Echocardiographic Structural Assessment Pre- LVAD
|
|
- Charlotte Brooke Simpson
- 5 years ago
- Views:
Transcription
1
2 None Disclosures
3
4
5 Echocardiographic Structural Assessment Pre- LVAD LVEF ( 25% for DT LVAD) Right ventricle Valvular disease Intra- cardiac shunts Intra- cardiac thrombi Ascending aorta
6 Case 1 50 yo M transferred from OSH with acute decompensated HF and cardiogenic shock 2 Prior bypass surgeries Stage III CKD with a baseline Cr 1.7 Renal failure and volume overload on inotropes Transferred for considera/on of advanced heart failure therapies
7
8
9
10
11
12 Case 1 HM II BTT LVAD Prophylac/c post- op CentriMag RVAD support Post- opera/ve course: RVAD weaned Milrinone for 2 weeks Stable, persistent RV failure Listed for Heart Transplant
13 Consequences of Post LVAD RV Failure Increased periopera/ve mortality Worse end- organ func/on Increased cost of hospitaliza/on and LOS Decreased survival to transplanta/on Peura, et al. Circula(on 2012;126:
14 Predic/ng RV Failure? Clinical and biochemical characteris/cs Echocardiographic characteris/cs Pre- procedure hemodynamics
15 Sample Risk Scores RV Failure Risk Score (Michigan) Heartmate 2 Risk Score Vasopressors (4 points) AST > 80 (2 pts) Bilirubin > 2 (2.5 pts) Scr > 2.3 (3 pts) CVP/PCWP > 0.63 Pre- op ven/latory support BUN > 39 OR of 7.6 (95% CI 3.4 to 17.1) with score > 5.5 J Am Coll Cardiol 2008;22: J Thorac Cardiovasc Surg 2010;139:
16
17
18
19
20
21 LVAD Management
22
23
24
25
26 Selec/ng an Op/mal LVAD Speed
27
28
29
30
31
32
33
34
35
36 LVAD Troubleshoo/ng
37 LVAD Troubleshoo/ng Pericardial effusions +/- tamponade RV dysfunc/on Under- filled LV Inflow cannula malposi/on AV Insufficiency Intra- cardiac thrombus Pump failure Adopted from Table 3 from J Am Coll Cardiol Img 2010;3:
38 LVAD Troubleshoo/ng Heart Failure HF with increased power HF with normal power High Flows with Normal Power Aor/c Insufficiency Arrhythmias Cannula Posi/on Suc/on Events GI Bleeding
39 LVAD Troubleshoo/ng Heart Failure HF with increased power HF with normal power High Flows with Normal Power Aor/c Insufficiency Arrhythmias Cannula Posi/on Suc/on Events GI Bleeding
40 Heart Failure with Increased Power Increased MAP Pump Thrombus Kink in the Ouqlow Cannula
41 Case 2 Heart Failure with Increased Power 41 yo M with NICM s/p HM II LVAD in 2011 doing well for 2 years un/l he develops new heart failure symptoms, power spikes to 13W, and dark urine. LDH 1728.
42
43
44
45
46
47 LVAD Troubleshoo/ng Heart Failure HF with increased power HF with normal power High Flows with Normal Power Aor/c Insufficiency Arrhythmias Cannula Posi/on Suc/on Events GI Bleeding
48 Heart Failure with Normal Power RV failure Tricuspid Valve Insufficiency Inflow Obstruc/on Mitral Stenosis
49 Case 3 Heart Failure with Normal Power 53 F with NICM and BMI 48.2 kg/m 2 HM II LVAD implanted 3 months prior Admired from clinic with volume overload despite up- /tra/on of diure/cs as an outpa/ent Speed 9200, Power 5.8 W, PI 3.3, Flow 4.6 L/min
50
51
52
53 Heart Failure with Normal Power Right Heart Cath RA: 19 RV: 33/16 PA: 33/15 (25) PCWP: 10 Aorta: 140/60 (87) CO 4.4 CI: 2.1 with a PA sat: 42%
54 LVAD Troubleshoo/ng Heart Failure HF with increased power HF with normal power High Flows with Normal Power Aor/c Insufficiency Arrhythmias Cannula Posi/on Suc/on Events GI Bleeding
55
56 Case 4 High flows with normal power 69 M s/p HM II LVAD for ICM Unevenqul Peri- Opera/ve Course Trivial AR on Pre- Op Echo
57
58
59
60
61
62
63 LVAD Troubleshoo/ng Heart Failure HF with increased power HF with normal power High Flows with Normal Power Aor/c Insufficiency Arrhythmias Speed drops / Suc/on Events Cannula Posi/on GI Bleeding
64 Case 5 Arrhythmia with speed drops 54 yo M with NICM Intermirent palpita/ons and lightheadedness HM II LVAD speed drops ( rpm) mul/ple /mes per minute ECG shows frequent PVC s
65
66 Case 6 Cannula posi/on and Arrhythmias 67 yo M with NICM HM II LVAD planned for Des/na/on Therapy 5 months post LVAD implanta/on Recurrent low flow and hypotensive episodes INR 1.7 on admission Frequent PVC s and runs of NSVT noted NSVT /ming correlates with symptoms
67
68
69 Case 7 Unexplained VT 72 yo man: DM, MDS Severe CAD/LVSD CABG Post CABG Day 7: failing arrest; HM II Complicated post- op course VT recurrent: refractory to meds Recurrent ICD shocks Echo suggests inflow cannula malposi/on
70
71 Intra- cardiac Shunts At baseline masked by leu to right shun/ng with elevated LVEDP/LAP Right to leu shun/ng auer LV decompression with VAD Risk for Paradoxical emboli
72 Case 8 LVAD and Intra- cardiac Shunts 42 yo M s/p HM II LVAD presents with slurred speech Recent DVT INR 1.6 Normal LDH
73
74
75 Conclusions Chest xray: overall device posi/oning visualiza/on Serial evalua/on for temporal shiuing cannula posi/on Echocardiography plays an important role in pre- LVAD implanta/on and post- LVAD management Evolving use for predic/ng post- LVAD RV failure Echo speed studies and ramp protocols useful tools to evaluate and op/mize LVAD func/on Outcomes data and further studies are necessary Echocardiography and CT are pivotal diagnos/c tools in LVAD trouble- shoo/ng
Right Ventricular Failure: Prediction, Prevention and Treatment
Right Ventricular Failure: Prediction, Prevention and Treatment 3 rd European Training Symposium for Heart Failure Cardiologists and Cardiac Surgeons University Hospital Bern June 24-25, 2016 Disclosures:
More informationDiagnosis of Device Thrombosis
Diagnosis of Device Thrombosis Andrew Civitello MD, FACC Medical Director, Heart Transplant Program Director, Fellowship Co-Director, Baylor St. Luke's Medical Center / Texas Heart Institute Trends in
More informationเอกราช อร ยะช ยพาณ ชย
30 July 2016 เอกราช อร ยะช ยพาณ ชย Heart Failure and Transplant Cardiology aekarach.a@chula.ac.th Disclosure Speaker, CME service: Merck, Otsuka, Servier Consultant, non-cme service: Novartis, Menarini
More informationMechanical Cardiac Support and Cardiac Transplant: The Role for Echocardiography
Mechanical Cardiac Support and Cardiac Transplant: The Role for Echocardiography David Langholz, M.D., F.A.C.C. Co-Director Cardiovascular Imaging Fredrick Meijer Heart and Vascular Institute Spectrum
More informationEcho in Heart Failure
Echo in Heart Failure Karima Addetia, MD Heart Failure: Definition A clinical syndrome that results from impairment of ventricular filling or ejection of blood. Manifestations include dyspnea and fatigue,
More informationLVAD Complications, Recovery
LVAD Complications, Recovery Abbas Ardehali, M.D., F.A.C.S. Professor of Surgery and Medicine, Division of Cardiac Surgery William E. Connor Chair in Cardiothoracic Transplantation Director, UCLA Heart,
More informationWhat are the indications for Tricuspid valve repair during LVAD Implant RANJIT JOHN, MD UNIVERSITY OF MINNESOTA
What are the indications for Tricuspid valve repair during LVAD Implant RANJIT JOHN, MD UNIVERSITY OF MINNESOTA Contraindications for LVAD Lack of social support system Nonreversible end organ failure
More informationComplications of Left Ventricular Assist Device Chronic Support. Dr. Tal Hasin RMC, Beilinson, Petach-Tiqva, Israel
Complications of Left Ventricular Assist Device Chronic Support. Dr. Tal Hasin RMC, Beilinson, Petach-Tiqva, Israel No disclosures Probability of survival Survival (%) Survival with LVAD Destination Bridge
More informationPlanned, Short-Term RVAD During Durable LVAD Implant: Indications and Management
Planned, Short-Term RVAD During Durable LVAD Implant: Indications and Management Yoshifumi Naka, MD, PhD Columbia University Medical Center New York, NY Disclosure Abbott/St. Jude Med./Thoratec Consultant
More informationUNIVERSITY OF UTAH HEALTH CARE HOSPITALS AND CLINICS
UNIVERSITY OF UTAH HEALTH CARE HOSPITALS AND CLINICS CARDIAC MECHANICAL SUPPORT PROGRAM GUIDELINES CARDIAC MECHANICAL SUPPORT: LVAD BASICS FREQUENT SCENARIOS AND TROUBLESHOOTING Review Date: July 2011
More informationRisk Factors for Adverse Outcome after HeartMate II Jennifer Cowger, MD, MS St. Vincent Heart Center of Indiana
Risk Factors for Adverse Outcome after HeartMate II Jennifer Cowger, MD, MS St. Vincent Heart Center of Indiana Advanced Heart Failure, Transplant, & Mechanical Circulatory Support Relevant Financial Relationship
More informationRamani GV et al. Mayo Clin Proc 2010;85:180-95
THERAPIES FOR ADVANCED HEART FAILURE: WHEN TO REFER Navin Rajagopalan, MD Assistant Professor of Medicine University of Kentucky Director, Congestive Heart Failure Medical Director of Cardiac Transplantation
More informationRay Matthews MD Professor of Clinical Medicine Chief of Cardiology University of Southern California
High Risk PCI Making Possible the Impossible Ray Matthews MD Professor of Clinical Medicine Chief of Cardiology University of Southern California Disclosures Abiomed Research Support Consulting Agreement
More informationMechanical Cardiac Support in Acute Heart Failure. Michael Felker, MD, MHS Associate Professor of Medicine Director of Heart Failure Research
Mechanical Cardiac Support in Acute Heart Failure Michael Felker, MD, MHS Associate Professor of Medicine Director of Heart Failure Research Disclosures Research Support and/or Consulting NHLBI Amgen Cytokinetics
More informationManagement of Acute Shock and Right Ventricular Failure
Management of Acute Shock and Right Ventricular Failure Nader Moazami, MD Department of Thoracic and Cardiovascular Surgery and Biomedical Engineering, Cleveland Clinic NONE Disclosures CARDIOGENIC SHOCK
More informationLeft Ventricular Assist Device: What Should I Report?
2017 SOTA, Tucson, AZ February 21, 2017 11:15 11:40 AM 25 min Left Ventricular Assist Device: What Should I Report? Muhamed Sarić MD, PhD, MPA Director of Noninvasive Cardiology Echo Lab Associate Professor
More informationUpdate on Mechanical Circulatory Support. AATS May 5, 2010 Toronto, ON Canada
Update on Mechanical Circulatory Support AATS May 5, 2010 Toronto, ON Canada Disclosures NONE Emergency Circulatory Support ECMO Tandem Heart Impella Assessment Cardiac Function Pulmonary function Valvular
More informationCARDIOLOGY UPDATE Ventricular Assist Devices in Heart Failure: How and When in 2016? Catherine Demers MD, MSc, FRCPC
CARDIOLOGY UPDATE 2016 Ventricular Assist Devices in Heart Failure: How and When in 2016? Catherine Demers MD, MSc, FRCPC CARDIOLOGY UPDATE 2016 Faculty/Presenter Disclosure No disclosure CARDIOLOGY UPDATE
More informationManagement of Cardiogenic Shock. Dr Stephen Pettit, Consultant Cardiologist
Dr Stephen Pettit, Consultant Cardiologist Cardiogenic shock Management of Cardiogenic Shock Outline Definition, INTERMACS classification Medical management of cardiogenic shock PA catheters and haemodynamic
More informationMechanical Support in the Failing Fontan-Kreutzer
Mechanical Support in the Failing Fontan-Kreutzer Stephanie Fuller MD, MS Thomas L. Spray Endowed Chair in Congenital Heart Surgery Associate Professor, The Perelman School of Medicine at the University
More informationSurgical Options for Advanced Heart Failure
Surgical Options for Advanced Heart Failure Benjamin Medalion, MD Director, Transplantation and Heart Failure Surgery Department of Cardiothoracic Surgery Rabin Medical Center, Beilinson Hospital Heart
More informationMedical Therapy after LVAD
Medical Therapy after LVAD Maria Frigerio 2nd Section of Cardiology, Heart Failure & Cardiac Transplant Unit DeGasperis CardioCenter, Niguarda Hospital, Milan, Italy Heart failure therapy in LVAD pts A
More informationVentricular Assist Device: Are Early Interventions Superior? Hamang Patel, MD Section of Cardiomyopathy & Heart Transplantation
Ventricular Assist Device: Are Early Interventions Superior? Hamang Patel, MD Section of Cardiomyopathy & Heart Transplantation Objectives Current rationale behind use of MCS Patient Selection Earlier?
More informationEcho Emergencies. Outline. Michael H. Picard, MD Massachusetts General Hospital Harvard Medical School No disclosures
Echo Emergencies Michael H. Picard, MD Massachusetts General Hospital Harvard Medical School No disclosures Outline Common emergency / on call scenarios Tamponade Pulmonary embolism/rv strain Cardiogenic
More informationShort and long term mechanical circulatory support: Management in intensive care. Dr Ana Hurtado Consultant Intensivist Harefield Hospital, UK
Short and long term mechanical circulatory support: Management in intensive care Dr Ana Hurtado Consultant Intensivist Harefield Hospital, UK Right device for the right patient why are you doing this?
More informationAortic Insufficiency: How Often Does It Occur and When To Treat
Aortic Insufficiency: How Often Does It Occur and When To Treat Simon Maltais, MD PhD Vice-Chair of Clinical Practice Director of MCS Program Department of Cardiovascular Surgery Mayo Clinic, Rochester,
More informationDECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST Cardiogenic Shock Mechanical Support Eulàlia Roig FESC Heart Failure and HT Unit Hospital Sant Pau - UAB Barcelona. Spain No conflics of interest Mechanical Circulatory
More informationLEFT VENTRICULAR ASSIST DEVICE COMPLICATIONS. Daniel Vargas, MD Section of Cardiothoracic Imaging University of Colorado Anschutz Medical Campus
LEFT VENTRICULAR ASSIST DEVICE COMPLICATIONS Daniel Vargas, MD Section of Cardiothoracic Imaging University of Colorado Anschutz Medical Campus OBJECTIVES Review the most common LVAD-related complications.
More informationAndrew Civitello MD, FACC
Timing the Transition from Short Term to Long Term Mechanical Circulatory Support Andrew Civitello MD, FACC Medical Director, Heart Transplant Program Director, Fellowship Co-Director, Baylor St. Luke's
More informationEvaluation of the Right Ventricle in Candidates for Right Ventricular Assist Device Implantation.
Evaluation of the Right Ventricle in Candidates for Right Ventricular Assist Device Implantation. Evaluation of RVAD Function. Ioannis A Paraskevaidis Attikon University Hospital Historical Perspective
More informationDestination Therapy For Advanced Heart Failure
Destination Therapy For Advanced Heart Failure Kevin Guffey, RN Vad Coordinator Tacoma General Hospital April 28, 2012 Current HF Estimates 300 Million Population HF=2.5% of Population 6.5-7 Million Patients
More informationYou Won t Believe What I Saw on. Disclosures. Goals. Dimensions 2013 October 18 th Michael Pfeiffer, MD. No Financial Disclosures
You Won t Believe What I Saw on that ECHO! Dimensions 2013 October 18 th Michael Pfeiffer, MD Disclosures No Financial Disclosures Goals Review unusual and unique echocardiographic images. Briefly present
More informationAcute Circulatory Support Should We or Shouldn t We?
Acute Circulatory Support Should We or Shouldn t We? Navin K. Kapur, MD, FACC, FSCAI Assistant Professor, Division of Cardiology Director, Acute Circulatory Support Program Director, Interventional Research
More information3/23/2018. Complications of VAD Therapy: Arrhythmias. Disclosures. Agenda. I have no relevant disclosures
March 23, 2018 Complications of VAD Therapy: Arrhythmias Sandeep M. Jani, MD, MPH Associate Directory of Advanced Heart Failure and Population Health MedStar Heart and Vascular Institute - Baltimore Sandeep
More informationThe Balancing Act Bleeding and Thrombosis in MCS. Muhammad Adil Soofi
The Balancing Act Bleeding and Thrombosis in MCS Muhammad Adil Soofi Road Map Survival and complications with LVAD What is the Burden of thrombosis and bleeding Why Bleeding and Thrombosis happen When
More informationRight Heart Failure in LVAD patients: Prevention and Management.
Christian Bermudez MD. Associate Professor Director Thoracic Transplantation Division Cardiac Surgery Department of Surgery University of Pennsylvania Right Heart Failure in LVAD patients: Prevention and
More informationComplications of VAD therapy - RV failure
Complications of VAD therapy - RV failure Nana Afari-Armah, MD Advanced heart failure and transplant cardiology Temple University Hospital 3/24/18 Goals Understand the role of the right ventricle in LVAD
More informationLow cardiac output & Mechanical Support นายแพทย อรรถภ ม ส ศ ภอรรถ ศ ลยศาสตร ห วใจและทรวงอก โรงพยาบาล ราชว ถ
Low cardiac output & Mechanical Support นายแพทย อรรถภ ม ส ศ ภอรรถ ศ ลยศาสตร ห วใจและทรวงอก โรงพยาบาล ราชว ถ Low cardiac output/cardiogenic Shock State of end-organ hypoperfusion due to cardiac failure.
More informationCardiogenic Shock Protocol
Cardiogenic Shock Protocol Impella Devices Best Practices in AMI Cardiogenic Shock Identify 1-3 SBP < 90 mmhg or on inotropes /pressors Cold, clammy, tachycardia Lactate elevated > 2 mmoi /L Stabilize
More informationCirculatory Support: From IABP to LVAD
Circulatory Support: From IABP to LVAD Howard A Cohen, MD, FACC, FSCAI Director Division of Cardiovascular Intervention Co Director Cardiovascular Interventional ti Laboratories Lenox Hill Heart & Vascular
More informationLeft Ventricular Assist Devices (LVADs): Overview and Future Directions
Left Ventricular Assist Devices (LVADs): Overview and Future Directions FATIMA KARAKI, M.D. PGY-3, DEPARTMENT OF MEDICINE WASHINGTON UNIVERSITY IN ST. LOUIS ST. LOUIS, MISSOURI, USA St. Louis, Missouri,
More informationArtificial Heart Program
Artificial Heart Program Provider Review: General VAD Overview Indications for VAD Bridge to transplant (BTT) historically most common (~80%) allow rehab from severe CHF while awaiting donor Bridge to
More informationECMO and VAD implantation
1 Udine ECMO Workshop ECMO and VAD implantation Prof. Tomaso Bottio Division of Cardiac Surgery (Director Prof. Gino gerosa) ECMO Extracorporeal membrane oxygena1on (ECMO) is a rescue therapy to support
More informationManagement of the Female Pa4ent with a Cardiac Murmur
Management of the Female Pa4ent with a Cardiac Murmur Allen Mogtader, MD, FACC, FACP, FASE Director, Non- Invasive Cardiology Laboratory (No Disclosures) Strategy for Evalua4ng Heart Murmurs ACC/AHA 2008
More informationVentricular Assisting Devices in the Cathlab. Unrestricted
Ventricular Assisting Devices in the Cathlab Unrestricted What is a VAD? A single system device that is surgically attached to the left ventricle of the heart and to the aorta for left ventricular support
More informationAcute heart failure: ECMO Cardiology & Vascular Medicine 2012
Acute heart failure: ECMO Cardiology & Vascular Medicine 2012 Lucia Jewbali cardiologist-intensivist 14 beds/8 ICU beds Acute coronary syndromes Heart failure/ Cardiogenic shock Post cardiotomy Heart
More informationEMS and Nursing Considerations in VAD Patient Care
EMS and Nursing Considerations in VAD Patient Care B R I T T A N Y B U T Z L E R B S N R N V A D C O O R D I N A T O R F R O E D T E R T A N D T H E M E D I C A L C O L L E G E O F W I 1 0 / 2 5 / 1 8
More informationHeart Failure Symposium: Case Presentation (The crash and burn and the smoldering patient)
Heart Failure Symposium: (The crash and burn and the smoldering patient) Patrick C. Magnus, MBBS, MPH Clinical Fellow Section of Cardiology Dartmouth Hitchcock Medical Center (Case 1) 66 year old man,
More informationConcomitant Aortic Valve Procedures in Patients Undergoing Implantation of Continuous-Flow LVADs: An INTERMACS Database Analysis
Concomitant Aortic Valve Procedures in Patients Undergoing Implantation of Continuous-Flow LVADs: An INTERMACS Database Analysis April 11, 2014 Jason O. Robertson, M.D., M.S.; David C. Naftel, Ph.D., Sunil
More informationMechanical Circulatory Support in the Management of Heart Failure
Mechanical Circulatory Support in the Management of Heart Failure Feras Bader, MD, MS, FACC Associate Professor of Medicine Director, Heart Failure and Transplant Cleveland Clinic Abu Dhabi Chairman, Heart
More informationCRT: whom does it benefit?
CRT: whom does it benefit? Francisco Leyva BSH Revalidation and Training 2018 Queen Elizabeth Hospital NICE guidelines for CRT LVEF 35% NYHA class I II III IV QRS
More informationEMS: Care of the VAD Patient. Brittany Butzler BSN RN VAD Coordinator Froedtert and the Medical College of WI
EMS: Care of the VAD Patient Brittany Butzler BSN RN VAD Coordinator Froedtert and the Medical College of WI Disclosure No relevant financial relationships by planners or presenters Left Ventricular Assist
More informationEcho assessment of patients with an ECMO device
Echo assessment of patients with an ECMO device Evangelos Leontiadis Cardiologist 1st Cardiology Dept. Onassis Cardiac Surgery Center Athens, Greece Gibbon HLM 1953 Goldstein DJ et al, NEJM 1998; 339:1522
More informationFrom Recovery to Transplant: One Patient's Journey
From Recovery to Transplant: One Patient's Journey Tonya Elliott, RN, MSN Assist Device and Thoracic Transplant Coordinator Inova Transplant Center at Inova Fairfax Hospital Falls Church, VA Introduction
More informationInitial experience with Imacor htee-guided management of patients following transplant and mechanical circulatory support.
Thomas Jefferson University Jefferson Digital Commons Department of Cancer Biology Faculty Papers Department of Cancer Biology Fall 11-1-2012 Initial experience with Imacor htee-guided management of patients
More informationVentricular Assist Devices and Emergency Services
Ventricular Assist Devices and Emergency Services Margaret Murray, DNP, FAHA Clinical Nurse Specialist- Cardiac Surgery, Cardiac Transplant and Ventricular Assist Devices ma.murray@hosp.wisc.edu Janean
More information1/21/2016. HeartMate II Indications for Use. Ventricular Assist Device Overview. Jon G. Echterling MSN, CCRN, FNP-BC. Learning Objectives
Ventricular Assist Device Overview Jon G. Echterling MSN, CCRN, FNP-BC February 5, 2016 Learning Objectives Identify the components and operation of the HeartMate II LVAD Describe the path blood follows
More informationIntra-operative Echocardiography: When to Go Back on Pump
Intra-operative Echocardiography: When to Go Back on Pump GREGORIO G. ROGELIO, MD., F.P.C.C. OUTLINE A. Indications for Intraoperative Echocardiography B. Role of Intraoperative Echocardiography C. Criteria
More informationAllinaHealthSystem 1
: Definition End-organ hypoperfusion secondary to cardiac failure Venoarterial ECMO: Patient Selection Michael A. Samara, MD FACC Advanced Heart Failure, Cardiac Transplant & Mechanical Circulatory Support
More informationComplications in CHD with a little help from our friends
Complications in CHD with a little help from our friends Systemic ventricular failure how can the surgeon help? Assist device or transplantation? Michael Huebler (Zurich, CH) Survivors of CHD Curative
More informationECMO AND SHORT-TERM SUPPORT:
ECMO AND SHORT-TERM SUPPORT: UTILIZATION GUIDELINES AND IMPACT OF THE NEW HEART ALLOCATION SYSTEM Jeffrey Teuteberg Section Chief of Heart Failure, Cardiac Transplant and Mechanical Circulatory Support
More informationCounterpulsation. John N. Nanas, MD, PhD. Professor and Head, 3 rd Cardiology Dept, University of Athens, Athens, Greece
John N. Nanas, MD, PhD Professor and Head, 3 rd Cardiology Dept, University of Athens, Athens, Greece History of counterpulsation 1952 Augmentation of CBF Adrian and Arthur Kantrowitz, Surgery 1952;14:678-87
More informationAcute peri-operative. Alexandre Mebazaa, Hôpital Lariboisière, Université Paris 7 U942 Inserm
Acute peri-operative left heart failure Alexandre Mebazaa, Hôpital Lariboisière, Université Paris 7 U942 Inserm Conflict of Interest Lecture fee: Orion No other conflicts for this lecture Acute peri-operative
More informationHow to Approach the Patient with CRT and Recurrent Heart Failure
How to Approach the Patient with CRT and Recurrent Heart Failure Byron K. Lee MD Associate Professor of Medicine Electrophysiology and Arrhythmia Section UCSF Update in Electrocardiography and Arrhythmias
More informationMCSD Pump Thrombosis : Industry Perspective
MCSD Pump Thrombosis : Industry Perspective John B. O Connell MD Vice President, Medical Affairs Thoratec Corporation 1 1 Thoratec Asia Pacific Mechanical Circulatory Support (MCS) Conference Agenda 15-17
More informationCENTRAL ECMO WHEN AND HOW? RANJIT JOHN, MD UNIVERSITY OF MINESOTA
CENTRAL ECMO WHEN AND HOW? RANJIT JOHN, MD UNIVERSITY OF MINESOTA Background How to do Case reports When to do Managing complications Post operative management strategies CASE PRESENTATION 46 year old
More informationExtra Corporeal Life Support for Acute Heart failure
Extra Corporeal Life Support for Acute Heart failure Benjamin Medalion, MD Director Heart and Lung Transplantation Department of Cardiothoracic Surgery Rabin Medical Center, Beilinson Campus, Israel Mechanical
More informationMinimally Invasive Insertion of HVAD
Minimally Invasive Insertion of HVAD Simon Maltais, MD PhD Vice-Chair of Clinical Practice Director of MCS Program Department of Cardiovascular Surgery Mayo Clinic, Rochester, MN AATS MCS 2018, Houston
More informationPredicting Major Outcomes after MCSD Implant. Risk Factors for Death, Transplant, and Recovery. James Kirklin, MD David Naftel, PhD
Predicting Major Outcomes after MCSD Implant Risk Factors for Death, Transplant, and Recovery James Kirklin, MD David Naftel, PhD 1 I have no financial disclosures (I am the Principle Investigator for
More informationEchocardiography Conference
Echocardiography Conference David Stultz, MD Cardiology Fellow, PGY-6 September 20, 2005 Atrial Septal Aneurysm Bulging of Fossa Ovalis Associated commonly with Atrial septal defect or small perforations
More informationCARDIOGENIC SHOCK. Antonio Pesenti. Università degli Studi di Milano Bicocca Azienda Ospedaliera San Gerardo Monza (MI)
CARDIOGENIC SHOCK Antonio Pesenti Università degli Studi di Milano Bicocca Azienda Ospedaliera San Gerardo Monza (MI) Primary myocardial dysfunction resulting in the inability of the heart to mantain an
More informationDEMYSTIFYING VADs. Nicolle Choquette RN MN Athabasca University
DEMYSTIFYING VADs Nicolle Choquette RN MN Athabasca University Objectives odefine o Heart Failure o VAD o o o o Post Operative Complications Acute Long Term Nursing Interventions What is Heart Failure?
More informationEpicardial VT Ablation The Cleveland Clinic Experience
Epicardial VT Ablation The Cleveland Clinic Experience Walid Saliba, MD, FHRS Director, EP Lab Cardiac Electrophysiology Heart and Vascular Institute Epicardial Access in the EP Lab Why Epicardial Special
More informationThe Role of Mechanical Circulatory Support in Cardiogenic Shock: When to Utilize
The Role of Mechanical Circulatory Support in Cardiogenic Shock: Presented by Nancy Scroggins ACNP, CNS-CC CV Surgery ACNP Bayshore Medical Center The Role of Mechanical Circulatory Support in Cardiogenic
More informationTed Feldman, M.D., MSCAI FACC FESC
Support Technologies and High Risk Intervention Patient Selection: When Not to Use Them Ted Feldman, M.D., MSCAI FACC FESC Evanston Hospital SCAI Fall Fellows Course Las Vegas December 7-10 th, 2014 Ted
More informationOutpatient Treatment of MCS Patient. F. Bennett Pearce, MD Professor of Pediatrics Med Director Heart Transplant COA
Outpatient Treatment of MCS Patient F. Bennett Pearce, MD Professor of Pediatrics Med Director Heart Transplant COA Disclosure Statement I DO NOT HAVE ANY RELEVANT FINANCIAL RELATIONSHIPS WITH ANY COMMERCIAL
More informationCardiogenic Shock. Carlos Cafri,, MD
Cardiogenic Shock Carlos Cafri,, MD SHOCK= Inadequate Tissue Mechanisms: Perfusion Inadequate oxygen delivery Release of inflammatory mediators Further microvascular changes, compromised blood flow and
More informationAdvances in Advanced Heart Failure Therapies. Disclosures. Management Algorithm for Patients in Cardiogenic Shock
Advances in Advanced Heart Failure Therapies 9 th Annual Dartmouth Conference on Advances in Heart Failure Therapies Dartmouth-Hitchcock Medical Center May 20, 2013 Joseph G. Rogers, M.D. Associate Professor
More informationHeart Transplantation is Dead
Heart Transplantation is Dead Alternatives to Transplantation in Heart Failure Sagar Damle, MD University of Colorado Health Sciences Center Grand Rounds September 8, 2008 Outline Why is there a debate?
More informationTAVR: Echo Measurements Pre, Post And Intra Procedure
2017 ASE Florida, Orlando, FL October 10, 2017 8:00 8:25 AM 25 min TAVR: Echo Measurements Pre, Post And Intra Procedure Muhamed Sarić MD, PhD, MPA Director of Noninvasive Cardiology Echo Lab Associate
More informationThe Who, How and When of Advanced Heart Failure Therapies. Disclosures. What is Advanced Heart Failure?
The Who, How and When of Advanced Heart Failure Therapies 9 th Annual Dartmouth Conference on Advances in Heart Failure Therapies Dartmouth-Hitchcock Medical Center Lebanon, NH May 20, 2013 Joseph G. Rogers,
More informationMultiple case reports of successful use, with only one case report of intra device thrombotic event
rfviia in VAD Patients Limited data exist regarding safety Multiple factors increase pro thrombotic potential Multiple case reports of successful use, with only one case report of intra device thrombotic
More informationCorrective Surgery in Severe Heart Failure. Jon Enlow, D.O., FACS Cardiothoracic Surgeon Riverside Methodist Hospital, Ohiohealth Columbus, Ohio
Corrective Surgery in Severe Heart Failure Jon Enlow, D.O., FACS Cardiothoracic Surgeon Riverside Methodist Hospital, Ohiohealth Columbus, Ohio Session Objectives 1.) Identify which patients with severe
More informationORIGINAL ARTICLE. Alexander M. Bernhardt a, *, Theo M.M.H. De By b, Hermann Reichenspurner a and Tobias Deuse a. Abstract INTRODUCTION
European Journal of Cardio-Thoracic Surgery 48 (2015) 158 162 doi:10.1093/ejcts/ezu406 Advance Access publication 29 October 2014 ORIGINAL ARTICLE Cite this article as: Bernhardt AM, De By TMMH, Reichenspurner
More informationFacts. STRONG Risk Factors for HF* LVAD, BiVAD, RVAD, HVAD 10/21/ million adults in the US have heart failure.
10/21/18 1 Facts 5.8 million adults in the US have heart failure. About ½ of those who have HF have a 5 year life expectancy. STRONG Risk Factors for HF* Coronary Heart Disease/MI/Afib COPD Renal Failure
More informationA Validated Practical Risk Score to Predict the Need for RVAD after Continuous-flow LVAD
A Validated Practical Risk Score to Predict the Need for RVAD after Continuous-flow LVAD SK Singh MD MSc, DK Pujara MBBS, J Anand MD, WE Cohn MD, OH Frazier MD, HR Mallidi MD Division of Transplant & Assist
More informationJennifer A. Brown The Cleveland Clinic School of Perfusion Cleveland, Ohio
Biventricular Heart Failure Advanced Treatment Options at The Cleveland Clinic Jennifer A. Brown The Cleveland Clinic School of Perfusion Cleveland, Ohio I have no disclosures. Examine respiratory and
More informationMitral Valve Disease, When to Intervene
Mitral Valve Disease, When to Intervene Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Current ACC/AHA guideline Stages
More informationCase - Advanced HF and Shock (INTERMACS 1)
Case - Advanced HF and Shock (INTERMACS 1) Navin K. Kapur, MD, FACC, FSCAI, FAHA Associate Professor, Department of Medicine Interventional Cardiology & Advanced Heart Failure Programs Executive Director,
More informationAdverse Event - Intermacs
version date: 6/28/2017 Adverse Event - Intermacs Adverse Event Status Please enter the date of the event you are reporting: Please enter a label describing this event: 1 of 24 version date: 6/28/2017
More informationAnalysis of Pump Thrombosis in the Intermacs Database
Analysis of Pump Thrombosis in the Intermacs Database Michael Acker William Measey Professor of Surgery Chief of Division of Cardiovascular Surgery Director of Heart and Vascular Center University of Pennsylvania
More informationLeft Ventricular Assist Device Malfunction: A Systematic Approach to Diagnosis
Journal of the American College of Cardiology Vol. 43, No. 9, 2004 2004 by the American College of Cardiology Foundation ISSN 0735-1097/04/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2003.11.055
More informationAdvanced MR Imaging in Myocarditis
Naeem Merchant MD FRCP Professor of Medicine Department of Radiology Department of Cardiac Sciences Cumming School of Medicine University of Calgary Advanced MR Imaging in Myocarditis The Lake Louise Criteria
More informationHEARTWARE HVAD WAVEFORM APP INSTRUCTIONS
HEARTWARE HVAD WAVEFORM APP INSTRUCTIONS TABLE OF CONTENTS Welcome... 3 HVAD Waveforms 1. Characteristics... 4 2. Theory of Operation... 5 3. Ao & LV Pressure... 6 4. HQ Curve... 7 5. PV Loops... 8 Home
More informationVADS; How far have we come?
VADS; How far have we come? 1 Most Recent Period Estimates of Relative Survival Rates for Prostate and Breast Cancer Relative Survival Rate, % (SE)* 5 Years 10 Years 15 Years 20 Years Breast cancer 86.4
More informationAssist Devices in STEMI- Intra-aortic Balloon Pump
Assist Devices in STEMI- Intra-aortic Balloon Pump Ioannis Iakovou, MD, PhD Onassis Cardiac Surgery Center Athens, Greece Cardiogenic shock 5-10% of pts after a heart attack 60000-70000 pts in Europe/year
More informationTranslating Device and Mechanical Support Guidelines to ACHD Research. Timothy M. Maul, CCP, PhD Perfusionist Sr. Research Scientist
Translating Device and Mechanical Support Guidelines to ACHD Research Timothy M. Maul, CCP, PhD Perfusionist Sr. Research Scientist Disclosures No financial disclosures May discuss off-label or investigational
More informationThe COUNTER HF Clinical Study for Heart Failure
The COUNTER HF Clinical Study for Heart Failure CAUTION: C- Pulse is an inves?ga?onal device. It is limited by Federal (or United States) Law to inves?ga?onal use only. It is not available for sale in
More information7. Echocardiography Appropriate Use Criteria (by Indication)
Criteria for Echocardiography 1133 7. Echocardiography Criteria (by ) Table 1. TTE for General Evaluation of Cardiac Structure and Function Suspected Cardiac Etiology General With TTE 1. Symptoms or conditions
More informationCath Lab Essentials : LV Assist Devices for Hemodynamic Support (IABP, Impella, Tandem Heart, ECMO)
Cath Lab Essentials : LV Assist Devices for Hemodynamic Support (IABP, Impella, Tandem Heart, ECMO) Michael A. Gibson, MD Assistant Professor of Medicine University of California, Irvine Division of Cardiology
More information