scholarly journals Wedged Sensor in Distress? Lessons Learned from Troubleshooting Dampened Transmitted PA Waveforms of CardioMEMS Device

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Robby Singh ◽  
Santo Scarfone ◽  
Marcel Zughaib
Keyword(s):  
Heart Failure ◽  
Rare Complication ◽  
Cost Effective ◽  
Lessons Learned ◽  
Pressure Monitoring ◽  
Readmission Rates ◽  
Inaccurate Data ◽  
Device Placement ◽  
Procedural Complications ◽  
Repeat Angiography

Introduction. Cardiovascular disease is a leading cause of morbidity and mortality with heart failure constituting a large portion of this spectrum. Heart failure patients have 90-day readmission rates of nearly 41% associated with a high expense. Numerous strategies to reduce readmissions have been attempted with the CardioMEMS pulmonary artery pressure monitoring system as one of the more successful ones. As this device becomes used more frequently, it is important to recognize procedural complications. We present of a rare complication where a patient underwent successful device placement and was subsequently found to have dampened waveforms which were due to device migration. Case Report. A 79-year-old male underwent successful CardioMEMS placement due to recurrent heart failure hospitalizations. 6 months later, the transmitted waveforms appeared dampened, and repeat angiography revealed a device that had migrated. Rather than abandoning the device, it was recalibrated and continued to transmit data and helped manage the patient’s heart failure. Conclusion. CardioMEMS is a cost-effective tool to help reduce heart failure hospitalizations. Device migration is a rare complication and can lead to inaccurate data. However, as seen in this case, the device can be successfully recalibrated and can continue to be utilized to help reduce heart failure admissions.

scholarly journals Diuretic lounge and the impact on hospital admissions for treatment of decompensated heart failure

QJM ◽  
2020 ◽  
Vol 113 (9) ◽  
pp. 651-656 ◽  
Author(s):  
A Ioannou ◽  
T Browne ◽  
S Jordan ◽  
S Metaxa ◽  
A K J Mandal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Cost Effective ◽  
Decompensated Heart Failure ◽  
Acute Hospital ◽  
Readmission Rates ◽  
Emergency Admissions ◽  
Heart Failure Patients ◽  
The Cost ◽  
The Impact

Abstract Background Heart failure is a prevalent condition associated with frequent and costly hospital admissions. Hospitalizations are primarily related to worsening fluid retention and often require admission for decongestion with intravenous diuretics. Objective To assess the safety of an outpatient intravenous diuresis service for heart failure patients, and its impact on emergency admissions and the cost of treatment. Methods We conducted a prospective observational cohort registry study on patients referred to the diuretic lounge at our acute hospital between May 2017 and April 2018. Results We analysed 245 patients treated in the diuretic lounge, of which 190 (77.6%) avoided hospitalization or any adverse events during the 60 days of follow up (77.6% vs. 22.4%; P < 0.001). The diuretic lounge service resulted in a significant decrease in emergency heart failure admissions compared to the previous 12 months (823 vs. 715 per annum; 68.6 ± 10.1 vs. 59.6 ± 14 per month; P = 0.04), and a numerical reduction in readmission rates (17.3% vs. 16.2%). The 13.1% decrease in admissions lead to financial savings of £315 497 per annum and £2921 per admission avoided. During the same time period, at the other acute hospital site in our trust, where no diuretic lounge service is available, the number of admissions did not significantly change (457 vs. 450 per annum; 37.5 ± 7.0 vs. 38.1 ± 7.6 per month; P = 0.81). Conclusion Ambulatory administration of intravenous diuretics reduces emergency admissions and is a safe and cost-effective alternative to treat acute decomposition in heart failure patients.

Percutaneous embolization of renal arteriovenous fistula

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 207-210 ◽  
Author(s):  
Sendi ◽  
Toia ◽  
Nussbaumer
Keyword(s):  
Heart Failure ◽  
Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Abdominal Discomfort ◽  
Renal Arteriovenous Fistula ◽  
Percutaneous Embolization ◽  
Arterial Access ◽  
Number Of Publications ◽  
Occluding Balloon

Acquired renal arteriovenous fistula is a rare complication following a nephrectomy and its diagnosis may be made many years after the intervention. The closure of the fistula is advisable in most cases, since it represents a risk for heart failure and rupture of the vessel. There are an increasing number of publications describing different techniques of occlusion. The case of a 70-year-old woman with abdominal discomfort due to a large renal arteriovenous fistula, 45 years after nephrectomy, is presented and current literature is reviewed. Percutaneous embolization was performed by placing an occluding balloon through the draining vein followed by the release of nine coils through arterial access. One day after successful occlusion of the fistula, clinical symptoms disappeared.

Heart Failure due to Tension Hydrothorax after Left Pneumonectomy

2013 ◽  
Vol 16 (6) ◽  
pp. 319 ◽  
Author(s):  
Kim Maguire ◽  
Calvin Leung ◽  
Visali Kodali ◽  
Brice Taylor ◽  
Jacques-Pierre Fontaine ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Rare Complication ◽  
Right Heart Failure ◽  
Symptomatic Improvement ◽  
Extrapleural Pneumonectomy ◽  
Pleural Mesothelioma ◽  
Low Cardiac Output ◽  
Mediastinal Shift ◽  
Left Pleural Effusion

Tension hydrothorax is a rare complication of pneumonectomy for pleural mesothelioma and an exceptionally rare cause of heart failure. We describe a patient who had undergone extrapleural pneumonectomy, chemotherapy, and radiation for pleural mesothelioma and who developed heart failure symptoms within months of the completion of treatment. Investigation showed a massive left pleural effusion resulting in tension hydrothorax, mediastinal shift, and evidence of right heart failure with constrictive physiology and low cardiac output. Therapeutic thoracentesis resulted in increase in cardiac output and symptomatic improvement.

Chronic Mechanical Circulatory Support for Patients with End-stage Heart Failure as a Definitive Treatment Option

2010 ◽  
Vol 6 (4) ◽  
pp. 22
Author(s):  
Patrycja Ganslmeier ◽  
Christof Schmid ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Definitive Treatment ◽  
Circulatory Support ◽  
Randomized Evaluation ◽  
Fda Approval ◽  
Cerebrovascular Events ◽  
Device Placement ◽  
End Stage Heart Failure ◽  
End Stage

Mechanical circulatory support for end-stage heart failure has become routine and is now increasingly used as definitive treatment. Several small devices qualify for this purpose, but only a few have gained US Food and Drug Administration (FDA) approval as yet. Several studies, including the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study, the Investigation of Non-transplant-Eligible Patients Who Are Inotrope Dependent (INTrEPID) and the HeartMate (HM) II trial have confirmed a significantly improved quality of life and functional capacity after device placement. However, cerebrovascular events, infection and device malfunction still pose a considerable risk to patients and hinder widespread use.

Length of Stay and Readmission Rates in Pediatric Acute Heart Failure

2021 ◽  
Vol 40 (4) ◽  
pp. S122-S123
Author(s):  
D.S. Burstein ◽  
C. Connelly ◽  
C.S. Almond ◽  
R.A. Niebler ◽  
J.A. Godown ◽  
...  
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Acute Heart Failure ◽  
Readmission Rates

scholarly journals Food Security, Environmental Health, and the Economy in Mexico: Lessons Learned with the COVID-19

2021 ◽  
Vol 13 (13) ◽  
pp. 7470
Author(s):  
Rebeca Monroy-Torres ◽  
Ángela Castillo-Chávez ◽  
Erika Carcaño-Valencia ◽  
Marco Hernández-Luna ◽  
Alex Caldera-Ortega ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Environmental Health ◽  
Public Policies ◽  
Cost Effective ◽  
Lessons Learned ◽  
Civil Society Organizations ◽  
Human Right ◽  
Healthy Environment ◽  
Mesh Terms

The COVID-19 pandemic showed an impact mainly on the health of people and the economy of households. The levels of food security in the world’s households, especially in Mexico, have decreased. When people do not have food security, their health is compromised and they have financial problems; on the other hand, environmental deterioration has a link with food security. The purpose of this review is to analysis of the current situation in Mexico of food security, environmental health and economy, the main lessons learned in these areas and their proposals integrating public policies. A review was carried out in the main databases (MEDLINE, Embase, CINAHL Plus, Web of Science, CAB Abstracts y PAIS Index) with the following keywords and according to the MeSH terms: Food security, food insecurity, environmental health, public policies, environmental, production, integrating the word COVID-19 in English and Spanish. Only 44.5% of Mexican households presented food security. For food insecurity, 22.6% had moderate and severe food insecurity, while 32.9% had mild insecurity. Food insecurity and the health impacts of environmental origin (waste management during the coronavirus pandemic, water contaminated by bacteria, viruses, and toxins; air pollution) generates impacts on economic activity by not offering food that meets health regulations. Without the application of cost-effective measures and interventions for the prevention and control of patients with obesity, the direct costs for 2023 will amount to 9 million dollars, which worsens the household economy. Despite having laws and policies on the right to food, a healthy environment (water), and opportunities for economic growth, these human rights are not fulfilled. The conclusion is that it is necessary to use a health and agroecological model to promote public policies (health, environment, and economy) that aims to prevent the discussed issues, with multidisciplinary and intersectoral interventions (government, academia, researchers, civil society organizations, industry, and population). This upholds the human right that all people should enjoy an adequate, healthy environment and have access to high-quality food.

scholarly journals Trends in cause-specific readmissions in heart failure with preserved versus reduced and mid-range ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
X.T Cui ◽  
E Thunstrom ◽  
U Dahlstrom ◽  
J.M Zhou ◽  
J.B Ge ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Temporal Trend ◽  
Funding Source ◽  
Preserved Ejection Fraction ◽  
Readmission Rates ◽  
P Values ◽  
National Board ◽  
Over Time

Abstract Background It remains unclear whether the readmission of heart failure (HF) patients has decreased over time and how it differs among HF with preserved ejection fraction (EF) (HFpEF) versus reduced EF (HFrEF) and mid-range EF (HFmrEF). Methods We evaluated HF patients index hospitalized from January 2004 to December 2011 in the Swedish Heart Failure Registry with 1-year follow-up. Outcome measures were the first occurring all-cause, cardiovascular (CV) and HF readmissions. Results Totally 20,877 HF patients (11,064 HFrEF, 4,215 HFmrEF, 5,562 HFpEF) were included in the study. All-cause readmission was highest in patients with HFpEF, whereas CV and HF readmissions were highest in HFrEF. From 2004 to 2011, HF readmission rates within 6 months (from 22.3% to 17.3%, P=0.003) and 1 year (from 27.7% to 23.4%, P=0.019) in HFpEF declined, and the risk for 1-year HF readmission in HFpEF was reduced by 7% after adjusting for age and sex (P=0.022). Likewise, risk factors for HF readmission in HFpEF changed. However, no significant changes in cause-specific readmissions were observed in HFrEF. Time to the first readmission did not change significantly from 2004 to 2011, regardless of EF subgroup (all P-values>0.05). Conclusions Although the burden of all-cause readmission remained highest in HFpEF versus HFrEF and HFmrEF, a declining temporal trend in 6-month and 1-year HF readmission rates was found in patients with HFpEF, suggesting that non-HF-related readmission represents a big challenge for clinical practice. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): The SwedeHF was funded by the Swedish National Board of Health and Welfare, the Swedish Association of Local Authorities and Regions.

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