HA330. Artif Organs 2023; 47:721-730. [PMID: 36398369 DOI: 10.1111/aor.14457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/13/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND ECMO support is associated with the development of a systemic hyper-inflammatory response, which may become quite significant and extreme in some cases. We hypothesize that Cytosorb or Jafron therapy may benefit patients on V-A ECMO in terms of levels of inflammatory markers such as IL-6, complications, and overall outcomes. METHODS We conducted a retrospective study of prospectively collected data in a single tertiary care center between January 2021 and April 2022. At the time of the analysis of this article, 20 patients on V-A ECMO had cytokine adsorption while on ECMO support: Cytosorb group (n = 10), Jafron group (n = 10). In 10 ECMO-supported patients cytokine adsorption was not used, this group served as a control group, which may be quite significant in some cases. Evaluation of the level of inflammatory markers (IL-1, 6, 8; CRP, Leukocyte, Lactate, PCT, NT-proBNP, TNF-α) was performed. RESULTS There was statistically significant longer CPB time, aortic cross-clamp time and ICU stay in cytokine adsorption groups than in the control group, but there were no differences between subgroups with different types of haemoadsorption used. Moreover, in the control group mortality rate was higher than in the cytokine adsorption groups (60% vs. 20%, p = 0.02). All patients had an elevation of inflammatory markers in the perioperative and immediate postoperative periods. After 72 h of intensive care, blood inflammation markers had a tendency to decline. CONCLUSION At the time of writing, hemadsorption in patients requiring V-A ECMO support represents a good therapeutic effect. This effect is permanent for the whole period of extracorporeal cytokine hemadsorption application for both CytoSorb and Jafron HA330 devices.
Collapse
Affiliation(s)
- Timur Lesbekov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | | | - Rymbay Kaliyev
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Aidyn Kuanyshbek
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Linar Faizov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Bolat Bekishev
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Nilufar Jabayeva
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | | | - Yuriy Pya
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| |
Collapse
|
9
|
Cornwell W, Hayward C, Jansz P, Strueber M, Zimpfer D, Cowger J, Kanwar M, Banayosy AE, Leprince P, Gustafsson F, Tsui S, Pya Y, Snyder T. Pre-Clinical Development & Testing of the CorWave Membrane LVAD. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
10
|
Cowger J, Cornwell W, Hayward C, Jansz P, Strueber M, Zimpfer D, Pya Y, Kanwar M, Banayosy AE, Leprince P, Gustafsson F, Tsui S, Snyder T. Rethinking Early Clinical Trials: Design of the CorWave LVAD Feasibility Trial. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
11
|
Lesbekov T, Kaliyev R, Nurmykhametova Z, Faizov L, Medressova A, Aripov M, Tanaliyev N, Zuparov E, Iskakova A, Pya Y. Ex-situ Normothermic ECMO Technology with Continuous Perfusate Hemofiltration for Organ Management. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
12
|
Lesbekov T, Nurmykhametova Z, Kaliyev R, Faizov L, Medressova A, Aripov M, Zuparov E, Kaliyev B, Pya Y. Beating heart and breathing lungs in the box: future of transplant and beyond. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-2926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Timur Lesbekov
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Zhuldyz Nurmykhametova
- Department of Operating Room with Mechanical Circulatory Support, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Rymbay Kaliyev
- Department of Operating Room with Mechanical Circulatory Support, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Linar Faizov
- Department of Operating Room with Mechanical Circulatory Support, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Assel Medressova
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Marat Aripov
- Department of Cardiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Eric Zuparov
- Department of Anesthesiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Baurzhan Kaliyev
- Department of Radiology, National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Yuriy Pya
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Astana, Kazakhstan
| |
Collapse
|
13
|
Kaliyev R, Lesbekov T, Bekbossynova M, Nurmykhametova Z, Medressova A, Kuanyshbek A, Faizov L, Samalavicius R, Pya Y. Successful Heart Transplantation After 7 h of Cold Storage and Paracorporeal Donor Heart Resuscitation. Transpl Int 2022; 35:10740. [PMID: 36300037 PMCID: PMC9588809 DOI: 10.3389/ti.2022.10740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Rymbay Kaliyev
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Timur Lesbekov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | | | - Zhuldyz Nurmykhametova
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
- *Correspondence: Zhuldyz Nurmykhametova,
| | - Assel Medressova
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Aidyn Kuanyshbek
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Linar Faizov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | | | - Yuriy Pya
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| |
Collapse
|
14
|
Loforte A, de By T, Gliozzi G, Schoenrath F, Cavalli G, Netuka I, Pya Y, Zimpfer D, Boschi S, Gummert J, Meyns B, Pacini D, Potapov E. Impact of Concomitant Cardiac Valvular Surgery During Implantation of Continuous-Flow Left Ventricular Assist Devices: A European Registry for Patients with Mechanical Circulatory Support (EUROMACS) Analysis. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
15
|
Pya Y, Bekbossynova M, Gaipov A, Lesbekov T, Kapyshev T, Kuanyshbek A, Tauekelova A, Litvinova L, Sailybayeva A, Vakhrushev I, Sarria-Santamera A. Mortality predictors of hospitalized patients with COVID-19: Retrospective cohort study from Nur-Sultan, Kazakhstan. PLoS One 2021; 16:e0261272. [PMID: 34936681 PMCID: PMC8694457 DOI: 10.1371/journal.pone.0261272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/25/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND First reported case of Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in Kazakhstan was identified in March 2020. Many specialized tertiary hospitals in Kazakhstan including National Research Cardiac Surgery Center (NRCSC) were re-organized to accept coronavirus disease 2019 (COVID-19) infected patients during summer months of 2020. Although many studies from worldwide reported their experience in treating patients with COVID-19, there are limited data available from the Central Asia countries. The aim of this study is to identify predictors of mortality associated with COVID-19 in NRCSC tertiary hospital in Nur-Sultan, Kazakhstan. METHODS This is a retrospective cohort study of patients admitted to the NRCSC between June 1st-August 31st 2020 with COVID-19. Demographic, clinical and laboratory data were collected from electronic records. In-hospital mortality was assessed as an outcome. Patients were followed-up until in-hospital death or discharge from the hospital. Descriptive statistics and factors associated with mortality were assessed using univariate and multivariate logistic regression models. RESULTS Two hundred thirty-nine admissions were recorded during the follow-up period. Mean age was 57 years and 61% were males. Median duration of stay at the hospital was 8 days and 34 (14%) patients died during the hospitalization. Non-survivors were more likely to be admitted later from the disease onset, with higher fever, lower oxygen saturation and increased respiratory rate compared to survivors. Leukocytosis, lymphopenia, anemia, elevated liver and kidney function tests, hypoproteinemia, elevated inflammatory markers (C-reactive protein (CRP), ferritin, and lactate dehydrogenase (LDH)) and coagulation tests (fibrinogen, D-dimer, international normalized ratio (INR), and activated partial thromboplastin time (aPTT)) at admission were associated with mortality. Age (OR 1.2, CI:1.01-1.43), respiratory rate (OR 1.38, CI: 1.07-1.77), and CRP (OR 1.39, CI: 1.04-1.87) were determined to be independent predictors of mortality. CONCLUSION This study describes 14% mortality rate from COVID-19 in the tertiary hospital. Many abnormal clinical and laboratory variables at admission were associated with poor outcome. Age, respiratory rate and CRP were found to be independent predictors of mortality. Our finding would help healthcare providers to predict the risk factors associated with high risk of mortality. Further investigations involving large cohorts should be provided to support our findings.
Collapse
Affiliation(s)
- Yuriy Pya
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Makhabbat Bekbossynova
- Department of Cardiology, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Abduzhappar Gaipov
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Timur Lesbekov
- Department of Cardiac Surgery, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Timur Kapyshev
- Center of Excellence, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Aidyn Kuanyshbek
- Department of Anesthesiology, Reanimation and Intensive Care Unit, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Ainur Tauekelova
- Department of Cardiology, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Liya Litvinova
- Quality and Risk Management Department, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Aliya Sailybayeva
- Research Department, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Ivan Vakhrushev
- Department of Anesthesiology, Reanimation and Intensive Care Unit, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | | |
Collapse
|
16
|
Loforte A, de By TMMH, Gliozzi G, Schönrath F, Mariani C, Netuka I, Pya Y, Zimpfer D, Cavalli GG, Gummert J, Meyns B, Pacini D, Potapov E. Impact of concomitant cardiac valvular surgery during implantation of continuous-flow left ventricular assist devices: A European registry for patients with mechanical circulatory support (EUROMACS) analysis. Artif Organs 2021; 46:813-826. [PMID: 34904255 DOI: 10.1111/aor.14143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/22/2021] [Accepted: 12/08/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND We investigated the clinical outcomes after cardiac valvular surgery procedures concomitant (CCPs) with left ventricular assist device (LVAD) implantation compared to propensity score (PS) matched controls using the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) data. METHODS Between 2006 and 2018, 2760 continuous-flow LVAD patients were identified. Of these, 533 underwent a CCP during the LVAD implant. RESULTS Cardiopulmonary bypass time (p < 0.001) and time for implant (p < 0.001) were both significantly longer in the LVAD+CCP group. Hospital mortality was comparable between the two groups from the unmatched population (15.7% vs. 14.1%, p = 0.073). Similarly, short-to-mid-term survival was similar in both groups, with 1-year, 3-year, and 5-year survival rates of 67.9%, 48.2%, and 27.7% versus 66.4%, 46.1%, and 26%, respectively (log-rank, p = 0.25). The results were similar in the PS-matched population. Hospital mortality was comparable between the two groups (18.9% vs. 17.4%, p = 0.074). The short-to-mid-term Kaplan-Meier survival analysis was similar for both groups, with 1-year, 3-year, and 5-year survival rates of 63.4%, 49.2%, and 24.7% versus 66.5%, 46%, and 25.1%, respectively (log-rank, p = 0.81). In the unmatched population, LVAD+CCP patients had longer intensive care unit (ICU) stays (p < 0.0001), longer mechanical ventilation time (p = 0.001), a higher rate of temporary right ventricular assist device (RVAD) support (p = 0.033), and a higher rate of renal replacement therapy (n = 35, 6.6% vs. n = 89, 4.0%, p = 0.014). In the PS-matched population, the LVAD+CCP patients had longer ICU stays (p = 0.019) and longer mechanical ventilation time (p = 0.002). CONCLUSIONS The effect of additive valvular procedures (CCPs) does not seem to affect short-term survival, significantly, based on our registry data analysis. However, the decision to perform CCPs should be balanced with the projected type of surgery and preoperative characteristics. LVAD+CCP patients remain a delicate population and adverse device-related events should be strictly monitored and managed.
Collapse
Affiliation(s)
- Antonio Loforte
- Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, Bologna, Italy
| | | | - Gregorio Gliozzi
- Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, Bologna, Italy
| | | | - Carlo Mariani
- Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, Bologna, Italy
| | - Ivan Netuka
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Astana Kazakhstan, Kazakhstan
| | | | - Giulio Giovanni Cavalli
- Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, Bologna, Italy
| | - Jan Gummert
- Heart and Diabetes Center North-Rhine Westphalia, Ruhr-Un, Bad Oeynhausen, Germany
| | - Bart Meyns
- Katholieke Universiteit Leuven, Leuven, Belgium
| | - Davide Pacini
- Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, Bologna, Italy
| | | | | |
Collapse
|
17
|
Netuka I, Pya Y, Poitier B, Ivak P, Konarik M, Perlès JC, Blažejová Z, Riha H, Bekbossynova M, Medressova A, Bousquet F, Latrémouille C, Jansen P. First Clinical Experience With the Pressure Sensor-Based Autoregulation of Blood Flow in an Artificial Heart. ASAIO J 2021; 67:1100-1108. [PMID: 34138778 PMCID: PMC8478302 DOI: 10.1097/mat.0000000000001485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The CARMAT-Total Artificial Heart (C-TAH) is designed to provide heart replacement therapy for patients with end-stage biventricular failure. This report details the reliability and efficacy of the autoregulation device control mechanism (auto-mode), designed to mimic normal physiologic responses to changing patient needs. Hemodynamic data from a continuous cohort of 10 patients implanted with the device, recorded over 1,842 support days in auto-mode, were analyzed with respect to daily changing physiologic needs. The C-TAH uses embedded pressure sensors to regulate the pump output. Right and left ventricular outputs are automatically balanced. The operator sets target values and the inbuilt algorithm adjusts the stroke volume and beat rate, and hence cardiac output, automatically. Auto-mode is set perioperatively after initial postcardiopulmonary bypass hemodynamic stabilization. All patients showed a range of average inflow pressures of between 5 and 20 mm Hg during their daily activities, resulting in cardiac output responses of between 4.3 and 7.3 L/min. Operator adjustments were cumulatively only required on 20 occasions. This report demonstrates that the C-TAH auto-mode effectively produces appropriate physiologic responses reflective of changing patients' daily needs and represents one of the unique characteristics of this device in providing almost physiologic heart replacement therapy.
Collapse
Affiliation(s)
- Ivan Netuka
- From the Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Yuriy Pya
- National Research Cardiac Surgery Center (NRCSC), Nur-Sultan (Astana), Kazakhstan
| | | | - Peter Ivak
- From the Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Miroslav Konarik
- From the Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jean-Christophe Perlès
- Carmat SA, Vélizy, France; and ¶Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Zuzana Blažejová
- From the Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Hynek Riha
- From the Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Makhabbat Bekbossynova
- From the Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Assel Medressova
- From the Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Fabien Bousquet
- Carmat SA, Vélizy, France; and ¶Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - Piet Jansen
- Carmat SA, Vélizy, France; and ¶Department of Anesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| |
Collapse
|
18
|
Pya Y, Medressova A, Faizov L, Kuanyshbek A, Kaliyev R, Myrzakhmetova G, Fleur PL. Response to the manuscript "ex vivo donor heart preservation in heart transplantation (HTx)-Is this the solution to increase the donor pool?". J Card Surg 2021; 36:4837-4838. [PMID: 34499393 DOI: 10.1111/jocs.15975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 08/28/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Yuriy Pya
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Assel Medressova
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Linar Faizov
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Aidyn Kuanyshbek
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Rymbai Kaliyev
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | | | - Philip la Fleur
- Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| |
Collapse
|
19
|
Schmitto JD, Mariani S, Li T, Dogan G, Hanke JS, Bara C, Pya Y, Zimpfer D, Krabatsch T, Garbade J, Rao V, Morshuis M, Beyersdorf F, Marasco S, Netuka I, Bauersachs J, Haverich A. Five-year outcomes of patients supported with HeartMate 3: a single-centre experience. Eur J Cardiothorac Surg 2021; 59:1155-1163. [PMID: 33585913 DOI: 10.1093/ejcts/ezab018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The HeartMate 3 left ventricular assist device was first implanted in 2014 and received the Conformité Européenne mark in 2015. Since then, several trials demonstrated its high haemocompatibility associated with good survival and low adverse events rates. Herein, we report our institutional experience with patients supported with HeartMate 3 for 5 years. METHODS This prospective cohort study included patients receiving a HeartMate 3 implantation in 2014 as part of the HeartMate 3 Conformité Européenne Mark clinical trial. Patients had follow-up visits every 3 months while on left ventricular assist device support, and all patients completed the 5-year follow-up. The primary end point was survival at 5 years. Secondary end points included adverse events, health status and quality of life. RESULTS Eight patients (men: 75%) aged 59 years (min-max: 52-66 years) were enrolled. At 5 years, survival was 100%. Patients remained on support for a median time of 1825 days (min-max: 101-1825 days); 2 patients successfully received cardiac transplants. No right heart failure, haemolysis, pump thrombosis, pump malfunction or neurological events occurred in any patients. A driveline infection was observed in 6 patients (0.25 events/patient-year). Compared to baseline, a significant improvement in quality of life and in New York Heart Association functional class was noted after the implant and for the whole follow-up time. A slight decline in kidney function and in the 6-min walk test results occurred after 3 years. CONCLUSIONS This study reports the longest single-centre follow-up of the HeartMate 3, showing excellent haemocompatibility over time with high survival and low complication rates at 5 years.
Collapse
Affiliation(s)
- Jan D Schmitto
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Silvia Mariani
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Tong Li
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Guenes Dogan
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Jasmin S Hanke
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Christoph Bara
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Daniel Zimpfer
- Division of Cardiac Surgery, Department of Surgery, Medical University Vienna, Vienna, Austria
| | - Thomas Krabatsch
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Jens Garbade
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Vivek Rao
- Department of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, ON, Canada
| | - Michiel Morshuis
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center, Bad Oeynhausen, Germany
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, University Heart Center Freiburg, and Medical Faculty of the Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Silvana Marasco
- Department of Cardiothoracic Surgery and Transplantation, The Alfred Hospital and Monash University, Melbourne, Australia
| | - Ivan Netuka
- Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Axel Haverich
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
20
|
Zimpfer D, Gustafsson F, Potapov E, Pya Y, Schmitto J, Berchtold-Herz M, Morshuis M, Shaw SM, Saeed D, Lavee J, Heatley G, Gazzola C, Garbade J. Two-year outcome after implantation of a full magnetically levitated left ventricular assist device: results from the ELEVATE Registry. Eur Heart J 2021; 41:3801-3809. [PMID: 33107561 DOI: 10.1093/eurheartj/ehaa639] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/26/2020] [Accepted: 07/27/2020] [Indexed: 12/28/2022] Open
Abstract
AIMS The ELEVATE Registry was designed to study long-term outcomes with the Heartmate 3 (HM3), a fully magnetically levitated centrifugal ventricular assist device, in a real-world population following CE-mark approval. METHODS AND RESULTS A total of 540 patients, implanted in Europe and the Middle East were followed in ELEVATE. The registry included 463 patients receiving the HM3 as primary implant (Primary Implant Cohort), 19 patients underwent a pump upgrade from another device (Pump Exchange Cohort) and 58 patients who had experienced an outcome before having the possibility to sign the Informed Consent, for which only outcome data were collected (Anonymized Cohort). Data collection included demographics, survival, adverse events, EQ-5D Visual Analog Score quality of life (EQ-5D VAS QOL) questionnaire, and 6-min walk distance (6MWD). Mean age was 55.6 ± 11.7 years (89% male, 48% ischaemic cardiomyopathy). Seventy per cent of patients were in INTERMACS Profile 1-3 and 12.7% were on temporary mechanical circulatory support. Primary Implant Cohort survival was 83% after 2 years. In the Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Primary Implant Cohort, strokes were observed in 10.2%, gastrointestinal bleedings in 9.7%, pump thrombosis in 1.5%, and outflow graft twists in 3.5%. Heartmate 3 implantation resulted in a significant and sustained improvement of functional capacity and QOL. CONCLUSION In a real-world population, cohort implanted with the HM3 left ventricular assist device we demonstrate good long-term survival, sustained improvement of functional capacity, and low rates of adverse events (including pump thrombosis). CLINICALTRIALS.GOV IDENTIFIER NCT02497950.
Collapse
Affiliation(s)
- Daniel Zimpfer
- Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel, 18-20 A-1090 Vienna, Austria
| | - Finn Gustafsson
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Yuriy Pya
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | | | | | - Michiel Morshuis
- Department of Cardiothoracic Surgery, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
| | - Steven M Shaw
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Diyar Saeed
- Cardiovascular Surgery, University Hospital of Dusseldorf, Dusseldorf, Germany
| | - Jacob Lavee
- Heart Transplantation Unit, Leviev Heart Center, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Jens Garbade
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| |
Collapse
|
21
|
Pya Y, Abdiorazova A. Elimination of drive exit line: transcutaneous energy transmission. Ann Cardiothorac Surg 2021; 10:393-395. [PMID: 34159122 DOI: 10.21037/acs-2020-cfmcs-200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Yuriy Pya
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan.,University Medical Center, Nur-Sultan, Kazakhstan
| | - Aigerim Abdiorazova
- Patient Relations Department, National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| |
Collapse
|
22
|
Medressova A, Faizov L, Kuanyshbek A, Kaliyev R, Myrzakhmetova G, la Fleur P, Pya Y. Successful heart transplantation after 17 h ex vivo time using the Organ Care System-3 years follow-up. J Card Surg 2021; 36:2592-2595. [PMID: 33783046 DOI: 10.1111/jocs.15519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 11/26/2022]
Abstract
Cold storage preservation is the standard approach for heart transplantation but is a time-limited method of care. Ex vivo heart perfusion expands the donor pool due by mitigating time and distance barriers and allows the possibility to improve graft function. We report long term follow up of a successful heart transplantation following an ex vivo time of 17 h using the Organ Care System in a patient with a left ventricular assist device.
Collapse
Affiliation(s)
- Assel Medressova
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Linar Faizov
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Aidyn Kuanyshbek
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | - Rymbai Kaliyev
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| | | | - Philip la Fleur
- Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
| |
Collapse
|
23
|
Netuka I, Pya Y, Zimpfer D, Potapov E, Garbade J, Rao V, Morshuis M, Beyersdorf F, Marasco S, Sood P, Gazzola C, Schmitto JD. First 5-year multicentric clinical trial experience with the HeartMate 3 left ventricular assist system. J Heart Lung Transplant 2021; 40:247-250. [PMID: 33500187 DOI: 10.1016/j.healun.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/04/2021] [Accepted: 01/04/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ivan Netuka
- Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Daniel Zimpfer
- Department of Cardiac Surgery, University of Vienna, Vienna, Austria
| | - Evgenij Potapov
- Department of Thoracic and Cardiovascular Surgery, German Heart Center, Berlin, Germany
| | - Jens Garbade
- University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Vivek Rao
- Department of Cardiovascular Surgery, Peter Munk Cardiac Centre, University of Toronto, Toronto, Ontario, Canada
| | - Michiel Morshuis
- Thoracic and Cardiovascular Surgery Clinic, Bad Oeynhausen, Germany
| | - Friedhelm Beyersdorf
- University Heart Center Freiburg, Medical Faculty, Albert-Ludwigs-University, Freiburg, Germany
| | - Silvana Marasco
- Cardiothoracic Unit, The Alfred Hospital, Melbourne, Australia
| | | | | | - Jan D Schmitto
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
24
|
Kaliyev R, Lesbekov T, Bekbossynov S, Nurmykhametova Z, Bekbossynova M, Novikova S, Medressova A, Smagulov N, Faizov L, Samalavicius R, Pya Y. Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage. J Cardiothorac Surg 2020; 15:323. [PMID: 33109229 PMCID: PMC7590799 DOI: 10.1186/s13019-020-01367-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/18/2020] [Indexed: 01/09/2023] Open
Abstract
Background Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for high-risk recipients bridged to transplantation with Mechanical Circulatory Support (MCS). Methods Between 2012 and 2018, we performed a retrospective single-center review of prospectively collected data. All patients who underwent heart transplantation with MCS using the OCS Heart (n = 25) versus standard cold storage (n = 10) were included in this study. Results During this period, 353 patients were implanted with left ventricular assisted device (LVAD) and 35 (10%) were bridged to heart transplantation. There was no significant difference in donor and recipient characteristics and risk factors. The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was a trend towards higher estimated risk of death at 1y in the OCS group (14.2 vs. 10.8% p = 0.083). Mean total ischemic time during preservation was statistically significantly longer in CS vs OCS group (210 (23) Vs 74.6 (13) min p = 0.001). Median ex vivo normothermic heart perfusion time in OCS was 348.4(132; 955) min. There was significant difference in total out of body time between OCS group 423(67) Vs CS group 210(23) min p = 0.002). All patients were alive on the 30th days post implant in CS groups and 96% in OCS group (p = 0.5). Conclusion Normothermic ex-vivo preservation of the allograft during transportation with the organ care system might be beneficial for long-time out of body organ preservation in comparison of cold storage especially for recipients on mechanical circulatory support.
Collapse
Affiliation(s)
- Rymbay Kaliyev
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Timur Lesbekov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Serik Bekbossynov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | | | | | - Svetlana Novikova
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Assel Medressova
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Nurlan Smagulov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | - Linar Faizov
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| | | | - Yuriy Pya
- National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
| |
Collapse
|
25
|
Netuka I, Pya Y, Bekbossynova M, Ivak P, Konarik M, Gustafsson F, Smadja DM, Jansen P, Latrémouille C. Initial bridge to transplant experience with a bioprosthetic autoregulated artificial heart. J Heart Lung Transplant 2020; 39:1491-1493. [PMID: 32758387 DOI: 10.1016/j.healun.2020.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/22/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Ivan Netuka
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Nur-Sultan (Astana), Kazakhstan
| | | | - Peter Ivak
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Miroslav Konarik
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Finn Gustafsson
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Piet Jansen
- Carmat SA, Vélizy-Villacoublay Cedex, France
| | | |
Collapse
|
26
|
Loforte A, Gliozzi G, Potapov E, Mariani C, Schönrath F, Netuka I, Pya Y, Gummert J, Meyns B, Pacini D, De By T. Concomitant Cardiac Procedures during Implantation of Long-Term Continuous-Flow LVADs: A European Registry for Patients with Mechanical Circulatory Support (EUROMACS) Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
27
|
Netuka I, Pya Y, Zimpfer D, Potapov E, Garbade J, Rao V, Morshuis M, Marasco S, Beyersdorf F, Gazzola C, Sood P, Schmitto J. First Long-Term 5-years Experience with the HeartMate 3 LVAS in Multicentric Clinical Trial. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
28
|
Kaliyev R, Lesbekov T, Bekbossynov S, Bekbossynova M, Nurmykhametova Z, Novikova S, Smagulov N, Medressova A, Faizov L, Ashyrov Z, la Fleur P, Samalavicius R, Pya Y. Comparison of Custodiol vs warm blood cardioplegia and conditioning of donor hearts during transportation with the organ care system. J Card Surg 2019; 34:969-975. [PMID: 31332833 PMCID: PMC6852406 DOI: 10.1111/jocs.14162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives Cold crystalloid cardioplegia for donor heart harvesting and cold ischemic storage conditions during the transportation is the standard of care during heart transplantation procedure. Organ care system (OCS) was introduced for more prolonged and reliable ex vivo organ management. This study evaluated the two different techniques used for myocardial preservation during the procurement and transportation of the heart using the OCS. Methods We performed prospective analysis of 43 patients with heart failure undergoing heart transplantation and using the OCS for donor organ transport. Donor hearts were arrested using blood cardioplegia and conditioning (n = 30) or standard Custodiol (SC) solution (
n = 13). Perfusion and cardiac function parameters were continuously monitored while the donor hearts were perfused in the OCS. Impact of preservation techniques on biochemical parameters and clinical outcomes were evaluated. Results All donor hearts had stable perfusion and lactate characteristics in the OCS, with similar measures between the two groups at the beginning of the ex vivo perfusion. Ex vivo heart perfusion mean ending concentration of Interleukin (IL)‐6 and IL‐8 was significantly lower in the blood cardioplegia group compared to the standard care group. Clinical outcomes were comparable between the two groups of patients. Conclusions The use of blood cardioplegia and conditioning could be a safe method for myocardial protection in distant procurement and preservation of donor hearts in the OCS.
Collapse
Affiliation(s)
- Rymbay Kaliyev
- National Research Center for Cardiac Surgery, Astana, Kazakhstan
| | - Timur Lesbekov
- National Research Center for Cardiac Surgery, Astana, Kazakhstan
| | | | | | | | | | - Nurlan Smagulov
- National Research Center for Cardiac Surgery, Astana, Kazakhstan
| | - Assel Medressova
- National Research Center for Cardiac Surgery, Astana, Kazakhstan
| | - Linar Faizov
- National Research Center for Cardiac Surgery, Astana, Kazakhstan
| | - Zhanibek Ashyrov
- National Research Center for Cardiac Surgery, Astana, Kazakhstan
| | - Philip la Fleur
- Nazarbayev University School of Medicine, Astana, Kazakhstan
| | | | - Yuriy Pya
- National Research Center for Cardiac Surgery, Astana, Kazakhstan
| |
Collapse
|
29
|
Veen KM, Caliskan K, de By TMMH, Mokhles MM, Soliman OI, Mohacsi P, Schoenrath F, Gummert J, Paluszkiewicz L, Netuka I, Loforte A, Pya Y, Takkenberg JJM, Bogers AJJC. Outcomes after tricuspid valve surgery concomitant with left ventricular assist device implantation in the EUROMACS registry: a propensity score matched analysis. Eur J Cardiothorac Surg 2019; 56:1081-1089. [DOI: 10.1093/ejcts/ezz208] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 06/03/2019] [Accepted: 06/06/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
OBJECTIVES
Tricuspid regurgitation (TR) is common in patients receiving a left ventricular assist device (LVAD). Controversy exists as to whether concomitant tricuspid valve surgery (TVS) is beneficial in currently treated patients. Therefore, our goal was to investigate the effect of TVS concomitant with a LVAD implant.
METHODS
The European Registry for Patients with Mechanical Circulatory Support was used to identify adult patients. Matched patients with and without concomitant TVS were compared using a propensity score matching strategy.
RESULTS
In total, 3323 patients underwent LVAD implantation of which 299 (9%) had TVS. After matching, 258 patients without TVS were matched to 258 patients with TVS. In the matched population, hospital deaths, days on inotropic support, temporary right ventricular assist device implants and hospital stay were comparable, whereas stay in the intensive care unit was higher in the TVS cohort (11 vs 15 days; P = 0.026). Late deaths (P = 0.17), cumulative incidence of unexpected hospital readmission (P = 0.15) and right heart failure (P = 0.55) were comparable between patients with and without concomitant TVS. In the matched population, probability of moderate-to-severe TR immediately after surgery was lower in patients with concomitant TVS compared to patients without TVS (33% vs 70%; P = 0.001). Nevertheless, the probability of moderate-to-severe TR decreased more quickly in patients without TVS (P = 0.030), resulting in comparable probabilities of moderate-to-severe TR within 1.5 years of follow-up.
CONCLUSIONS
In matched patients, TVS concomitant with LVAD implant does not seem to be associated with better clinical outcomes. Concomitant TVS reduced TR significantly early after LVAD implant; however, differences in probability of TR disappeared during the follow-up period.
Collapse
Affiliation(s)
- Kevin M Veen
- Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, Netherlands
| | - Kadir Caliskan
- Department of Cardiology, Erasmus MC, Rotterdam, Netherlands
| | | | - Mostafa M Mokhles
- Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, Netherlands
| | - Osama I Soliman
- Department of Cardiology, Erasmus MC, Rotterdam, Netherlands
| | - Paul Mohacsi
- Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Felix Schoenrath
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Jan Gummert
- Department for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Lech Paluszkiewicz
- Department for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Ivan Netuka
- Department of Cardiothoracic Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Antonio Loforte
- Cardiac Surgery Unit, Policlinico di S. Orsola, Bologna, Italy
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Astana, Kazakhstan
| | | | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, Netherlands
| |
Collapse
|
30
|
Pya Y, Mussayev A, Alimbayev S, Medressova A, Bekbossynov S, Andossova S, Khissamutdinov N, Jetybayeva S, la Fleur P. Left Ventricular Assist Device Outflow Graft Pseudoaneurysm Treated with Covered Balloon Expandable Stent. ASAIO J 2019; 66:e74-e76. [PMID: 31192842 DOI: 10.1097/mat.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Left ventricular assist device (LVAD) outflow graft injury is a very rare complication after LVAD implantation and is usually treated surgically. This is a case report of successful stenting of the damaged outflow graft 2.5 years after LVAD implantation, followed by successful heart transplantation.
Collapse
Affiliation(s)
- Yuriy Pya
- From the National Research Cardiac Surgery Center, Nur-Sultan (Astana), Kazakhstan
| | | | - Serik Alimbayev
- Department of Interventional cardiology, Nur-Sultan (Astana), Kazakhstan
| | | | | | | | | | | | - Philip la Fleur
- Nazarbayev University School of Medicine, Nur-Sultan (Astana), Kazakhstan
| |
Collapse
|
31
|
Mirza K, Gustafsson F, Pya Y, Shaw S, Diegeler A, Netuka I, Lavee J, Garbade J, Morshuis M, Heatley J, Saeed D, Potapov E, Schmitto J, Zimpfer D. Atrial Fibrillation is a Predictor of Poor Physical Capacity 6 Months after Implantation of a Full Magnetically Levitated Left Ventricular Assist Device: An Analysis from ELEVATE. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
32
|
Richez U, Latremouille C, Netuka I, Roussel J, Saubamea B, Rossi E, Kindo M, Pya Y, Capel A, Jansen P, Carpentier A, Smadja D. Hemocompatibility of Bioprosthetic valve in bovine pericardium is based on fibrin formation and its endothelization. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.02.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
33
|
Saeed D, Garbade J, Gustafsson F, Lavee J, Morshuis M, Zimpfer D, Potapov E, Pya Y, Schmitto J, Shaw S. Two-Year Outcomes in Real World Patients Treated with Heartmate 3TM Left Ventricular Assist Device for Advanced Heart Failure: Data from the ELEVATE Registry. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
34
|
Garbade J, Gustafsson F, Shaw S, Lavee J, Saeed D, Pya Y, Krabatsch T, Schmitto JD, Morshuis M, Chuang J, Zimpfer D. Postmarket Experience With HeartMate 3 Left Ventricular Assist Device: 30-Day Outcomes From the ELEVATE Registry. Ann Thorac Surg 2019; 107:33-39. [DOI: 10.1016/j.athoracsur.2018.07.092] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 06/15/2018] [Accepted: 07/30/2018] [Indexed: 10/28/2022]
|
35
|
Gustafsson F, Shaw S, Lavee J, Saeed D, Pya Y, Krabatsch T, Schmitto J, Morshuis M, Chuang J, Damme L, Zimpfer D, Garbade J. Six-month outcomes after treatment of advanced heart failure with a full magnetically levitated continuous flow left ventricular assist device: report from the ELEVATE registry. Eur Heart J 2018; 39:3454-3460. [DOI: 10.1093/eurheartj/ehy513] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 08/05/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Finn Gustafsson
- Rigshospitalet, Department of Cardiology, University of Copenhagen 9 Blegdamsvej, Copenhagen, Denmark
| | - Steven Shaw
- Manchester University NHS Foundation Trust, Southmoor Road, Manchester, UK
| | - Jacob Lavee
- Heart Transplantation Unit, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Hasomer, Ramat Gan, Israel
| | - Diyar Saeed
- Cardiovascular Surgery, University Hospital of Duesseldorf, Moorenstrasse 5, Dusseldorf, Germany
| | - Yuriy Pya
- National Research Cardiac Surgery Center, 38 Turan Street, Astana, Kazakhstan
| | | | - Jan Schmitto
- Hannover Medical School, Carl-Neuberg Strasse 1, Hannover, Germany
| | - Michiel Morshuis
- Department of Cardiothoracic Surgery, Herz- und Diabeteszentrum NRW, Georgstrasse 11, Bad Oeynhausen, Germany
| | - Joyce Chuang
- Abbott, Abbott Park Road, Abbott Park, Chicago, IL, USA
| | - Laura Damme
- Abbott, Abbott Park Road, Abbott Park, Chicago, IL, USA
| | - Daniel Zimpfer
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Waehringer Guertel 18–20, Vienna, Austria
| | - Jens Garbade
- Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Struempellstr. 39, Leipzig, Germany
| |
Collapse
|
36
|
Schmitto JD, Pya Y, Zimpfer D, Krabatsch T, Garbade J, Rao V, Morshuis M, Beyersdorf F, Marasco S, Sood P, Damme L, Netuka I. Long-term evaluation of a fully magnetically levitated circulatory support device for advanced heart failure-two-year results from the HeartMate 3 CE Mark Study. Eur J Heart Fail 2018; 21:90-97. [PMID: 30052304 DOI: 10.1002/ejhf.1284] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 06/11/2018] [Accepted: 06/26/2018] [Indexed: 01/25/2023] Open
Abstract
AIM This study aimed to assess safety and outcomes of patients, 2 years after implantation with the HeartMate 3 Left Ventricular Assist System. METHODS AND RESULTS This study included 50 adults with New York Heart Association (NYHA) class IIIB or IV symptoms or American College of Cardiology/American Heart Association stage D heart failure with an ejection fraction ≤25% and a cardiac index ≤2.2 L/min/m2 without inotropes, or inotrope-dependent with optimal medical management, or listed for heart transplant. The median duration of left ventricular assist device support was 694 days (range: 19-833 days). At baseline, cardiac index was 1.8 ±0.5 L/min/m2 , 58% of patients were receiving inotropes, and 92% were INTERMACS profiles 2-4. At 2 years, Kaplan-Meier survival was 74 ±6%, 5 (10%) patients were transplanted, and 32 patients (64%) remain with support. Adverse event rates include bleeding requiring surgery (16%), gastrointestinal bleeding (20%), driveline infection (24%), ischaemic stroke (16%), haemorrhagic stroke (8%), right heart failure (14%), and outflow graft thrombosis (2%). Notably, no haemolysis, pump thrombosis, or pump malfunction events occurred. At 2 years, 47% of patients remained in NYHA class I and 41% in NYHA class II (P <0.0001). From baseline to 2 years, the mean six-minute walk distance increased from 239 m to 347 m (P <0.0001), and the mean EQ-5D quality of life score improved from 48.2 to 70.6 (P < 0.0001). CONCLUSIONS Two years post-HeartMate 3 implantation, results show expected and acceptable survival, enhanced haemocompatibility, improved patient functional status and quality of life. This corroborates the success of HeartMate 3 since its first-in-man implantation case in Germany. ClinicalTrials.gov: NCT02170363.
Collapse
Affiliation(s)
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Astana, Kazakhstan
| | | | | | | | - Vivek Rao
- Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Canada
| | - Michiel Morshuis
- Thoracic and Cardiovascular Surgery Clinic, Bad Oeynhausen, Germany
| | - Friedhelm Beyersdorf
- University Heart Center Freiburg-Bad Krozingen, Medical Faculty, Albert Ludwigs-University, Freiburg, Germany
| | | | | | | | - Ivan Netuka
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| |
Collapse
|
37
|
Krabatsch T, Netuka I, Schmitto JD, Zimpfer D, Garbade J, Rao V, Morshuis M, Beyersdorf F, Marasco S, Damme L, Pya Y. Heartmate 3 fully magnetically levitated left ventricular assist device for the treatment of advanced heart failure -1 year results from the Ce mark trial. J Cardiothorac Surg 2017; 12:23. [PMID: 28376837 PMCID: PMC5379553 DOI: 10.1186/s13019-017-0587-3] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 03/24/2017] [Indexed: 12/22/2022] Open
Abstract
Background The HeartMate 3 Left Ventricular Assist System (LVAS) (St. Jude Medical Inc., St Paul, MN) with full magnetic levitation allows for wide and consistent blood flow paths and an artificial pulse designed for enhanced hemocompatibility. The HeartMate 3 received market approval in the European Union in 2015 following completion of a multicenter study. After reaching the 6-month study endpoint, patients continue to be followed for 2 years with the 1-year results presented herein. Methods A prospective, non-randomized study included adults with advanced heart failure and ejection fraction (EF) ≤ 25%, cardiac index (CI) ≤ 2.2 L/min/m2 while not on inotropes, or inotrope dependent, or on optimal medical management for 45/60 days. Results Fifty patients—54% bridge to transplant (BTT) and 46% destination therapy (DT)—were enrolled and implanted with the HeartMate 3. At baseline, 92% of the patients were INTERMACS profiles 2–4, with cardiac index 1.8 + 0.5 L/min/m2 and 58% were supported with inotropes. At 1 year, 74% of the patients remain on support, 18% expired, 6% transplanted, and 2% explanted. The adverse events include 12% gastrointestinal bleeding, 16% driveline infections, 18% strokes, and 2% outflow graft thrombosis. There was no hemolysis, pump thrombosis or pump malfunction through 1 year. The six-minute walk test distance increased from a mean of 273 m to 371 m (P <0.0001). EQ-5D quality-of-life score increased from a mean of 52.7 to 70.8 (P = 0.0006). Conclusions The 1-year HeartMate 3 LVAS results show survival and adverse-event profile are similar to other approved devices, with no pump thrombosis or pump failure. Patient’s functional status and quality of life significantly improved over time. Trial registration Clinicaltrials.gov registration number: NCT02170363. Registered June 19, 2014.
Collapse
Affiliation(s)
- Thomas Krabatsch
- German Heart Center, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, D-13353, Berlin, Germany.
| | - Ivan Netuka
- Institute for Clinical and Experimental Medicine, Vídenská 1958/9 Praha 4, Prague, Czech Republic
| | - Jan D Schmitto
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Daniel Zimpfer
- University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria
| | - Jens Garbade
- Heart Center Leipzig, Struempellstrasse 39, 04289, Leipzig, Germany
| | - Vivek Rao
- Toronto General Hospital, 4N-464 200 Elizabeth St.,, Toronto, ON, M5G 2C4, Canada
| | - Michiel Morshuis
- Herz- und Diabeteszentrum NRW, Georgstr. 11, 32545, Bad Oeynhausen, Germany
| | - Friedhelm Beyersdorf
- University Heart Center Freiburg-Bad Krozingen, Hugstetterstr 55, D-79106, Freiburg, Germany
| | - Silvana Marasco
- The Alfred Hospital, 55 Commercial Road, Prahran, VIC, 3181, Melbourne, Australia
| | - Laura Damme
- St. Jude Medical, 11 Da Vincilaan, Zaventem, 1935, Belgium
| | - Yuriy Pya
- National Research Cardiac Surgery Center, 010000, 38 Turan St., Astana, Kazakhstan
| |
Collapse
|
38
|
Morrissey O, Xie R, Schaenman J, Husain S, Mooney M, Nakatani T, Kormos R, Gómez-Bueno M, Aslam S, Pya Y, Hannan M. Epidemiology of Fungal Infections (FI) in Mechanical Circulatory Support Device (MCSD) Recipients: Analysis of IMACS Registry 2013-2015. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
39
|
Zimpfer D, Netuka I, Schmitto JD, Pya Y, Garbade J, Morshuis M, Beyersdorf F, Marasco S, Rao V, Damme L, Sood P, Krabatsch T. Multicentre clinical trial experience with the HeartMate 3 left ventricular assist device: 30-day outcomes. Eur J Cardiothorac Surg 2016; 50:548-54. [PMID: 27436871 DOI: 10.1093/ejcts/ezw169] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 01/11/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objective of this study was to describe the operative experience and 30-day outcomes of patients implanted with the HeartMate 3 Left Ventricular Assist System (LVAS) during the Conformité Européenne (CE) Mark clinical trial. METHODS Adult patients met inclusion and exclusion criteria defining advanced-stage heart failure and included the indications of bridge to transplant and destination therapy. Operative parameters, outcomes, adverse events, physical status and quality-of-life parameters were assessed in the first 30 days after LVAS implant. RESULTS Fifty patients were implanted with the HeartMate 3 at 10 centres in 6 countries. The 30-day survival rate was 98%. The median operative and cardiopulmonary bypass times were 200 (range: 95-585) min and 84 (range: 47-250) min, respectively. Patients required transfusion with packed red blood cells (3.6 ± 2.3 units), fresh frozen plasma (6.5 ± 5 units) and platelets (2 ± 1 units). Six patients (12%) required reoperation for postoperative bleeding and 10 patients (20%) did not require blood transfusion. The median intensive care time was 6 days (range: 1-112 days) and the total hospital stay was 28 days (range: 14-116 days). The most common adverse events were bleeding (15, 30%), arrhythmia (14, 28%) and infection (10, 20%). There were 2 (4%) strokes. CONCLUSIONS The 30-day outcomes following implantation of the HeartMate 3 demonstrates excellent survival with low adverse event rates. The LVAD performed as intended with no haemolysis or device failure. CLINICALTRIALSGOV IDENTIFIER NCT02170363. HeartMate 3™ CE Mark Clinical Investigation Plan (HM3 CE Mark).
Collapse
Affiliation(s)
| | - Ivan Netuka
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - Yuriy Pya
- National Research Cardiac Surgery Center, Astana, Kazakhstan
| | | | - Michiel Morshuis
- Thoracic and Cardiovascular Surgery Clinic, Bad Oeynhausen, Germany
| | | | | | - Vivek Rao
- Toronto General Hospital, Toronto, Canada
| | | | | | | |
Collapse
|
40
|
Aripov M, Mussayev A, Alimbayev S, Goncharov A, Zhusupova G, Pya Y. Individualised renal artery denervation improves blood pressure control in Kazakhstani patients with resistant hypertension. Kardiol Pol 2016; 75:101-107. [PMID: 27296285 DOI: 10.5603/kp.a2016.0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/01/2016] [Accepted: 04/28/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The prevalence of hypertension in Kazakhstan is high, and the majority of patients are not adequately controlled. Treatment with renal artery denervation (RAD) could represent a useful therapeutic option for a subset of patients in Kazakhstan with resistant hypertension. AIM To assess the impact of RAD in a cohort of patients from Kazakhstan with resistant hypertension. METHODS Between March 2012 and December 2013, 63 patients underwent RAD at our tertiary care centre. Eligibility criteria were office blood pressure more than 160 mm Hg systolic (SBP) or more than 90 mm Hg diastolic (DBP) despite being treated with three or more antihypertensive medications, including a diuretic. Ambulatory blood pressure was measured at baseline and at month 12, and monitoring also included impact on insulin resistance and renal function. RESULTS There were significant decreases of 25 ± 24 mm Hg for ambulatory SBP during the daytime and of 26 ± 23 mm Hg for ambulatory SBP during the nighttime (p < 0.0001). We observed significant decreases of 12 ± 14 mm Hg for ambula-tory daytime DBP and of 11 ± 14 mm Hg in ambulatory nighttime DBP (p < 0.0001). A decrease in creatinine clearance was observed from 100.2 ± 33.6 mL/min at baseline to 90.2 ± 22.8 mL/min at month 12 (p < 0.001). Homeostasis model assessment-insulin resistance (HOMA-IR) decreased from 3.0 ± 4.6 at baseline to 2.5 ± 3.7 at 12 months (p = 0.007). CONCLUSIONS In this population RAD resulted in statistically and clinically significant blood pressure reduction at 12 months with minimal adverse events.
Collapse
Affiliation(s)
- Marat Aripov
- "National Research Centre for Cardiac Surgery" JSC, Astana Medical University, Kazakhstan.
| | | | | | | | | | | |
Collapse
|
41
|
Netuka I, Sood P, Pya Y, Zimpfer D, Krabatsch T, Garbade J, Rao V, Morshuis M, Marasco S, Beyersdorf F, Damme L, Schmitto JD. Fully Magnetically Levitated Left Ventricular Assist System for Treating Advanced HF: A Multicenter Study. J Am Coll Cardiol 2016; 66:2579-2589. [PMID: 26670056 DOI: 10.1016/j.jacc.2015.09.083] [Citation(s) in RCA: 184] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/11/2015] [Accepted: 09/14/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND The HeartMate 3 left ventricular assist system (LVAS) is intended to provide long-term support to patients with advanced heart failure. The centrifugal flow pump is designed for enhanced hemocompatibility by incorporating a magnetically levitated rotor with wide blood-flow paths and an artificial pulse. OBJECTIVES The aim of this single-arm, prospective, multicenter study was to evaluate the performance and safety of this LVAS. METHODS The primary endpoint was 6-month survival compared with INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support)-derived performance goal. Patients were adults with ejection fraction ≤ 25%, cardiac index ≤ 2.2 l/min/m(2) without inotropes or were inotrope-dependent on optimal medical management, or listed for transplant. RESULTS Fifty patients were enrolled at 10 centers. The indications for LVAS support were bridge to transplantation (54%) or destination therapy (46%). At 6 months, 88% of patients continued on support, 4% received transplants, and 8% died. Thirty-day mortality was 2% and 6-month survival 92%, which exceeded the 88% performance goal. Support with the fully magnetically levitated LVAS significantly reduced mortality risk by 66% compared with the Seattle Heart Failure Model-predicted survival of 78% (p = 0.0093). Key adverse events included reoperation for bleeding (14%), driveline infection (10%), gastrointestinal bleeding (8%), and debilitating stroke (modified Rankin Score > 3) (8%). There were no pump exchanges, pump malfunctions, pump thrombosis, or hemolysis events. New York Heart Association classification, 6-min walk test, and quality-of-life scores showed progressive and sustained improvement. CONCLUSIONS The results show that the fully magnetically levitated centrifugal-flow chronic LVAS is safe, with high 30-day and 6-month survival rates, a favorable adverse event profile, and improved quality of life and functional status. (HeartMate 3™ CE Mark Clinical Investigation Plan [HM3 CE Mark]; NCT02170363).
Collapse
Affiliation(s)
- Ivan Netuka
- Department of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Second Department of Surgery, Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
| | - Poornima Sood
- Clinical Affairs, St. Jude Medical, Burlington, Massachusetts
| | - Yuriy Pya
- National Research Cardiac Surgery Center, Astana, Kazakhstan
| | - Daniel Zimpfer
- Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas Krabatsch
- Department of Cardiothoracic and Vascular Surgery, German Heart Center, Berlin, Germany
| | - Jens Garbade
- Heart Center Leipzig, Department of Cardiac Surgery, University of Leipzig, Leipzig, Germany
| | - Vivek Rao
- Toronto General Hospital, Toronto, Canada
| | - Michiel Morshuis
- Thoracic and Cardiovascular Surgery Clinic, Bad Oeynhausen, Germany
| | - Silvana Marasco
- Cardiothoracic Surgical Unit, The Alfred Hospital, Melbourne, Australia
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery Freiburg, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany
| | - Laura Damme
- Clinical Affairs, St. Jude Medical, Burlington, Massachusetts
| | - Jan D Schmitto
- Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
42
|
Pya Y, Bekbossynov S, Bekbossynova M, Andossova S, Dzhetybayeva S, Medressova A, Murzagaliyev M, Novikova S, Salov R, Abildayeva R, Damme L. HeartMate 3 Left Ventricular Assist Device Pre- and Post-Approval Experience Through 1 Year at a Single Center. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
43
|
Rao V, Netuka I, Schmitto J, Pya Y, Heatley J, Damme L. An Examination of Bleeding and Thromboembolic Complications during the First Year of Support with the HeartMate 3 Fully Magnetically-Levitated Left Ventricular Assist Device. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
44
|
Krabatsch T, Schmitto J, Pya Y, Zimpfer D, Garbade J, Rao V, Morshuis M, Marasco S, Beyersdorf F, Sood P, Damme L, Netuka I. HeartMate 3 Fully Magnetically Levitated Left Ventricular Assist Device for the Treatment of Advanced Heart Failure -1 Year Results from the CE Mark Trial. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
45
|
Medressova A, Bekbossynov S, Murzagaliyev M, Dzhetybayeva S, Andossova S, Bekbossynova M, Pya Y. Three-year outcomes with left ventricular assist devices in country with restricted heart transplantation. J Cardiothorac Surg 2015. [PMCID: PMC4693869 DOI: 10.1186/1749-8090-10-s1-a32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
46
|
Netuka I, Pya Y, Zimpfer D, Krabatsch T, Garbade J, Rao V, Morshuis M, Marasco S, Beyersdorf F, Sood P, Damme L, Schmitto JD. HeartMate 3, Fully Magnetically Levitated Left Ventricular Assist Device for the Treatment of Advanced Heart Failure –Results from the CE Mark Trial. J Card Fail 2015. [DOI: 10.1016/j.cardfail.2015.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
Pya Y, Bekbossynova M, Jetybayeva S, Bekbossynov S, Andossova S, Salov R, Medressova A, Novikova S, Murzagaliyev M. Initial 3-year outcomes with left ventricular assist devices in a country with a nascent heart transplantation program. ESC Heart Fail 2015; 3:26-34. [PMID: 27774264 PMCID: PMC5061086 DOI: 10.1002/ehf2.12066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/09/2015] [Accepted: 08/26/2015] [Indexed: 12/21/2022] Open
Abstract
AIMS The need for the left ventricular assist devices (LVAD) in patients with end-stage heart failure is well established, but prior to 2011, this was not available to patients in Kazakhstan. We describe the development of the sole LVAD programme in the context of a nascent heart transplantation programme and clinical outcomes for the first three years. METHODS AND RESULTS From November 2011 to November 2014, 146 patients underwent implantation of 152 VADs (approximately 50 devices implanted per year). We retrospectively analyzed data from 135 LVAD patients who received HeartMate II (n = 95) or HeartWare (n = 40) devices. In 75 patients LVAD was used as a bridge-to-transplantation and in 60 patients as destination therapy, but only 3 of 135 LVAD patients received heart transplant. Forty-three patients of the LVAD cohort had died by the end of the follow-up period. The mean time on LVAD was 466 ± 330 days (range 5-1200 days). Kaplan-Meier survival estimates for patients who continued on LVAD support were 93% after 1 month, 86% after 6 months and 77% after 12 months. The most common complications within the first 30 days after implant included right ventricular failure (n = 20, 1.85 events/patient-year), renal failure (n = 19, 1.76 events/patient-year) and bleeding (n = 33, 3.0 events/patient-year). Beyond 30 days adverse events included driveline infections (n = 46, 0.56 events/patient-year) and stroke (n = 33, 0.21 events/patient-year). CONCLUSIONS LVADs are an important therapeutic alternative to heart transplantation in the context of a developing heart transplant programme with outcomes that are comparable to those reported by other centres.
Collapse
Affiliation(s)
- Yuriy Pya
- JSC National Research Center for Cardiac Surgery Astana Kazakhstan
| | | | | | | | | | - Roman Salov
- JSC National Research Center for Cardiac Surgery Astana Kazakhstan
| | - Assel Medressova
- JSC National Research Center for Cardiac Surgery Astana Kazakhstan
| | | | | |
Collapse
|
48
|
Pya Y, Medressova A, Novikova S, Murzagaliyev M, Dzhetybayeva S, Andossova S, Bekbossynov S, Bekbossynova M. VAD Destination Therapy Outcomes - Kazakhstan’s Experience. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
49
|
Bekbossynov S, Medressova A, Murzagaliyev M, Salov R, Dzhetybayeva S, Andossova S, Bekbossynova M, Pya Y. [Surgical heart failure treatment program - the experience of Kazakhstan]. G Ital Cardiol (Rome) 2014; 15:144-8. [PMID: 24770427 DOI: 10.1714/1463.16161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In Kazakhstan, geographical and cultural reasons do not favor the development of heart transplant activity. Thus, a surgical program for treatment of advanced, refractory heart failure was implemented, focusing the efforts on ventricular assist device (VAD) therapy. The program, supported and funded by the national healthcare system, is based on a single, highly specialized surgical Center for the operation, and on a regional infrastructure for outpatient follow-up. Regional VAD coordinators are educated by the National Center. They are in charge of regular patient check, anticoagulant and antiplatelet treatment prescription, and continuing patients' and caregivers' education, mainly regarding driveline exit site dressing and driveline stabilization. From November 2011 to November 2013, 95 patients received 100 devices, mainly for left ventricular support (LVAD): HeartMate II, n=70, HeartWare, n=25. Mean age was 49.5 years, and 87.37% of the patients were males. Most patients had INTERMACS profile 4 (55%), followed by 3 and 2 (17% each). Symptomatic and functional improvement are testified by changes from baseline to month 3 of NYHA functional class (from III-IV to I-II), results of the 6-min walk test (from 152 to 440 m), and NT-proBNP levels (from 6997 to 1126 pg/ml). Overall 1-year survival was 69%, with a trend for outcome improvement over time and a relationship with preoperative INTERMACS profile (1-year survival of 60% in patients with INTERMACS profile 1-2 vs 75% in those with INTERMACS profile 3-4). In summary, where and when a heart transplant program cannot be implemented, LVAD represents a realistic therapeutic alternative. The key points for a successful VAD program are a dedicated, highly specialized multidisciplinary team at the Cardiac Surgery Center, an infrastructure throughout the country for coordinated outpatient follow-up, adequate reimbursement for this activity, and support by the healthcare system.
Collapse
|
50
|
Caiani E, Pellegrini A, Carminati M, Lang R, Auricchio A, Vaida P, Obase K, Sakakura T, Komeda M, Okura H, Yoshida K, Zeppellini R, Noni M, Rigo T, Erente G, Carasi M, Costa A, Ramondo B, Thorell L, Akesson-Lindow T, Shahgaldi K, Germanakis I, Fotaki A, Peppes S, Sifakis S, Parthenakis F, Makrigiannakis A, Richter U, Sveric K, Forkmann M, Wunderlich C, Strasser R, Djikic D, Potpara T, Polovina M, Marcetic Z, Peric V, Ostenfeld E, Werther-Evaldsson A, Engblom H, Ingvarsson A, Roijer A, Meurling C, Holm J, Radegran G, Carlsson M, Tabuchi H, Yamanaka T, Katahira Y, Tanaka M, Kurokawa T, Nakajima H, Ohtsuki S, Saijo Y, Yambe T, D'alto M, Romeo E, Argiento P, D'andrea A, Vanderpool R, Correra A, Sarubbi B, Calabro' R, Russo M, Naeije R, Saha SK, Warsame TA, Caelian AG, Malicse M, Kiotsekoglou A, Omran AS, Sharif D, Sharif-Rasslan A, Shahla C, Khalil A, Rosenschein U, Erturk M, Oner E, Kalkan A, Pusuroglu H, Ozyilmaz S, Akgul O, Aksu H, Akturk F, Celik O, Uslu N, Bandera F, Pellegrino M, Generati G, Donghi V, Alfonzetti E, Guazzi M, Rangel I, Goncalves A, Sousa C, Correia A, Martins E, Silva-Cardoso J, Macedo F, Maciel M, Lee S, Kim W, Yun H, Jung L, Kim E, Ko J, Enescu O, Florescu M, Rimbas R, Cinteza M, Vinereanu D, Kosmala W, Rojek A, Cielecka-Prynda M, Laczmanski L, Mysiak A, Przewlocka-Kosmala M, Liu D, Hu K, Niemann M, Herrmann S, Cikes M, Gaudron P, Knop S, Ertl G, Bijnens B, Weidemann F, Saravi M, Tamadoni A, Jalalian R, Hojati M, Ramezani S, Yildiz A, Inci U, Bilik M, Yuksel M, Oyumlu M, Kayan F, Ozaydogdu N, Aydin M, Akil M, Tekbas E, Shang Q, Zhang Q, Fang F, Wang S, Li R, Lee AP, Yu C, Mornos C, Ionac A, Cozma D, Popescu I, Ionescu G, Dan R, Petrescu L, Sawant A, Srivatsa S, Adhikari P, Mills P, Srivatsa S, Boshchenko A, Vrublevsky A, Karpov R, Trifunovic D, Stankovic S, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Banovic M, Tesic M, Petrovic M, Dragovic M, Ostojic M, Zencirci E, Esen Zencirci A, Degirmencioglu A, Karakus G, Ekmekci A, Erdem A, Ozden K, Erer H, Akyol A, Eren M, Zamfir D, Tautu O, Onciul S, Marinescu C, Onut R, Comanescu I, Oprescu N, Iancovici S, Dorobantu M, Melao F, Pereira M, Ribeiro V, Oliveira S, Araujo C, Subirana I, Marrugat J, Dias P, Azevedo A, Grillo MT, Piamonti B, Abate E, Porto A, Dell'angela L, Gatti G, Poletti A, Pappalardo A, Sinagra G, Pinto-Teixeira P, Galrinho A, Branco L, Fiarresga A, Sousa L, Cacela D, Portugal G, Rio P, Abreu J, Ferreira R, Fadel B, Abdullah N, Al-Admawi M, Pergola V, Bech-Hanssen O, Di Salvo G, Tigen MK, Pala S, Karaahmet T, Dundar C, Bulut M, Izgi A, Esen AM, Kirma C, Boerlage-Van Dijk K, Yamawaki M, Wiegerinck E, Meregalli P, Bindraban N, Vis M, Koch K, Piek J, Bouma B, Baan J, Mizia M, Sikora-Puz A, Gieszczyk-Strozik K, Lasota B, Chmiel A, Chudek J, Jasinski M, Deja M, Mizia-Stec K, Silva Fazendas Adame PR, Caldeira D, Stuart B, Almeida S, Cruz I, Ferreira A, Lopes L, Joao I, Cotrim C, Pereira H, Unger P, Dedobbeleer C, Stoupel E, Preumont N, Argacha J, Berkenboom G, Van Camp G, Malev E, Reeva S, Vasina L, Pshepiy A, Korshunova A, Timofeev E, Zemtsovsky E, Jorgensen PG, Jensen J, Fritz-Hansen T, Biering-Sorensen T, Jons C, Olsen N, Henri C, Magne J, Dulgheru R, Laaraibi S, Voilliot D, Kou S, Pierard L, Lancellotti P, Tayyareci Y, Dworakowski R, Kogoj P, Reiken J, Kenny C, Maccarthy P, Wendler O, Monaghan M, Song J, Ha T, Jung Y, Seo M, Choi S, Kim Y, Sun B, Kim D, Kang D, Song J, Le Tourneau T, Topilsky Y, Inamo J, Mahoney D, Suri R, Schaff H, Enriquez-Sarano M, Bonaque Gonzalez J, Sanchez Espino A, Merchan Ortega G, Bolivar Herrera N, Ikuta I, Macancela Quinonez J, Munoz Troyano S, Ferrer Lopez R, Gomez Recio M, Dreyfus J, Cimadevilla C, Brochet E, Himbert D, Iung B, Vahanian A, Messika-Zeitoun D, Izumo M, Takeuchi M, Seo Y, Yamashita E, Suzuki K, Ishizu T, Sato K, Aonuma K, Otsuji Y, Akashi Y, Muraru D, Addetia K, Veronesi F, Corsi C, Mor-Avi V, Yamat M, Weinert L, Lang R, Badano L, Minamisawa M, Koyama J, Kozuka A, Motoki H, Izawa A, Tomita T, Miyashita Y, Ikeda U, Florescu C, Niemann M, Liu D, Hu K, Herrmann S, Gaudron P, Scholz F, Stoerk S, Ertl G, Weidemann F, Marchel M, Serafin A, Kochanowski J, Piatkowski R, Madej-Pilarczyk A, Filipiak K, Hausmanowa-Petrusewicz I, Opolski G, Meimoun P, M'barek D, Clerc J, Neikova A, Elmkies F, Tzvetkov B, Luycx-Bore A, Cardoso C, Zemir H, Mansencal N, Arslan M, El Mahmoud R, Pilliere R, Dubourg O, Ikonomidis I, Lambadiari V, Pavlidis G, Koukoulis C, Kousathana F, Varoudi M, Tritakis V, Triantafyllidi H, Dimitriadis G, Lekakis I, Kovacs A, Kosztin A, Solymossy K, Celeng C, Apor A, Faludi M, Berta K, Szeplaki G, Foldes G, Merkely B, Kimura K, Daimon M, Nakajima T, Motoyoshi Y, Komori T, Nakao T, Kawata T, Uno K, Takenaka K, Komuro I, Gabric ID, Vazdar L, Pintaric H, Planinc D, Vinter O, Trbusic M, Bulj N, Nobre Menezes M, Silva Marques J, Magalhaes R, Carvalho V, Costa P, Brito D, Almeida A, Nunes-Diogo A, Davidsen ES, Bergerot C, Ernande L, Barthelet M, Thivolet S, Decker-Bellaton A, Altman M, Thibault H, Moulin P, Derumeaux G, Huttin O, Voilliot D, Frikha Z, Aliot E, Venner C, Juilliere Y, Selton-Suty C, Yamada T, Ooshima M, Hayashi H, Okabe S, Johno H, Murata H, Charalampopoulos A, Tzoulaki I, Howard L, Davies R, Gin-Sing W, Grapsa J, Wilkins M, Gibbs J, Castillo J, Bandeira A, Albuquerque E, Silveira C, Pyankov V, Chuyasova Y, Lichodziejewska B, Goliszek S, Kurnicka K, Dzikowska Diduch O, Kostrubiec M, Krupa M, Grudzka K, Ciurzynski M, Palczewski P, Pruszczyk P, Arana X, Oria G, Onaindia J, Rodriguez I, Velasco S, Cacicedo A, Palomar S, Subinas A, Zumalde J, Laraudogoitia E, Saeed S, Kokorina M, Fromm A, Oeygarden H, Waje-Andreassen U, Gerdts E, Gomez E, Vallejo N, Pedro-Botet L, Mateu L, Nunyez R, Llobera L, Bayes A, Sabria M, Antonini-Canterin F, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Antonini-Canterin F, Pudil R, Praus R, Vasatova M, Vojacek J, Palicka V, Hulek P, Pradel S, Mohty D, Damy T, Echahidi N, Lavergne D, Virot P, Aboyans V, Jaccard A, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Antonini-Canterin F, Doulaptsis C, Symons R, Matos A, Florian A, Masci P, Dymarkowski S, Janssens S, Bogaert J, Lestuzzi C, Moreo A, Celik S, Lafaras C, Dequanter D, Tomkowski W, De Biasio M, Cervesato E, Massa L, Imazio M, Watanabe N, Kijima Y, Akagi T, Toh N, Oe H, Nakagawa K, Tanabe Y, Ikeda M, Okada K, Ito H, Milanesi O, Biffanti R, Varotto E, Cerutti A, Reffo E, Castaldi B, Maschietto N, Vida V, Padalino M, Stellin G, Bejiqi R, Retkoceri R, Bejiqi H, Retkoceri A, Surdulli S, Massoure P, Cautela J, Roche N, Chenilleau M, Gil J, Fourcade L, Akhundova A, Cincin A, Sunbul M, Sari I, Tigen M, Basaran Y, Suermeci G, Butz T, Schilling I, Sasko B, Liebeton J, Van Bracht M, Tzikas S, Prull M, Wennemann R, Trappe H, Attenhofer Jost CH, Pfyffer M, Scharf C, Seifert B, Faeh-Gunz A, Naegeli B, Candinas R, Medeiros-Domingo A, Wierzbowska-Drabik K, Roszczyk N, Sobczak M, Plewka M, Krecki R, Kasprzak J, Ikonomidis I, Varoudi M, Papadavid E, Theodoropoulos K, Papadakis I, Pavlidis G, Triantafyllidi H, Anastasiou - Nana M, Rigopoulos D, Lekakis J, Tereshina O, Surkova E, Vachev A, Merchan Ortega G, Bonaque Gonzalez J, Sanchez Espino A, Bolivar Herrera N, Bravo Bustos D, Ikuta I, Aguado Martin M, Navarro Garcia F, Ruiz Lopez F, Gomez Recio M, Merchan Ortega G, Bonaque Gonzalez J, Bravo Bustos D, Sanchez Espino A, Bolivar Herrera N, Bonaque Gonzalez J, Navarro Garcia F, Aguado Martin M, Ruiz Lopez M, Gomez Recio M, Eguchi H, Maruo T, Endo K, Nakamura K, Yokota K, Fuku Y, Yamamoto H, Komiya T, Kadota K, Mitsudo K, Nagy AI, Manouras A, Gunyeli E, Shahgaldi K, Winter R, Hoffmann R, Barletta G, Von Bardeleben S, Kasprzak J, Greis C, Vanoverschelde J, Becher H, Hu K, Liu D, Niemann M, Herrmann S, Cikes M, Gaudron P, Knop S, Ertl G, Bijnens B, Weidemann F, Di Salvo G, Al Bulbul Z, Issa Z, Khan A, Faiz A, Rahmatullah S, Fadel B, Siblini G, Al Fayyadh M, Menting ME, Van Den Bosch A, Mcghie J, Cuypers J, Witsenburg M, Van Dalen B, Geleijnse M, Roos-Hesselink J, Olsen F, Jorgensen P, Mogelvang R, Jensen J, Fritz-Hansen T, Bech J, Biering-Sorensen T, Agoston G, Pap R, Saghy L, Forster T, Varga A, Scandura S, Capodanno D, Dipasqua F, Mangiafico S, Caggegi AM, Grasso C, Pistritto AM, Imme' S, Ministeri M, Tamburino C, Cameli M, Lisi M, D'ascenzi F, Cameli P, Losito M, Sparla S, Lunghetti S, Favilli R, Fineschi M, Mondillo S, Ojaghihaghighi Z, Javani B, Haghjoo M, Moladoust H, Shahrzad S, Ghadrdoust B, Altman M, Aussoleil A, Bergerot C, Bonnefoy-Cudraz E, Derumeaux GA, Thibault H, Shkolnik E, Vasyuk Y, Nesvetov V, Shkolnik L, Varlan G, Gronkova N, Kinova E, Borizanova A, Goudev A, Saracoglu E, Ural D, Sahin T, Al N, Cakmak H, Akbulut T, Akay K, Ural E, Mushtaq S, Andreini D, Pontone G, Bertella E, Conte E, Baggiano A, Annoni A, Formenti A, Fiorentini C, Pepi M, Cosgrove C, Carr L, Chao C, Dahiya A, Prasad S, Younger J, Biering-Sorensen T, Christensen L, Krieger D, Mogelvang R, Jensen J, Hojberg S, Host N, Karlsen F, Christensen H, Medressova A, Abikeyeva L, Dzhetybayeva S, Andossova S, Kuatbayev Y, Bekbossynova M, Bekbossynov S, Pya Y, Farsalinos K, Tsiapras D, Kyrzopoulos S, Spyrou A, Stefopoulos C, Romagna G, Tsimopoulou K, Tsakalou M, Voudris V, Cacicedo A, Velasco Del Castillo S, Anton Ladislao A, Aguirre Larracoechea U, Onaindia Gandarias J, Romero Pereiro A, Arana Achaga X, Zugazabeitia Irazabal G, Laraudogoitia Zaldumbide E, Lekuona Goya I, Varela A, Kotsovilis S, Salagianni M, Andreakos V, Davos C, Merchan Ortega G, Bonaque Gonzalez J, Sanchez Espino A, Bolivar Herrera N, Macancela Quinones J, Ikuta I, Ferrer Lopez R, Munoz Troyano S, Bravo Bustos D, Gomez Recio M. Poster session Friday 13 December - PM: 13/12/2013, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|