Article
Cardiac & Cardiovascular Systems
Dominic Emerson, Joanna Chikwe, Pedro Catarino, Mohamed Hassanein, Luqin Deng, Ryan S. Cantor, Amy Roach, Robert Cole, Fardad Esmailian, Jon Kobashigawa, Jaime Moriguchi, James K. Kirklin
Summary: In contemporary practice, elderly patients receiving LVADs showed improved survival, increased functional capacity, enhanced quality of life, and fewer complications compared with younger patients.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Review
Engineering, Biomedical
Amit Alam, David A. Baran, Harsh Doshi, Johanna Van Zyl, Srikant Patlolla, Mahmoud Salem, Aasim Afzal, Farah Al-Saffar, Shelley A. Hall
Summary: This systematic review evaluates the safety and efficacy of the ProtekDuo as a right ventricular support device. The results from 7 studies show that the ProtekDuo is a safe and feasible option with low mortality rates.
Article
Cardiac & Cardiovascular Systems
Jared P. Beller, J. Hunter Mehaffey, Zachary K. Wegermann, Maria Grau-Sepulveda, Sean M. O'Brien, J. Matthew Brennan, Vinod Thourani, Vinay Badhwar, Francis D. Pagani, Gorav Ailawadi, Leora T. Yarboro, Nicholas R. Teman
Summary: Patients with severe right ventricular failure during durable left ventricular assist device implantation may benefit from the use of RVAD over VA-ECMO. Regardless of the type of support, initiation at the index operation was associated with improved outcomes.
ANNALS OF THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Brent C. Lampert, Jeffrey J. Teuteberg, Jennifer Cowger, Nahush A. Mokadam, Ryan S. Cantor, Raymond L. Benza, Asvin M. Ganapathi, Susan L. Myers, William Hiesinger, Joseph Woo, Francis Pagani, James K. Kirklin, Bryan A. Whitson
Summary: Comparing outcomes of patients implanted with continuous flow LVADs via thoracotomy and sternotomy approaches, it was found that thoracotomy did not reduce right ventricular failure or improve survival, but did result in a shorter postoperative length of stay.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Masashi Kawabori, Taylor Nordan, Navin K. Kapur, Gregory S. Couper
Summary: Right ventricular failure has a negative impact on prognosis post left ventricular assist device implantation. However, a strategy for primary prevention of right ventricular failure in high-risk patients has been proposed.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Medicine, General & Internal
Vincenzo Tarzia, Matteo Ponzoni, Demetrio Pittarello, Gino Gerosa
Summary: We propose a patient-tailored strategy that utilizes the ProtekDuo cannula in an innovative way to perform cardiopulmonary bypass during LVAD implantation in ECMO patients, considering the risk for postoperative right heart failure. Our preliminary study showed that this strategy is feasible for planned minimally invasive right ventricular support in ECMO patients scheduled for a durable LVAD implantation.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Claudio A. Bravo, Andrew G. Navarro, Karanpreet K. Dhaliwal, Maziar Khorsandi, Jeffrey E. Keenan, Parvathi Mudigonda, Kevin D. O'Brien, Claudius Mahr
Summary: Left ventricular assist device (LVAD) therapy is a life-saving option for patients with advanced heart failure who do not respond to medical treatment. However, a significant percentage of LVAD patients develop right heart failure (RHF), which is associated with poor outcomes. The mechanisms of RHF are complex, involving patient factors, surgical factors, and hemodynamic factors. Despite advances in surgical techniques and LVAD technology, RHF remains a major cause of morbidity and mortality among LVAD patients. Current medical therapies for RHF are limited, and cardiac transplantation or supportive management are the only options for these patients. Efforts to predict the risk of RHF in LVAD patients have been challenging, with varying definitions of RHF in different studies. Additionally, most research in this field has focused on early-onset RHF, while late-onset RHF is increasingly recognized as a significant problem. This review aims to describe the unique physiology of the right ventricle and the changes caused by LVADs that may contribute to both early- and late-onset RHF. The available treatments for RHF, including mechanical circulatory support and medical therapies, will also be analyzed.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
E. Wilson Grandin, Gaurav Gulati, Jose Nunez, Kevin Kennedy, J. Eduardo Rame, Pavan Atluri, Francis D. Pagani, James K. Kirklin, Robert L. Kormos, Jeffrey Teuteberg, Michael S. Kiernan
Summary: Adult CF-LVAD patients receiving early PDE5i showed similar rates of late right heart failure, mortality and major bleeding compared to those who did not receive early PDE5i.
CIRCULATION-HEART FAILURE
(2022)
Article
Cardiac & Cardiovascular Systems
Rashmi Jain, Lauren K. Truby, Veli K. Topkara
Summary: Residual MR is associated with worse clinical outcomes in patients supported by LVAD, and strategies to minimize MR should be considered in LVAD patients with residual MR.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)
Article
Health Care Sciences & Services
Dusko Terzic, Svetozar Putnik, Emilija Nestorovic, Vladimir Jovicic, Dejan Lazovic, Nemanja Rancic, Vladimir Milicevic, Dragan Ivanisevic, Radmila Karan, Aleksandar Mikic
Summary: The aim of this study was to examine the incidence and significance of right heart failure (RHF) in the early and late phase of left ventricular assist device (LVAD) implantation with identification of predictive factors for RHF development. The study found that ERHF and LRHF development were associated with factors such as brain natriuretic peptide (BNP), pre-surgery RHF, FAC, prior renal insufficiency, and total duration of ICU stay.
Article
Cardiac & Cardiovascular Systems
Sung-Min Cho, J. Hunter Mehaffey, Susan L. Meyers, Ryan S. Cantor, Randall C. Starling, James K. Kirklin, Jeffrey P. Jacobs, John Kern, Ken Uchino, Leora T. Yarboro
Summary: Comparing two contemporary centrifugal-flow left ventricular assist devices, HM3 is associated with lower hazard of major NAEs compared to HVAD in both early postimplantation period and constant hazard phase.
Article
Cardiac & Cardiovascular Systems
Kathleen L. Grady, Pariya L. Fazeli, James K. Kirklin, Salpy Pamboukian, Connie White-Williams
Summary: Factors related to health-related quality of life 2 years after LVAD implantation include patients' preimplant intended goal of therapy, clinical, and psychological variables, among which the short-term group had a significantly higher VAS score compared to the other two groups.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Cardiac & Cardiovascular Systems
Anubodh S. Varshney, Ersilia M. DeFilippis, Jennifer A. Cowger, Ivan Netuka, Sean P. Pinney, Michael M. Givertz
Summary: With the increasing prevalence of advanced heart failure, treatment options such as heart transplantation and LVAD support have shown to improve quality of life and extend survival. Recent advancements, including the use of HeartMate 3 in clinical practice and revisions to the organ allocation system, have led to better management of LVAD-related complications. Although contemporary LVAD recipients have higher illness severity preoperatively, they have higher survival rates and lower adverse event rates compared to previous eras. However, challenges such as bleeding, infection, neurologic events, and right ventricular failure still limit the wider implementation of LVAD support. Ongoing efforts to optimize management of current LVAD devices and develop next-generation devices are expected to further enhance outcomes for patients with advanced heart failure.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Eduard Rodenas-Alesina, Darshan H. Brahmbhatt, Vivek Rao, Marcus Salvatori, Filio Billia
Summary: This review discusses the occurrence of RVF in LVAD patients and provides multiple tools for predicting the risk of RVF, aiding in the selection of suitable LVAD candidates. It also presents a multidisciplinary approach to early RVF management and the indications and management of right ventricular assist devices.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Medicine, General & Internal
Alessia Gambaro, Gianmarco Lombardi, Francesco Onorati, Leonardo Gottin, Flavio Luciano Ribichini
Summary: LVAD implantation has complex effects on the kidneys, particularly regarding renal function. Creatinine-based eGFR formulas help in assessing patient prognosis, while deterioration in renal function in LVAD patients negatively impacts outcomes.
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2021)
Article
Engineering, Biomedical
Konstantin Zhigalov, Jef Van den Eynde, Alina Zubarevich, Thomas Chrosch, Lukas Goerdt, Arian Arjomandi Rad, Robert Vardanyan, Michel Pompeu Barros Oliveira Sa, Peter Luedike, Nikolaus Pizanis, Achim Koch, Bastian Schmack, Markus Kamler, Arjang Ruhparwar, Alexander Weymann
Summary: The study found that using the CytoSorb device for extracorporeal blood purification did not significantly reduce morbidity or mortality for patients undergoing LVAD implantation. Patients treated with CytoSorb were more likely to experience respiratory failure, require longer mechanical ventilation, and need tracheostomy compared to those not treated with CytoSorb.
Article
Engineering, Biomedical
Alina Zubarevich, Konstantin Zhigalov, Marcin Szczechowicz, Arian Arjomandi Rad, Robert Vardanyan, Saeed Torabi, Maria Papathanasiou, Peter Luedike, Achim Koch, Nikolaus Pizanis, Markus Kamler, Bastian Schmack, Arjang Ruhparwar, Alexander Weymann
Summary: In this retrospective study of 35 patients in acute cardiogenic shock, the bridge with ECLS to durable LVAD was shown to have acceptable survival rates and significant recovery of liver and kidney function, suggesting it is a feasible method for patients presenting with end-stage heart failure and cardiogenic shock.
INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS
(2022)
Article
Cardiac & Cardiovascular Systems
Alina Zubarevich, Arian Arjomandi Rad, Marcin Szczechowicz, Anja Osswald, Bastian Schmack, Arjang Ruhparwar, Alexander Weymann
Summary: This paper introduces the Artisential (R) surgeon-powered robotic instruments and discusses their advantages compared to conventional and robotic devices.
JOURNAL OF CARDIAC SURGERY
(2022)
Article
Surgery
Alina Zubarevich, Marcin Szczechowicz, Rolf-Alexander Janosi, Alexander Lind, Tienush Rassaf, Rizwan Malik, Matthias Thielmann, Bastian Schmack, Markus Kamler, Arjang Ruhparwar, Alexander Weymann, Daniel Wendt
Summary: Transapical and transaortic TAVR in high-risk patients who are not suitable for transfemoral access are still reasonable alternatives, with STS and STS/ACC scores being highly accurate predictors of in-hospital mortality in these patients.
MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES
(2022)
Article
Engineering, Biomedical
Alina Zubarevich, Arian Arjomandi Rad, Marcin Szczechowicz, Peter Luedike, Achim Koch, Nikolaus Pizanis, Markus Kamler, Arjang Ruhparwar, Alexander Weymann, Bastian Schmack
Summary: This study reviewed the clinical experience with the Impella(R) pump and analyzed the major adverse events associated with the device. The results showed that the Impella(R) pump is an appropriate therapeutic option for patients with acute cardiogenic shock, providing sufficient left ventricular unloading without the risk of stroke.
Article
Multidisciplinary Sciences
Zaki Haidari, Ender Demircioglu, Kristina Boss, Bartosz Tyczynski, Matthias Thielmann, Bastian Schmack, Andreas Kribben, Alexander Weymann, Mohamed El Gabry, Arjang Ruhparwar, Daniel Wendt
Summary: This study evaluated the clinical effects of intraoperative hemoadsorption in high-risk patients with infective endocarditis. The results showed that intraoperative hemoadsorption significantly reduced sepsis-associated mortality and resulted in faster recovery of hemodynamics and organ function.
Article
Cardiac & Cardiovascular Systems
Ali Haddad, Olga Tsarenko, Cynthia Szalai, Ahmed Mohamed, Marcel Hochreiter, Marc Moritz Berger, Bastian Schmack, Arjang Ruhparwar, Thorsten Brenner, Sharaf-Eldin Shehada
Summary: This study aimed to evaluate the reliability and accuracy of noninvasive measurement of systolic pulmonary artery pressure (SPAP) using Doppler echocardiography compared to invasive measurement using pulmonal artery catheter (PAC) in patients with mitral regurgitation (MR) undergoing surgery. The results showed that transesophageal echocardiography underestimated SPAP compared to PAC measurement, and there was a significant difference between the two approaches. Therefore, the use of PAC is recommended for the diagnosis and monitoring of pulmonary hypertension (PH) in MR patients.
REVIEWS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Chemistry, Multidisciplinary
Alexander Weymann, Javad Foroughi, Robert Vardanyan, Prakash P. P. Punjabi, Bastian Schmack, Sinmisola Aloko, Geoffrey M. M. Spinks, Chun H. H. Wang, Arian Arjomandi Rad, Arjang Ruhparwar
Summary: Medical soft robotics is a rapidly developing field in the treatment of cardiovascular diseases, offering a promising future for heart failure patients worldwide. This review focuses on artificial muscle-based soft robotic biomedical devices, particularly electrothermally artificial heart muscles (AHMs), and their potential to support cardiac function. These artificial muscles can undergo complex deformations, aiding cardiac function while maintaining a limited weight and use of space. Future research opportunities and directions, as well as the limitations of currently available devices, are critically analyzed.
ADVANCED MATERIALS
(2023)
Article
Engineering, Biomedical
Alina Zubarevich, Anja Osswald, Lukman Amanov, Arian Arjomandi Rad, Bastian Schmack, Arjang Ruhparwar, Alexander Weymann
Summary: Through ex vivo perfusion and decellularization, we have successfully created bioengineered transplantable heart-lung scaffolds. The development of this technology could provide a life-saving conduit, significantly reducing the risks of heart-lung surgery and improving postoperative quality of life.
Article
Engineering, Biomedical
Simon Wernhart, Maria Papathanasiou, Aiste Jakstaite, Julia Hoffmann, Bastian Schmack, Juergen Hedderich, Arjang Ruhparwar, Tienush Rassaf, Peter Luedike
Summary: The aim of this study was to investigate whether left ventricular assist device (LVAD) can reverse exercise oscillatory ventilation (EOV) in patients with heart failure and prevent short-term rehospitalization. The results showed that lower maximal oxygen consumption (VO2peak) was associated with rehospitalization, and the occurrence rate of EOV was similar in LVAD and heart failure patients. This may indicate insufficient unloading during exercise in chronic LVAD therapy and limited exercise capacity following LVAD implantation. Further studies are needed to determine whether EOV can serve as a non-invasive predictor of insufficient LV unloading and necessitating LVAD reprograming.
Article
Cardiac & Cardiovascular Systems
Alina Zubarevich, Arian Arjomandi Rad, Lukman Amanov, Marcin Szczechowicz, Anja Osswald, Saeed Torabi, Bastian Schmack, Arjang Ruhparwar, Alexander Weymann
Summary: In this study, we reviewed the experience of using sutureless aortic valve replacement in patients with pure aortic regurgitation. The results showed that the surgery achieved good postoperative outcomes in these patients.
JOURNAL OF CARDIOTHORACIC SURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Peter Luedike, Maria Papathanasiou, Bastian Schmack, Markus Kamler, Christian Perings, Arjang Ruhparwar, Tienush Rassaf
Summary: Diagnosis and treatment of heart failure is challenging, and the development of specialized HF networks is necessary for patients to access guideline directed therapies. These networks should include different levels of healthcare providers and consider regional peculiarities, academic standards, quality indicators, interdisciplinarity, and reimbursement strategies. Certification systems at the national and regional level are important to ensure guideline standards and prevent regional hierarchies or dependencies. The networks should also incorporate digital communication, educational programs, telehealth concepts, and follow-up algorithms to enhance sustainability and efficacy.
Article
Respiratory System
Anja Osswald, Alexander Weymann, Konstantinos Tsagakis, Alina Zubarevich, Matthias Thielmann, Bastian Schmack, Arjang Ruhparwar, Christof Karmonik
Summary: Distal stent graft induced new entry (dSINE) is an emerging complication after frozen elephant trunk (FET) procedure. This computational fluid dynamics (CFD) study investigated the role of wall shear stress (WSS) after the development of dSINE based on hemodynamic changes. The results suggest that the increase in WSS may play an important role in weakening the aortic wall and other adverse events similar to aortic rupture.
JOURNAL OF THORACIC DISEASE
(2023)
Article
Cardiac & Cardiovascular Systems
Jamila Kremer, Etienne Fasolt Richard Corvin Meinert, Mina Farag, Florian Mueller, Jasmin Penelope Soethoff, Matthias Karck, Bastian Schmack, Anna Lassia Meyer, Gregor Warnecke
Summary: Cold atmospheric plasma treatment is an effective, safe, and non-invasive adjunct technique for treating driveline infections in LVAD patients.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2022)
Article
Cardiac & Cardiovascular Systems
Bernd Niemann, Christian Stoppe, Michael Wittenberg, Susanne Rohrbach, Saeed Diyar, Michael Billion, Evgenij Potapov, Mehmet Oezkur, Payam Akhyari, Bastian Schmack, David Schibilsky, Alexander M. Bernhardt, Jan D. Schmitto, Christian Hagl, Paolo Masiello, Andreas Boening
Summary: Cardiac support systems are increasingly used in the treatment of heart failure and cardiogenic shock. Choosing the appropriate support device, management strategies, and treatment approaches are crucial for the recovery of patients. However, it remains unclear which patients benefit from certain systems, when to initiate mechanical circulatory support, which support system to choose, and what the future prospects and developments are.
THORACIC AND CARDIOVASCULAR SURGEON
(2022)