- MeSH
- Anticoagulants therapeutic use MeSH
- Assisted Circulation instrumentation MeSH
- Long-Term Care * methods MeSH
- Humans MeSH
- Patient Care methods MeSH
- Heart-Assist Devices * MeSH
- Postoperative Complications MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
INTRODUCTION: Long-term use of continuous-flow left ventricular assist devices may have negative consequences for autonomic, cardiovascular and gastrointestinal function. It has thus been suggested that non-invasive monitoring of arterial pulsatility in patients with a left ventricular assist device is highly important for ensuring patient safety and longevity. We have developed a novel, semi-automated frequency-domain-based index of arterial pulsatility that is obtained during suprasystolic occlusions of the upper arm: the 'cuff pulsatility index'. PURPOSE: The purpose of this study was to evaluate the relationship between the cuff pulsatility index and invasively determined arterial pulsatility in patients with a left ventricular assist device. METHODS: Twenty-three patients with a left ventricular assist device with end-stage heart failure (six females: age = 65 ± 9 years; body mass index = 30.5 ± 3.7 kg m-2) were recruited for this study. Suprasystolic occlusions were performed on the upper arm of the patient's dominant side, from which the cuff pressure waveform was obtained. Arterial blood pressure was obtained from the radial artery on the contralateral arm. Measurements were obtained in triplicate. The relationship between the cuff pressure and arterial blood pressure waveforms was assessed in the frequency-domain using coherence analysis. A mixed-effects approach was used to assess the relationship between cuff pulsatility index and invasively determined arterial pulsatility (i.e. pulse pressure). RESULTS: The cuff pressure and arterial blood pressure waveforms demonstrated a high coherence up to the fifth harmonic of the cardiac frequency (heart rate). The cuff pulsatility index accurately tracked changes in arterial pulse pressure within a given patient across repeated measurements. CONCLUSIONS: The cuff pulsatility index shows promise as a non-invasive index for monitoring residual arterial pulsatility in patients with a left ventricular assist device across time.
- MeSH
- Arteries physiopathology MeSH
- Assisted Circulation instrumentation methods MeSH
- Diagnostic Techniques, Cardiovascular MeSH
- Blood Pressure physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Heart-Assist Devices * MeSH
- Pulse methods MeSH
- Pulsatile Flow physiology MeSH
- Reproducibility of Results MeSH
- Aged MeSH
- Heart Failure * physiopathology therapy MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Keywords
- HeartMate III,
- MeSH
- Assisted Circulation instrumentation MeSH
- Chronic Disease * MeSH
- Humans MeSH
- Heart-Assist Devices * MeSH
- Heart Failure * surgery MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- About
- Netuka, Ivan, 1973- Authority
In the severe form of peripartum cardiomyopathy short and long-term continuous flow ventricular assist devices offer a safe bridge to transplant where cardiac transplantation seems to be the only hope and treatment end point for most of these patients. In this report we described the outcome of a 33 years old patient on the 32nd gestational week with peripartum cardiomyopathy who was successfully treated with biventricular mechanical assist devices and cardiac transplantation.
- MeSH
- Mitral Valve Annuloplasty MeSH
- Assisted Circulation methods instrumentation MeSH
- Adult MeSH
- Hysterectomy MeSH
- Cardiomyopathies * surgery therapy MeSH
- Klebsiella pneumoniae pathogenicity MeSH
- Humans MeSH
- Mitral Valve Insufficiency diagnostic imaging MeSH
- Pregnancy MeSH
- Heart Transplantation MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Assisted Circulation * instrumentation utilization MeSH
- Humans MeSH
- Heart-Assist Devices * utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- Keywords
- srdeční podpory,
- MeSH
- Assisted Circulation methods instrumentation adverse effects utilization MeSH
- Shock, Cardiogenic * diagnosis etiology complications mortality nursing therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Nursing Care methods MeSH
- Heart-Assist Devices history classification contraindications trends utilization MeSH
- Aged MeSH
- Statistics as Topic MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Chart MeSH
Narastajúca prevalencia srdcového zlyhávania na jednej strane a stagnujúci alebo až klesajúci počet vhodných darcov na strane druhej vedie ku snahe nahradiť činnosť srdca umelým čerpadlom. V posledných desaťročiach medicínsky aj technologický pokrok umožnili konštrukciu zariadení, ktoré sú schopné vo väčšej alebo menšej miere, na dlhšiu alebo kratšiu dobu podporiť, alebo aj úplne nahradiť funkciu srdca ako pumpy. Autori prinášajú aktuálny prehľad o mechanických podporných systémoch obehu/srdca a ich postavení v liečbe srdcového zlyhávania ako aj v programe transplantácie srdca.
The increasing prevalence of heart failure, on the one hand, and the stagnating or declining number of suitable heart donors on the other, has led to an effort to substitute the heart function with an artificial pump. During recent decades, medical and technological progress has allowed the construction of devices that support or substitute the pumping function of the heart. The authors submit a current overview of mechanical cardiac support devices and their role in the treatment of heart failure, as well as in the heart transplant programme.
- MeSH
- Assisted Circulation methods instrumentation utilization MeSH
- Electric Stimulation methods MeSH
- Drug Therapy methods trends utilization MeSH
- HLA Antigens immunology drug effects MeSH
- Cardiovascular Diseases diagnosis complications therapy MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Heart-Assist Devices classification trends utilization MeSH
- Prostheses and Implants MeSH
- Heart Failure diagnosis drug therapy therapy MeSH
- Statistics as Topic MeSH
- Heart Transplantation MeSH
- Heart, Artificial MeSH
- Check Tag
- Humans MeSH
Profylaktické použití mechanické podpory oběhu u rizikové perkutánní koronární intervence (PCI) je jednou z metod ke snížení rizika periprocedurálních komplikací u nemocných s kritickým koronárním nálezem a současnou závažnou dysfunkcí levé komory, přidruženou chlopenní vadou, hemodynamickou či elektrickou nestabilitou a závažnou nekardiální komorbiditou. V současnosti nejčastěji používané podpory však neumožňují nahradit úplnou zástavu krevního oběhu nebo vyžadují komplikované zavedení. Alternativou k dnes běžně používaným metodám je použití mimotělního oběhu s vřazeným membránovým oxygenátorem (ECMO), který umožňuje v případě nutnosti i kompletní náhradu krevního oběhu pacienta. Do srpna 2009 jsme tento systém na našem pracovišti použili celkem u 12 pacientů, z toho u pěti nemocných jako podporu vysoce rizikové PCI; rádi bychom shrnuli první zkušenosti se třemi systémy od různých výrobců, jejich výhody, možnosti a limity. Použití mimotělní podpory oběhu je v podmínkách kardiologického oddělení kardiocentra technicky i organizačně zvládnutelné a zdá se být nadějnou metodou k překlenutí i těch nejzávažnějších komplikací během rizikové perkutánní koronární intervence. Zavedení této techniky navíc otevřelo i další možnosti využití, např. u standardními prostředky nezvratitelného kardiogenního šoku.
Prophylactic use of mechanical circulatory support in high-risk percutaneous coronary intervention (PCI) is an approach designed to reduce the risk of periprocedural complications in patients with critical coronary lesions and co-existing severe left ventricular dysfunction, associated heart valve disease, hemodynamic or electrical instability, and severe non-cardiac comorbidity. However, the currently most-oft used support systems do not allow eliminating complete circulatory arrest or are too overcomplicated to set up. An alternative to the current common methods is the use of an extracorporeal circuit with an in-built extracorporeal membrane oxygenator (ECMO) capable of replacing a patient’s circulation as needed. By August 2009, we employed the system in a total of 12 patients, of this number, in fi ve as support to high-risk PCI performed in our center. The present paper summarizes our initial experience with three systems available from diff erent manufacturers, their advantages, potential uses, and limitations. Use of extracorporeal circulatory support in the setting of a department of cardiology of a heart center is feasible, both technically and organizationally, and seems to hold promise for managing the most serious complications during high-risk PCI. In addition, introduction of this technique has helped to identify other potential uses such as in cardiogenic shock, irreversible by standard measures.
- MeSH
- Assisted Circulation methods instrumentation utilization MeSH
- Angioplasty, Balloon, Coronary methods adverse effects utilization MeSH
- Cardiac Care Facilities methods organization & administration trends MeSH
- Shock, Cardiogenic complications therapy MeSH
- Humans MeSH
- Extracorporeal Membrane Oxygenation methods instrumentation utilization MeSH
- Extracorporeal Circulation methods instrumentation utilization MeSH
- Heart Diseases complications therapy MeSH
- Outcome and Process Assessment, Health Care methods trends utilization MeSH
- Check Tag
- Humans MeSH
- MeSH
- Assisted Circulation methods instrumentation utilization MeSH
- Hospitals, Pediatric MeSH
- Financing, Organized MeSH
- Data Interpretation, Statistical MeSH
- Hospitals, Teaching MeSH
- Oxygenators, Membrane utilization MeSH
- Prospective Studies MeSH
- Advanced Cardiac Life Support methods instrumentation utilization MeSH
- Heart Failure therapy MeSH
- Heart Defects, Congenital therapy MeSH
