BACKGROUND The purpose of the present study was to determine the impact of preoperative percutaneous cardiopulmonary support (PCPS) on long-term survival following implantation of a left ventricular assist device (LVAD). METHODS AND RESULTS Between 1999 and 2010, we used implantable (n=12) and paracorporeal (n=91) LVADs in 103 consecutive cardiomyopathy patients as a bridge to transplantation...

BACKGROUND Molecular mechanisms underlying the deterioration of patients undergoing LV assist device (LVAD) implantation remain poorly understood. We studied the cytokines tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta and IL-6 and the terminal stage of the apoptotic pathway in patients with decompensating heart failure who required LVAD support and compared them with patients wit...

OBJECTIVES The objective of the present study was to determine whether improved contractility after left ventricular assist device (LVAD) support reflects altered myocyte calcium cycling and changes in calcium-handling proteins. BACKGROUND Previous reports demonstrate that LVAD support induces sustained unloading of the heart with regression of pathologic hypertrophy and improvements in contr...

We have recently shown that ventricular unloading with an implantable left ventricular assist device (LVAD) leads to improved calcium handling and membrane integrity and redistribution of alpha adrenoreceptors (AARs) and betaadrenoreceptors (BARs). Here, we used fluorescence deconvolution microscopy to examine the effect of LVAD type (pulsatile vs non-pulsatile) on upregulation and redistributi...

BACKGROUND In patients with left ventricular non-compaction (LVNC), implantation of a left ventricular assist device (LVAD) may be performed as a bridge to transplantation. In this respect, the particular characteristics of the left ventricular myocardium may represent a challenge. CASE PRESENTATION We report a patient with LVNC who required urgent heart transplantation for inflow cannula obs...

OBJECTIVES This study sought to assess the effectiveness of a novel percutaneous method to treat left ventricular assist device (LVAD)-associated severe aortic insufficiency (AI) in a series of patients determined to be poor reoperative candidates. BACKGROUND The increased use of continuous-flow LVAD in advanced heart failure has led to marked changes in the management of patients with this c...

BACKGROUND Although multiple studies have shown that the left ventricular assist device (LVAD) improves distorted cardiac geometry, the pathological mechanisms of the "reverse remodeling" of the heart are unknown. Our goal was to determine the effects of LVAD support on cardiac myocyte size and shape. METHODS AND RESULTS Isolated myocytes were obtained at cardiac transplantation from 30 faili...

Valvular disease is common in patients undergoing left ventricular assist device (LVAD) implantation. Concomitant valve surgery increases procedural complexity and cardiopulmonary bypass time and may lead to worse outcomes. Although mitral regurgitation is the most common mitral valve dysfunction in patients undergoing LVAD implantation, mitral stenosis (MS) is occasionally encountered. MS can ...

BACKGROUND The use of extracorporeal life support (extracorporeal membrane oxygenation [ECMO]) as a direct bridge to heart transplant in adult patients is associated with poor survival. Similarly, the use of an implantable left ventricular assist device (LVAD) to salvage patients with cardiac arrest, severe hemodynamic instability, and multiorgan failure results in poor outcome. The use of LVAD...

The effects of continuous flow left ventricular assist device (CF-LVAD) support on microvascular endothelial function in New York Heart Association (NYHA) class IV heart failure (HF) patients are currently unknown. Microvascular endothelial function was assessed by beat-to-beat plethysmographic measurement of finger arterial pulse wave signal changes for 5 min following reactive hyperemia. A gr...