The role of extracorporeal membrane oxygenation (ECMO) in the management critically ill COVID-19 patients remains unclear. Our study aims to analyze outcomes and risk factors from treated with ECMO. This retrospective, single-center includes 17 Univariate multivariate parametric survival regression identified predictors survival. Nine (53%) were successfully weaned ECMO discharged. incidence in-hospital mortality was 47%. In a univariate analysis, only four out 83 pre-ECMO variables...

Background: The decision-making process to use percutaneous mechanical circulatory support in the context of elective high-risk coronary intervention (HRPCI) is complex and evolving. aim this study evaluate left ventricular end-diastolic pressure (LVEDP) as a parameter identify patients that may benefit from protected HRCPI (pHRPCI) procedure. Methods: Overall, 62 (pHRPCI n = 31 vs. non-pHRPCI 31) with artery disease ejection fraction (LVEF) ≤35% were included. primary endpoint was defined...

Abstract Background Atrial fibrillation (AF) is prevalent among patients with left ventricular assist devices (LVADs); however, the exact influence of different types AF on clinical outcomes these unknown. The purpose this study was to ascertain impact LVADs. Methods records 162 LVADs HeartMate 3 ( n = 64) and II 98) at a single center were reviewed. Kaplan‒Meier survival analysis Cox proportional hazards regression used analyze associations paroxysmal atrial (pAF), permanent (peAF),...

Abstract Heart transplantation (HTx) is a definitive treatment for selected patients with advanced heart failure. However, primary graft dysfunction (PGD), severe early complication, major cause of post-HTx morbidity and mortality. This paper explores the pathophysiology, diagnostic approaches, management strategies PGD, particular focus on temporary mechanical circulatory support (MCS) devices such as venoarterial extracorporeal membrane oxygenation Impella. It also highlights essential...

Right heart failure (RHF) after the implantation of a left ventricular assist device (LVAD) remains dreaded postoperative complication. Using 2D speckle-tracking echocardiography, it is possible to acquire right global and regional function. The aim our study was assess whether echocardiography values will better predict RHF post-continuous-flow LVAD implantation.From January 2014 2016, 54 patients who underwent were included retrospectively analysed. Clinical, invasive haemodynamic (right...

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a potential treatment option in critically ill COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) if mechanical ventilation (MV) insufficient; however, thromboembolic and bleeding events (TEBE) during ECMO still need to be investigated. Methods We conducted retrospective, single-center study including treated with ECMO. Additionally, we performed univariate analysis of 85 pre-ECMO variables identify...

Purpose: Timing and ideal reconstructive approach in deep sternal wound infection (DSWI) mediastinitis still remain controversially debated. We present our own combined surgical strategy of bilateral pectoralis major muscle flap (BPMMF) or omental (OF) transposition.

This study aimed to determine standard left (LV) and right ventricular (RV) transesophageal echocardiographic (TEE) measurements in swine. Additionally, global myocardial work index (GWI) was estimated using pressure-strain loops (PSL). A comprehensive TEE examination conducted ten anesthetized, intubated mechanically ventilated healthy female German landrace swine, weighing 44 57 kg. For GWI calculation, we performed LV RV segmental strain analysis used invasively measured pressure obtain...

Abstract Aims This study aimed to compare the changes in left ventricle (LV) and right (RV) geometry performance after implantation of HeartMate II (HMII) 3 (HM3). In addition, we investigated whether echocardiographic parameters LV sphericity index (LVSI) novel pressure‐dimension (PDI) can predict post‐operative ventricular failure (RVF). Methods results Between 2012 2020, 46 patients [HMII ( n = 22) HM3 24)] met study's criteria had echocardiography tests pre‐operatively, 6 12 months...

The use of left ventricular assist devices (LVADs) has gained significant importance for treatment end-stage heart failure. Fast-track procedures are well established in cardiac surgery, whereas knowledge their benefits after LVAD implantation is sparse. We hypothesized that ultra-fast-track anesthesia (UFTA) with in-theater extubation or at a maximum 4 h. surgery feasible Interagency Registry Mechanically Assisted Circulatory Support (INTERMACS) level 3 and patients might prevent...

Background Bedside non-invasive techniques, such as radial artery tonometry, to estimate hemodynamic parameters have gained increased relevance an attractive alternative and efficient method measure hemodynamics in outpatient departments. For our pilot study, we sought compare cardiac output (CO), stroke volume (SV) estimated from a tonometry blood pressure pulse analyzer (BPPA) (DMP-Life, DAEYOMEDI Co., Gyeonggi-do, South Korea) pulsed-wave Doppler (PWD) echocardiography derived parameters....

It remains unclear to what extent the outcomes and complications of extracorporeal membrane oxygenation (ECMO) therapy in COVID-19 patients with acute respiratory distress syndrome (ARDS) differ from non-COVID-19 ARDS patients. In an observational, propensity-matched study, after ECMO support were compared between 19 suffering (COVID group) 34 matched (NCOVID our historical cohort. A 1:2 propensity matching was performed based on survival prediction (RESP) score, age, gender, bilirubin,...

Introduction Various clinical scores have been developed to predict organ dysfunction and mortality in patients undergoing cardiac surgery, but outcome prediction may be inaccurate for some patient groups. Proenkephalin A (penKid) bioactive adrenomedullin (bio-ADM) emerged as promising biomarkers correlating with shock dysfunction. This imposes the question of whether they can used prognostic risk stratification perioperative setting surgery. Methods Patients surgery were prospectively...

Background: Abnormal liver function tests can identify severe cardiopulmonary failure. The aspartate transaminase/alanine transaminase (AST/ALT) ratio, or the De Ritis is commonly used to evaluate acute damage. However, its prognostic value in pulmonary embolism (PE) unknown. Methods: Two cohorts, including patients with intermediate- and high-risk PEs, were established: one an abnormal baseline AST/ALT ratio (>1) another a normal (<1). primary outcome was 60-day mortality. Secondary...

The survival rate of cardiac arrest (CA) can be improved by utilizing percutaneous left ventricular assist devices (pLVADs) instead conventional chest compressions. However, existing pLVADs require complex fluoroscopy-guided placement along a guidewire and suffer from limited blood flow due to their cross-sectional area. recently developed self-expandable Impella CP (ECP) pLVAD addresses these limitations enabling guidewire-free increasing the pump This study evaluates feasibility...

Objectives: Several mechanical circulatory assist devices are used to treat critically ill patients requiring hemodynamic support during post-myocardial infarction or cardiogenic shock. However, little guidance is available choose an appropriate device match a particular patient's needs. An increased understanding of effects the pump systems and their impact on myocardial pre-/afterload might help better understand behavior in different clinical settings. Methods: This was open-labeled,...

Low-level hemolysis (LLH) after left ventricular assist device implantation contributes to thromboembolic events (TE). Free plasma hemoglobin (fHb) scavenges nitric oxide (NO), which causes endothelial dysfunction and activates platelets. fHb also interacts with von Willebrand factor (vWF). We hypothesized that improved hemodynamic enhanced NO signaling in HeartMate II (HMII) patients LLH taking the phosphodiesterase-5 inhibitor sildenafil may reduce risk of TE.From 2011 2015, 83 underwent...

Systemic inflammation and oxidative stress remain the main causes of complications in patients with heart failure receiving a left ventricular assist device (LVAD). Selenoproteins are cornerstone antioxidant defense mechanisms for improving inflammatory conditions.In monocentric, double-blinded pilot trial scheduled LVAD implantation were randomized to receive 300 mcg selenium orally evening before surgery, followed by high-dose intravenous supplementation (3000 after anesthesia induction,...

Acquired von Willebrand syndrome (AvWS) is associated with postoperative bleeding complications in patients continuous flow left ventricular assist devices (CF-LVADs). The aim of this study to analyze the perioperative vWF profile comparing an axial pump (HMII) a centrifugal (HVAD) regarding correlation between occurrence AvWS, early- and late-postoperative events.From July 2013 until March 2015 blood samples 33 (12 HMII/ 8 HVAD/ 13 controls) were prospectively collected at 12 different time...

Sutureless aortic valve prostheses are gaining popularity due to the substantial reduction in cross-clamp time. In this study, we report our observations on cusp-fluttering phenomenon of Perceval bioprosthesis (LivaNova, London, UK) using a combination technical and medical perspectives.Between August 2014 December 2016, total 108 patients (69% women) with mean age 78 years had replacement (34 combined procedures). All underwent transoesophageal echocardiography (TOE) intraoperatively. TOE...

Minimally invasive surgery for left ventricular assist device implantation may have advantages over conventional sternotomy (CS). Additionally, ultra-fast-track anesthesia has been linked to better outcomes after cardiac surgery. This study summarizes our early experience of combining minimally with (MIFTA) in patients receiving HeartMate 3 devices and compares the between MIFTA CS.From October 2015 January 2019, 18 49 Interagency Registry Mechanically Assisted Circulatory Support profiles...

Purpose: To assess whether thoracic non-cardiac surgery has an influence on right ventricular function (RVF) compared to known impaired postoperative RV after cardiac surgery.

In long-term left ventricular assist device (LVAD) therapy, recurrent bleeding events may justify cessation of anticoagulation therapy (AT). However, data about THE safety and risks AT in LVAD patients are scarce.