1
|
Welp H, Sindermann J, Dell'Aquila AM, Deschka H, Hoffmeier A, Scherer M. Economic aspects of long-term left ventricular assist device treatment for chronic heart failure. ESC Heart Fail 2024; 11:2849-2856. [PMID: 38769653 PMCID: PMC11424323 DOI: 10.1002/ehf2.14774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/19/2023] [Accepted: 03/10/2024] [Indexed: 05/22/2024] Open
Abstract
AIMS Technological advances and the current shortage of donor organs have contributed to an increase in the number of left ventricular assist device (LVAD) implantations in patients with end-stage heart failure. Demographic change and medical progress might raise the number of these patients, resulting in a further increase in the number of LVAD implantations. The aim of this study was to evaluate the long-term costs of LVAD therapy and identify diagnoses resulting in expensive stays. METHODS AND RESULTS In this retrospective analysis of prospectively collected data, all patients after implantation of a second- or third-generation LVAD by 31 March 2022 were included. In addition to demographic and survival data, revenues and case mix points were determined for each patient. Of the 163 patients included, 75.5% were male. The mean age at LVAD implantation was 52 ± 14 years. The mean survival was 1458 ± 127 days. During follow-up, the total inpatient treatment time per patient was 70 ± 87 days. The average duration of outpatient treatment was 55.1%, based on the total duration of support. The average revenue per patient for the implant stay was $193 192.35 ± $111 801.29, for inpatient readmissions $52 068.96 ± $116 630.00, and for outpatient care $53 195.94 ± $62 363.53. CONCLUSIONS LVAD implantation in patients with end-stage heart failure leads to improved survival but a significant increase in treatment costs. Further multi-centre studies are necessary in order to be able to assess the effects of long-term LVAD treatment on the healthcare system.
Collapse
Affiliation(s)
- Henryk Welp
- Department of Cardiothoracic SurgeryUniversity Hospital of MuensterAlbert Schweitzer Campus 1, A148149MuensterGermany
- Interdisciplinary Heart Failure SectionUniversity Hospital of MuensterMuensterGermany
| | - Jürgen Sindermann
- Department of Cardiothoracic SurgeryUniversity Hospital of MuensterAlbert Schweitzer Campus 1, A148149MuensterGermany
- Interdisciplinary Heart Failure SectionUniversity Hospital of MuensterMuensterGermany
- Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart FailureUniversity Hospital of MuensterMuensterGermany
| | - Angelo Maria Dell'Aquila
- Department of Cardiothoracic SurgeryUniversity Hospital of MuensterAlbert Schweitzer Campus 1, A148149MuensterGermany
| | - Heinz Deschka
- Department of Cardiothoracic SurgeryUniversity Hospital of MuensterAlbert Schweitzer Campus 1, A148149MuensterGermany
| | - Andreas Hoffmeier
- Department of Cardiothoracic SurgeryUniversity Hospital of MuensterAlbert Schweitzer Campus 1, A148149MuensterGermany
| | - Mirela Scherer
- Department of Cardiothoracic SurgeryUniversity Hospital of MuensterAlbert Schweitzer Campus 1, A148149MuensterGermany
| |
Collapse
|
2
|
Konst B, Ohlsson L, Henriksson L, Sandstedt M, Persson A, Ebbers T. Optimization of photon counting CT for cardiac imaging in patients with left ventricular assist devices: An in-depth assessment of metal artifacts. J Appl Clin Med Phys 2024; 25:e14386. [PMID: 38739330 PMCID: PMC11244676 DOI: 10.1002/acm2.14386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/22/2024] [Accepted: 04/21/2024] [Indexed: 05/14/2024] Open
Abstract
PURPOSE Photon counting CT (PCCT) holds promise for mitigating metal artifacts and can produce virtual mono-energetic images (VMI), while maintaining temporal resolution, making it a valuable tool for characterizing the heart. This study aimed to evaluate and optimize PCCT for cardiac imaging in patients during left ventricular assistance device (LVAD) therapy by conducting an in-depth objective assessment of metal artifacts and visual grading. METHODS Various scan and reconstruction settings were tested on a phantom and further evaluated on a patient acquisition to identify the optimal protocol settings. The phantom comprised an empty thoracic cavity, supplemented with heart and lungs from a cadaveric lamb. The heart was implanted with an LVAD (HeartMate 3) and iodine contrast. Scans were performed on a PCCT (NAEOTOM Alpha, Siemens Healthcare). Metal artifacts were assessed by three objective methods: Hounsfield units (HU)/SD measurements (DiffHU and SDARTIFACT), Fourier analysis (AmplitudeLowFreq), and depicted LVAD volume in the images (BloomVol). Radiologists graded metal artifacts and the diagnostic interpretability in the LVAD lumen, cardiac tissue, lung tissue, and spinal cord using a 5-point rating scale. Regression and correlation analysis were conducted to determine the assessment method most closely associated with acquisition and reconstruction parameters, as well as the objective method demonstrating the highest correlation with visual grading. RESULTS Due to blooming artifacts, the LVAD volume fluctuated between 27.0 and 92.7 cm3. This variance was primarily influenced by kVp, kernel, keV, and iMAR (R2 = 0.989). Radiologists favored pacemaker iMAR, 3 mm slice thickness, and T3D keV and kernel Bv56f for minimal metal artifacts in cardiac tissue assessment, and 110 keV and Qr40f for lung tissue interpretation. The model adequacy for DiffHU SDARTIFACT, AmplitueLowFreq, and BloomVol was 0.28, 0.76, 0.29, and 0.99 respectively for phantom data, and 0.95, 0.98, 1.00, and 0.99 for in-vivo data. For in-vivo data, the correlation between visual grading (VGSUM) and DiffHU SDARTIFACT, AmplitueLowFreq, and BloomVol was -0.16, -0.01, -0.48, and -0.40 respectively. CONCLUSION We found that optimal scan settings for LVAD imaging involved using 120 kVp and IQ level 80. Employing T3D with pacemaker iMAR, the sharpest allowed vascular kernel (Bv56f), and VMI at 110 keV with kernel Qr40 yields images suitable for cardiac imaging during LVAD-therapy. Volumetric measurements of the LVAD for determination of the extent of blooming artifacts was shown to be the best objective method to assess metal artifacts.
Collapse
Affiliation(s)
- Bente Konst
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
- Department of RadiologyVestfold HospitalTønsbergNorway
| | - Linus Ohlsson
- Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
- Department of Thoracic and Vascular Surgery in Östergötland, and Department of HealthMedicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Lilian Henriksson
- Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
- Department of Radiology in Linköpingand Department of HealthMedicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Mårten Sandstedt
- Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
- Department of Radiology in Linköpingand Department of HealthMedicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Anders Persson
- Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
- Department of Radiology in Linköpingand Department of HealthMedicine and Caring SciencesLinköping UniversityLinköpingSweden
| | - Tino Ebbers
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
| |
Collapse
|
3
|
Montisci A, Palmieri V, Vietri MT, Sala S, Maiello C, Donatelli F, Napoli C. Big Data in cardiac surgery: real world and perspectives. J Cardiothorac Surg 2022; 17:277. [PMID: 36309702 PMCID: PMC9617748 DOI: 10.1186/s13019-022-02025-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Big Data, and the derived analysis techniques, such as artificial intelligence and machine learning, have been considered a revolution in the modern practice of medicine. Big Data comes from multiple sources, encompassing electronic health records, clinical studies, imaging data, registries, administrative databases, patient-reported outcomes and OMICS profiles. The main objective of such analyses is to unveil hidden associations and patterns. In cardiac surgery, the main targets for the use of Big Data are the construction of predictive models to recognize patterns or associations better representing the individual risk or prognosis compared to classical surgical risk scores. The results of these studies contributed to kindle the interest for personalized medicine and contributed to recognize the limitations of randomized controlled trials in representing the real world. However, the main sources of evidence for guidelines and recommendations remain RCTs and meta-analysis. The extent of the revolution of Big Data and new analytical models in cardiac surgery is yet to be determined.
Collapse
|
4
|
Can a Heart Recently Recovered from an Acute Pulmonary Embolism Supported by Venoarterial Extracorporeal Membrane Oxygenation be Considered for Donation? ASAIO J 2022; 68:e90-e91. [PMID: 35239540 DOI: 10.1097/mat.0000000000001686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
5
|
Runyan C, Marshall C, Aronow H, Vongkavivathanakul S, Daniels L, Currey J, Coleman B. Evaluation of Team-Based Learning to Increase Nurses' Knowledge of the Ventricular Assist Device. J Contin Educ Nurs 2021; 52:13-20. [PMID: 33373002 DOI: 10.3928/00220124-20201215-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 06/17/2020] [Indexed: 11/20/2022]
Abstract
Ventricular assist devices (VAD) are used to extend life expectancy for patients with advanced heart failure. Approximately 102 hospitals nationwide have a VAD program, but the majority implant only a small number of devices each year. This low-volume and high-acuity patient population can create concerns for maintaining nursing knowledge skill levels. Nursing staff from a step-down telemetry floor in a large urban hospital completed an Individual Readiness Assessment Test to assess their knowledge and accuracy in the care of mechanical circulatory support patients using the Immediate Feedback Assessment Technique. The nurses were then assigned to small groups and worked as a team to complete the same test known as the Group Readiness Assessment Test. Study results suggest that team-based learning was effective in increasing knowledge of mechanical circulatory support. [J Contin Educ Nurs. 2021;52(1):13-20.].
Collapse
|
6
|
Coutance G, Kransdorf E, Bonnet G, Loupy A, Kobashigawa J, Patel JK. Statistical performance of 16 posttransplant risk scores in a contemporary cohort of heart transplant recipients. Am J Transplant 2021; 21:645-656. [PMID: 32713121 DOI: 10.1111/ajt.16217] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/06/2020] [Accepted: 07/19/2020] [Indexed: 01/25/2023]
Abstract
Accurate risk stratification of early heart transplant failure is required to avoid futile transplants and rationalize donor selection. We aimed to evaluate the statistical performance of existing risk scores on a contemporary cohort of heart transplant recipients. After an exhaustive search, we identified 16 relevant risk scores. From the UNOS database, we selected all first noncombined adult heart transplants performed between 2014 and 2017 for validation. The primary endpoint was death or retransplant during the first year posttransplant. For all scores, we analyzed their association with outcomes, sensitivity, specificity, likelihood ratios, and discrimination (concordance index and overlap of individual scores). The cohort included 9396 patients. All scores were significantly associated with the primary outcome (P < .001 for all scores). Their likelihood ratios, both negative and positive, were poor. The discriminative performance of all scores was limited, with concordance index ranging from 0.544 to 0.646 (median 0.594) and an important overlap of individual scores between patients with or without the primary endpoint. Subgroup analyses revealed important variation in discrimination according to donor age, recipient age, and the type of assist device used at transplant. Our findings raise concerns about the use of currently available scores in the clinical field.
Collapse
Affiliation(s)
- Guillaume Coutance
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA.,Paris Translational Research Centre for Organ Transplantation, Université de Paris, INSERM UMR 970, Paris, France
| | - Evan Kransdorf
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA
| | - Guillaume Bonnet
- Paris Translational Research Centre for Organ Transplantation, Université de Paris, INSERM UMR 970, Paris, France
| | - Alexandre Loupy
- Paris Translational Research Centre for Organ Transplantation, Université de Paris, INSERM UMR 970, Paris, France
| | - Jon Kobashigawa
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA
| | - Jignesh K Patel
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA
| |
Collapse
|
7
|
Boutolleau D, Coutance G, Désiré E, Bouglé A, Bréchot N, Leprince P, Varnous S. Association between cytomegalovirus infection and allograft rejection in a large contemporary cohort of heart transplant recipients. Transpl Infect Dis 2021; 23:e13569. [PMID: 33452851 DOI: 10.1111/tid.13569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cytomegalovirus (CMV) infection remains a common complication after heart transplantation (HTx). The association between CMV infection and allograft rejection is debated in the era of efficient prophylactic antiviral therapies. METHODS This single-center cohort study utilized a highly phenotyped database of HTx recipients (2012-2016). The primary endpoint was the analysis of the association between CMV infection (CMV load ≥ 500 IU/mL whole blood) and the risk of allograft rejection (cellular rejection ≥ 1R1B, antibody-mediated rejection ≥ pAMR1). Secondary endpoints included the analysis of a higher CMV load threshold (≥10 000 IU/mL) and different risk periods after PCR positivity. A mixed-effect logistic regression model with a random intercept was applied. Results were adjusted for important risk factors of rejection. RESULTS Overall, 384 patients were included and 6388 CMV loads and 3,494 endomyocardial biopsies were analyzed. CMV infections ≥ 500 IU/mL were diagnosed on 1223 (19.2%) blood samples from 284 (72.1%) patients and allograft rejections on 246 biopsies (7%) from 149 patients (38.8%). We did not find any association between CMV infection ≥ 500 IU/mL and rejection (univariable: OR 0.94, 95% CI [0.61, 1.45], P = .78, multivariable: OR 0.86, 95% CI [0.55, 1.33], P = .85). These results were consistent when analyzing a higher CMV load threshold and different periods of risk, reinforced by internal validation procedures and a posteriori calculation of the power (primary endpoint: power = 0.82, 95% CI [0.79-0.84]) and reproducible across different clinical scenarios. CONCLUSIONS CMV infection was not associated with an increased risk of rejection in a contemporary cohort of HTx recipients.
Collapse
Affiliation(s)
- David Boutolleau
- Virology Department, Sorbonne Université, INSERM UMR U1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Team 3 THERAVIR, and Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, National Reference Centre for Herpesviruses, Paris, France
| | - Guillaume Coutance
- Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, Paris, France
| | - Eva Désiré
- Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, Paris, France
| | - Adrien Bouglé
- Department of Anesthesiology and Critical Care Medicine, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), Cardiology Institute, Pitié-Salpêtrière Hospital, Paris, France
| | - Nicolas Bréchot
- Department of Medical Intensive Care Unit, Cardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, Paris, France.,INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Pascal Leprince
- Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, Paris, France
| | - Shaida Varnous
- Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, Paris, France
| |
Collapse
|
8
|
Sisti N, Mandoli GE, Sciaccaluga C, Valente S, Mondillo S, Cameli M. Insight into Atrial Fibrillation in LVAD Patients: From Clinical Implications to Prognosis. Pulse (Basel) 2020; 8:2-14. [PMID: 32999873 DOI: 10.1159/000506600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/14/2020] [Indexed: 12/21/2022] Open
Abstract
The use of left ventricular assist devices (LVADs), whether for destination therapy or bridge to transplantation, has gained increasing validation in recent years in patients with advanced heart failure. Arrhythmias can be the most challenging variables in the management of such patients but the main attention has always been focused on ventricular arrhythmias given the detrimental impact on mortality. Nevertheless, atrial fibrillation (AF) is the most common rhythm disorder associated with advanced heart failure and may therefore characterize the LVADs' pre- and postimplantation periods. Indeed, the consequences of AF in the population suffering from standard heart failure may require a more comprehensive evaluation in the presence of or in sight of an LVAD, making the AF clinical management in these patients potentially complex. Several studies have been based on this subject with different and often conflicting results, leaving many questions unresolved. The purpose of this review is to summarize the main pieces of evidence about the clinical impact of AF in LVAD patients, underlining the main implications in terms of hemodynamics, thromboembolic risk, bleeding and prognosis. Therapeutic considerations about the clinical management of these patients are also made according to the latest evidence.
Collapse
Affiliation(s)
- Nicolò Sisti
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | | | | | - Serafina Valente
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - Sergio Mondillo
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - Matteo Cameli
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| |
Collapse
|
9
|
Parody-Rúa E, Rubio-Valera M, Guevara-Cuellar C, Gómez-Lumbreras A, Casajuana-Closas M, Carbonell-Duacastella C, Aznar-Lou I. Economic Evaluations Informed Exclusively by Real World Data: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1171. [PMID: 32059593 PMCID: PMC7068655 DOI: 10.3390/ijerph17041171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/03/2020] [Accepted: 02/08/2020] [Indexed: 12/28/2022]
Abstract
Economic evaluations using Real World Data (RWD) has been increasing in the very recent years, however, this source of information has several advantages and limitations. The aim of this review was to assess the quality of full economic evaluations (EE) developed using RWD. A systematic review was carried out through articles from the following databases: PubMed, Embase, Web of Science and Centre for Reviews and Dissemination. Included were studies that employed RWD for both costs and effectiveness. Methodological quality of the studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Of the 14,011 studies identified, 93 were included. Roughly half of the studies were carried out in a hospital setting. The most frequently assessed illnesses were neoplasms while the most evaluated interventions were pharmacological. The main source of costs and effects of RWD were information systems. The most frequent clinical outcome was survival. Some 47% of studies met at least 80% of CHEERS criteria. Studies were conducted with samples of 100-1000 patients or more, were randomized, and those that reported bias controls were those that fulfilled most CHEERS criteria. In conclusion, fewer than half the studies met 80% of the CHEERS checklist criteria.
Collapse
Affiliation(s)
- Elizabeth Parody-Rúa
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu–Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Spain; (M.R.-V.); (C.C.-D.); (I.A.-L.)
- Primary Care Prevention and Health Promotion Network (redIAPP), 08007 Barcelona, Spain
| | - Maria Rubio-Valera
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu–Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Spain; (M.R.-V.); (C.C.-D.); (I.A.-L.)
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | | | - Ainhoa Gómez-Lumbreras
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), 08007 Barcelona, Spain; (A.G.-L.); (M.C.-C.)
- Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain
- Health Science School, Universitat de Girona, 17071 Girona, Spain
| | - Marc Casajuana-Closas
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), 08007 Barcelona, Spain; (A.G.-L.); (M.C.-C.)
- Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Spain
| | - Cristina Carbonell-Duacastella
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu–Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Spain; (M.R.-V.); (C.C.-D.); (I.A.-L.)
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Ignacio Aznar-Lou
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu–Institut de Recerca Sant Joan de Déu, 08830 Barcelona, Spain; (M.R.-V.); (C.C.-D.); (I.A.-L.)
- CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| |
Collapse
|
10
|
Hamdan A, Puymirat E, Danchin N, Aissaoui N. Left ventricular assist device may improve glycemic control in diabetes mellitus patients but the reverse is not true. J Thorac Dis 2019; 10:S4093-S4095. [PMID: 30631564 DOI: 10.21037/jtd.2018.09.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Amer Hamdan
- Department of Intensive Care, Hôpital Européen Georges Pompidou (HEGP) Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Etienne Puymirat
- Department of cardiology, HEGP, APHP, Paris, France.,Université Paris Descartes, Paris, France
| | - Nicolas Danchin
- Department of cardiology, HEGP, APHP, Paris, France.,Université Paris Descartes, Paris, France
| | - Nadia Aissaoui
- Department of Intensive Care, Hôpital Européen Georges Pompidou (HEGP) Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.,Université Paris Descartes, Paris, France.,Paris-Cardiovascular-Research-Center, INSERM U970, Paris, France
| |
Collapse
|
11
|
Hamdan A, Ortuno S, Guerot E, Aissaoui N. L’assistance monoventriculaire gauche de longue durée : indications, management et complications. MEDECINE INTENSIVE REANIMATION 2018. [DOI: 10.3166/rea-2018-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
12
|
Left Ventricular Assist Devices - A State of the Art Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018. [PMID: 29532330 DOI: 10.1007/5584_2018_145] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Cardiovascular diseases are the leading cause of mortality rates throughout the world. Next to an insufficient number of healthy donors, this has led to increasing numbers of patients on heart transplant waiting lists with prolonged waiting times. Innovative technological advancements have led to the production of ventricular assist devices that play an increasingly important role in end stage heart failure therapy. This review is intended to provide an overview of current implantable left ventricular assist devices, different design concepts and implantation techniques. Challenges such as infections and thromboembolic events that may occur during LVAD implantations have also been discussed.
Collapse
|