THE RISING NUMBEROF PATIENTSWITH ADVANCED HEART FAILUREWHO RECEIVE DURABLE MECHANICAL CIRCULATORY SUPPORT (MCS) DEVICES requires improved recognition of device complications (1). Imaging is invariably needed because the clinical presentation is nonspecific. In our institution, we perform both a baseline echocardiographic study and a pump speed optimization test when left ventricular assist devi...

Number of left ventricular assist device (LVAD) implantations increases every year, particularly LVADs for destination therapy (DT). Right ventricular failure (RVF) has been recognized as a serious complication of LVAD implantation. Reported incidence of RVF after LVAD ranges from 6% to 44%, varying mostly due to differences in RVF definition, different types of LVADs, and differences in patien...

Mechanical ventilation has, since its introduction into clinical practice, undergone a major evolution from controlled ventilation to various modes of assisted ventilation. Neurally adjusted ventilatory assist (NAVA) is the newest development. The implementation of NAVA requires the introduction of a catheter to measure the electrical activity of the diaphragm (EA(di)). NAVA relies, opposite to...

OBJECTIVES Orthotopic heart transplantation is the standard of care for end-stage heart disease. Left ventricular assist device implantation offers an alternative treatment approach. Left ventricular assist device practice has changed dramatically since the 2008 Food and Drug Administration approval of the HeartMate II (Thoratec, Pleasanton, Calif), but at what societal cost? The present study ...

Proteomics is the study of the collection of proteins (the proteome) expressed in a given system. The field of proteomics can be divided into three subtypes: • profiling – identification and quantification of the proteins in a sample and drawing comparisons between samples, • functional – the study of the behavior of specific proteins, and • structural – the study of protein folding and the com...

The Jarvik-2000 is an axial-flow left-ventricular-assist-device (LVAD) designed for permanent use. The power supply is provided by a cable plugged into a skull-pedestal mounted in the retro-auricular area. We describe the surgical technique and discuss potential and encountered problems. q 2002 Elsevier Science B.V. All rights reserved.

Thousand cankers disease (TCD) is a newly recognized disease of various species of walnut (Juglans). Black walnut (Juglans nigra) is particularly susceptible to TCD and during the past decade it has devastated plantings of black walnut in most western states. In July 2010 thousand cankers disease was found over an extensive area around Knoxville, Tennessee, the first finding of TCD within the n...

OBJECTIVES This qualitative study describes the experiences of spousal caregivers of a patient with end-stage heart failure (HF) from pre-LVAD to post-LVAD-DT implantation. BACKGROUND LVAD-DTs are implanted as permanent devices for end-stage HF patients with the goal of improving the length and quality of life. LVADs create new demands for both patients and caregivers. METHODS In-depth, sem...

Here we present a patient after implantation of a left ventricular assist device (HeartWare) for destination therapy complicated by recurrent thrombosis of the device. At 14 months after implantation, the patient presented with a pump thrombosis after an INR incompliance period. A surgical pump exchange was performed and the patient recovered uneventfully. Five months later a pump thrombosis oc...