Adverse events in contemporary continuous-flow left ventricular assist devices: A multi- institutional comparison shows significant differences John M.

Slides:

Advertisements

Similar presentations

MCSRN Mechanical Circulatory Support Research Network

Advertisements

Jennifer A. Cowger, MD, Matthew A

Operative outcomes in mitral valve surgery: Combined effect of surgeon and hospital volume in a population-based analysis Arman Kilic, MD, Ashish S.

Aortic valve replacement in low-flow, low-gradient aortic stenosis: Left ventricular ejection fraction matters Victor Dayan, MD, PhD, Philippe Pibarot,

Palliative Medicine and Preparedness Planning for Patients Receiving Left Ventricular Assist Device as Destination Therapy—Challenges to Measuring Impact.

A 20-year experience with isolated pericardiectomy: Analysis of indications and outcomes Erin A. Gillaspie, MD, John M. Stulak, MD, Richard C. Daly,

Zain Khalpey, MD, PhD, MRCS (Eng), Nicole Sydow, MD, Marvin J

Long-term mechanical circulatory support: A new disease state?

Association of device surface and biomaterials with immunologic sensitization after mechanical support Isaac George, MD, Patrick Colley, BS, Mark J.

Pump Replacement for Left Ventricular Assist Device Failure Can Be Done Safely and Is Associated With Low Mortality Nader Moazami, MD, Carmelo A. Milano,

Laura Harvey, MD, Christopher Holley, MD, Samit S

Martin Strueber, MD, Anna L

A tale of two centrifugal left ventricular assist devices

The days of future past Neel K. Ranganath, MD, Aubrey C. Galloway, MD

Effects on pre- and posttransplant pulmonary hemodynamics in patients with continuous-flow left ventricular assist devices Ranjit John, MD, Kenneth Liao,

Intrinsic cardiac stem cells are essential for regeneration

Centers for Disease Control “increased-risk” organ donor: Not so risky? Francis D. Pagani, MD, PhD The Journal of Thoracic and Cardiovascular Surgery

Elucidating the intricate mechanisms of gastrointestinal bleeding in a continuous-flow left ventricular assist device will lead to future therapeutic.

Form ever follows function

Victor van Berkel, MD, PhD

How should we treat air leaks?

Go on-pump or off-pump in diabetic patients?

In vitro hemodynamic characterization of HeartMate II at 6000 rpm: Implications for weaning and recovery Gengo Sunagawa, MD, Nicole Byram, BS, Jamshid.

Right ventricular failure in patients with the HeartMate II continuous-flow left ventricular assist device: Incidence, risk factors, and effect on outcomes

Intra-aortic balloon pump therapy negatively affects flow through a continuous-flow left ventricular assist device Dipanjan Banerjee, MD, MS, Chun Choi,

The lord of the rings Antonio Miceli, MD, PhD

Continuous-Flow Left Ventricular Assist Device Implantation in Patients With a Small Left Ventricle Masashi Kawabori, MD, Chitaru Kurihara, MD, Tadahisa.

Expanding left ventricular assist device use to patients with disabilities: The role of assistive technology Juan A. Crestanello, MD The Journal of.

Kyle W. Riggs, MD, David L.S. Morales, MD

Intra-aortic balloon pumps and continuous flow left ventricular assist devices: Don't let balloon pumps overstay their welcome Kevin G. Soucy, PhD, Steven.

Long-term outcome of patients on continuous-flow left ventricular assist device support Koji Takeda, MD, PhD, Hiroo Takayama, MD, PhD, Bindu Kalesan,

Left ventricular assist device therapy in a patient with hearing and speech disabilities Sotirios Spiliopoulos, MD, PhD, Vera Hergesell, MD, Otto Dapunt,

Nicholas A. Haglund, MD, Mary E. Davis, MS, CCRP, Nicole M

Ranjit John, MD, Yoshifumi Naka, MD, Soon J

The assessment of cost effectiveness and the effectiveness of cost assessment in cardiothoracic surgery Vinay Badhwar, MD The Journal of Thoracic and.

Right ventricular failure after cardiac surgery: Why can't right ventricular assist device support fix the problem? Francis D. Pagani, MD, PhD The Journal.

“Some people see innovation as change, but we have never really seen it like that. It's understanding things and making them better.” Adapted from Tim.

Successful combined procedure of HeartMate II left ventricular assist device implantation and minimally invasive transapical aortic valve replacement

Durability of left ventricular assist devices: Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) 2006 to 2011 William L.

William L. Holman, MD, James K. Kirklin, MD, David C

Minimally invasive off-pump implantation of HeartMate 3 left ventricular assist device Diyar Saeed, MD, PhD, Stephan Sixt, MD, PhD, Alexander Albert,

Jeevanantham Rajeswaran, PhD, Eugene H. Blackstone, MD

Fenton H. McCarthy, MD, MS, Nimesh D. Desai, MD, PhD

Anticoagulation with apixaban in a patient with a left ventricular assist device and gastrointestinal bleeding: A viable alternative to warfarin? Francesco.

A fate worse than death Jennifer S. Lawton, MD

The Ross procedure: Time to reevaluate the guidelines

Outcomes of Patients Receiving Temporary Circulatory Support Before Durable Ventricular Assist Device Palak Shah, MD, MS, Francis D. Pagani, MD, PhD,

Mechanical Circulatory Support and Heart Transplantation: Donor and Recipient Factors Influencing Graft Survival Simon Maltais, MD, PhD, Nikhil P. Jaik,

Early Outcomes With Marginal Donor Hearts Compared With Left Ventricular Assist Device Support in Patients With Advanced Heart Failure Erin M. Schumer,

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

Surgical approach to continuous-flow left ventricular assist device explantation: A comparison of outcomes Andrew C.W. Baldwin, MD, Elena Sandoval, MD,

Patients with unbalanced atrioventricular canal defects can undergo the Fontan operation with good outcomes Sitaram M. Emani, MD The Journal of Thoracic.

Left ventricular assist device implantation after acute anterior wall myocardial infarction and cardiogenic shock: A two-center study Nicholas C. Dang,

The origins of open heart surgery at the University of Minnesota 1951 to 1956 Richard A. DeWall, MD The Journal of Thoracic and Cardiovascular Surgery

Use of polytetrafluoroethylene vascular graft to cover the kinking protector of left ventricular assist device facilitates later pump exchange Evgenij.

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

The future of cardiac surgery training: A survival guide

Ventricular assistant in restrictive cardiomyopathy: Making the right connection Robert D.B. Jaquiss, MD The Journal of Thoracic and Cardiovascular Surgery

Hope should not spring eternal

Postcardiac transplant survival in the current era in patients receiving continuous-flow left ventricular assist devices Forum Kamdar, MD, Ranjit John,

Seeing is believing: A call for routine early postoperative hemodynamic transesophageal echocardiography monitoring after left ventricular assist device.

“The more things change…”: The challenges ahead

Appropriate Use Criteria for coronary revascularization in patients with stable ischemic heart disease: What the surgeon needs to know Harold L. Lazar,

Ryan R. Davies, MD The Journal of Thoracic and Cardiovascular Surgery

The evolution of cardiothoracic critical care

Gastrointestinal bleeding after left ventricular assist device implantation: It is all about the platelets Juan A. Crestanello, MD The Journal of Thoracic.

Did you like Terminator 3 better than Terminator 2

Marginal Donor Use in Patients Undergoing Heart Transplantation With Left Ventricular Assist Device Explantation Marat Fudim, MD, Mary E. Davis, MS,

How do we follow up our patients

Presentation transcript:

Adverse events in contemporary continuous-flow left ventricular assist devices: A multi- institutional comparison shows significant differences John M. Stulak, MD, Mary E. Davis, MS, Nicholas Haglund, MD, Shannon Dunlay, MD, Jennifer Cowger, MD, Palak Shah, MD, Francis D. Pagani, MD, PhD, Keith D. Aaronson, MD, Simon Maltais, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 1, Pages 177-189 (January 2016) DOI: 10.1016/j.jtcvs.2015.09.100 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Overall survival for patients undergoing HMII (solid line) versus HVAD (dotted line) implantation; no difference was found, with data stratified by device type (P = .96). HMII, HeartMate II; HVAD, HeartWare ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Time-related cumulative risk of GI bleeding for patients undergoing HMII (solid line) versus HVAD (dotted line) implantation; no significant difference was found, with data stratified by device type (P = .18). HMII, HeartMate II; HVAD, HeartWare ventricular assist device; GI, gastrointestinal. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Time-related cumulative risk of any infection for patients undergoing HMII (solid line) versus HVAD (dotted line) implantation; the risk was significantly higher with the HVAD, with stratification by device type (P = .039). HMII, HeartMate II; HVAD, HeartWare ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Time-related cumulative risk of percutaneous driveline infection for patients undergoing HMII (solid line) versus HVAD (dotted line) implantation; no difference was found, with data stratified by device type (P = .14). HMII, HeartMate II; HVAD, HeartWare ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 A, Time-related cumulative risk of stroke for patients undergoing HMII (solid line) versus HVAD (dotted line) implantation; a significantly higher risk of stroke was found with the HVAD, with data stratified by device type (P = .006). B, No significant difference between devices was found in the cumulative risk of transient ischemic attack (P = .69). C, No significant difference was found between devices in the cumulative risk of ischemic stroke (P = .17). D, The cumulative risk of hemorrhagic stroke was significantly higher with the HVAD (P = .006). HMII, HeartMate II; HVAD, HeartWare ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 A, Time-related cumulative risk of stroke for patients undergoing HMII (solid line) versus HVAD (dotted line) implantation; a significantly higher risk of stroke was found with the HVAD, with data stratified by device type (P = .006). B, No significant difference between devices was found in the cumulative risk of transient ischemic attack (P = .69). C, No significant difference was found between devices in the cumulative risk of ischemic stroke (P = .17). D, The cumulative risk of hemorrhagic stroke was significantly higher with the HVAD (P = .006). HMII, HeartMate II; HVAD, HeartWare ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 A, Time-related cumulative risk of pump thrombus for patients undergoing HMII (solid line) versus HVAD (dotted line) implantation; no difference was found, with data stratified by device type (P = .35). B, No difference was found in cumulative risk of pump thrombus before (solid line), versus after, August 2011 (dotted line) (P = .33). HMII, HeartMate II; HVAD, HeartWare ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Adverse event risk comparison of the HVAD versus the HMII. The HVAD was associated with a higher risk of stroke and any infection, and a trend toward increased percutaneous driveline infection. AE, Adverse event; GI, gastrointestinal; HVAD, HeartWare ventricular assist device; HMII, HeartMate II. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 8 Competing outcomes are presented for patients after implantation with the HMII left ventricular assist device. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 9 Competing outcomes are presented for patients after implantation with the HVAD. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Adverse event risk for the HVAD versus the HMII LVADs. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 177-189DOI: (10.1016/j.jtcvs.2015.09.100) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions