scholarly journals The Novel Use of Mechanical Circulatory Support to Demonstrate Pulmonary Hypertension Reversibility in Mitral Stenosis

2021 ◽  
Vol 40 (4) ◽  
pp. S498
Author(s):  
A. Sparks ◽  
M. Kawabori ◽  
T. Nordan ◽  
C. Hironaka ◽  
Y. Zahn ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Stenosis ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
The Novel

scholarly journals The Novel Use of Mechanical Circulatory Support to Demonstrate Pulmonary Hypertension Reversibility in Mitral Stenosis

2021 ◽  
Author(s):  
Aaron Sparks ◽  
Masashi Kawabori ◽  
Frederick Chen ◽  
Gregory Couper
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Circulatory Support ◽  
Right Heart ◽  
Ventricular Ejection Fraction

A 56-year-old female with a history of rheumatic mitral stenosis presented with severe pulmonary edema. Transthoracic echocardiogram demonstrated severe MS (mean valve area .5 cm2, mean gradient of 16 mmHg) with preserved left ventricular ejection fraction. Right heart catheterization demonstrated elevated pulmonary artery (PA) pressures of 110/80 mmHg and a wedge pressure of 40 mmHg. Mechanical circulatory support (MCS) was initiated with extracorporeal left atrial to femoral artery bypass. MCS allowed preoperative unloading of the left atrium. The volume status and lung congestion were optimized before surgery. In addition, pulmonary hypertension reversibility was demonstrated with significantly lower PA pressures after initiation of MCS. Intraoperatively, the MCS left atrial inflow cannula was pulled back into the right heart and used as a venous cannula for cardiopulmonary bypass. Successful mitral valve replacement was performed. Postoperatively, the mitral valve mean gradient was 3 mmHg.

Simulation training on bedside veno-arterial extracorporeal membrane oxygenation decannulation

2020 ◽  
Vol 21 (6) ◽  
pp. 1017-1022
Author(s):  
Shek Yin Au ◽  
Ka Man Fong ◽  
Kwong Shun Chan ◽  
Sai Kwong Yung ◽  
Rowlina Pui Wah Leung ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Mechanical Circulatory Support ◽  
Simulation Training ◽  
Decompensated Heart Failure ◽  
Circulatory Support ◽  
Large Artery ◽  
The Novel ◽  
Membrane Oxygenation ◽  
Vascular Closure Devices ◽  
Large Vein

Veno-arterial extracorporeal membrane oxygenation is a form of mechanical circulatory support for patients with refractory decompensated heart failure. Blood is drawn from a large vein and pumped back to a large artery, usually a femoral artery through large bore catheters. When the heart recovers, the extracorporeal membrane oxygenation support can be terminated and the catheters are decannulated. The bleeding at the venous side can be controlled by prolonged compression; however, the arteriotomy wound needs to be repaired. Conventionally, the arteriotomy wounds require open vascular repair in the operating theater. The novel application of percutaneous vascular closure devices, which have been commonly used in vascular operations and percutaneous structural heart interventions, could be applied for closure of arteriotomy wounds at the bedside after extracorporeal membrane oxygenation support. The post-close ProGlide (Abbott Vascular) technique was shown to be safe and could potentially save time and manpower. The wounds are much smaller as compared with the conventional open repair and potentially, the chance of wound infection can be reduced. However, the success of percutaneous bedside closure requires careful prior planning and technique training. Backup plans with vascular surgeons’ standby are essential in case of failure of closure. Staffs in the extracorporeal membrane oxygenation centers need to be familiar with the preparation, the procedure as well as the device application technique for successful percutaneous closure. The long learning curve and the limited case load mean that such skills are best trained by simulation scenarios. This article described how this new technique and the team logistics can be trained by simulation.

Reversal of secondary pulmonary hypertension by axial and pulsatile mechanical circulatory support

2010 ◽  
Vol 29 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Guillermo Torre-Amione ◽  
Robert E. Southard ◽  
Matthias M. Loebe ◽  
Keith A. Youker ◽  
Brian Bruckner ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Secondary Pulmonary Hypertension

scholarly journals Mechanical circulatory support restores eligibility for heart transplant in patients with significant pulmonary hypertension

2020 ◽  
Author(s):  
Agnieszka Biełka ◽  
Mariusz Kalinowski ◽  
Michał Hawranek ◽  
Justyna Małyszek-Tumidajewicz ◽  
Jerzy Pacholewicz ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Transplant ◽  
Mechanical Circulatory Support ◽  
Circulatory Support

scholarly journals The Challenges of PAH in Pregnancy

2011 ◽  
Vol 10 (3) ◽  
pp. 181-189
Author(s):  
Deborah Jo Levine ◽  
Evelyn Horn ◽  
Irene Lang ◽  
Ron Oudiz ◽  
Dianne Zwicke
Keyword(s):  
Pulmonary Hypertension ◽  
Los Angeles ◽  
Mechanical Circulatory Support ◽  
Medical Center ◽  
Circulatory Support ◽  
University Of Wisconsin ◽  
School Of Medicine ◽  
Hypertension Clinic ◽  
October 17 ◽  
Medical University

PAH patients who become pregnant– certainly against medical advice– or whose disease is diagnosed while pregnant present myriad challenges. On October 17, 2011, a group of physicians who have dealt with these complicated issues met by telephone to discuss their approaches and thoughts on dealing with these unique patients. Co-guest editor Deborah Jo Levine facilitated the discussion among Drs Ron Oudiz, Director of the Pulmonary Hypertension Center at Los Angeles County Harbor-UCLA Medical Center; Irene Lang, cardiologist at the Medical University of Vienna; Evelyn Horn, Director of the Heart Failure, Mechanical Circulatory Support, Pulmonary Hypertension Program at Cornell and adjunct professor at Columbia; and Dianne Zwicke, Medical Director of the Pulmonary Hypertension Clinic at Aurora St. Luke's Medical Center in Milwaukee, University of Wisconsin School of Medicine.

Mechanical Circulatory Support in Patients with Pulmonary Hypertension

2019 ◽  
pp. 47-53
Author(s):  
David Ishizawar
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Cardiac Transplantation ◽  
Mechanical Circulatory Support ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Pulmonary Vascular Disease ◽  
Ventricular Assist

Pulmonary hypertension (PH) is a heterogeneous group of diagnoses including pulmonary vascular disease, left-sided heart failure, lung disease, and thromboembolic disease. Regardless of the cause, PH is often associated with increased morbidity and mortality. In systolic heart failure, the development of irreversible PH precludes cardiac transplantation because the risk of allograft right-ventricular failure and death is increased. In these cases, left ventricular assist devices (LVADs) can provide circulatory support and the potential to reverse PH. This chapter discusses the WHO classifications of PH and the associated diagnoses, mechanisms, and medical and surgical treatments for PH. It also discusses the strategies for reversing PH, the indications for selecting patients with PH for heart transplantation, and how exposure of the donor heart to elevated pulmonary pressures can affect the recipient. In many of these challenging patients, mechanical circulatory support as a bridge to candidacy has permitted successful cardiac transplantation.

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