scholarly journals pVAD-assisted left main DK-Crush Bifurcation PCI Post-ViV TAVR

2021 ◽  
Vol 6 (1) ◽  
pp. 029-032
Author(s):  
Das Anshuman ◽  
Maria Planek Isabel Camara ◽  
Attanasio Steve

We describe successful percutaneous coronary intervention (PCI) of significantly diseased ostial left main (LM) and distal LM bifurcation (Medina 1,1,1) in a patient with a reduced left ventricular ejection fraction and a recent valve-in-valve balloon-expandable TAVR using the DK-Crush technique with the support of a percutaneous left ventricular assist device.

2018 ◽  
Vol 25 (17) ◽  
pp. 1838-1842 ◽  
Author(s):  
Massimo Pistono ◽  
Marco Gnemmi ◽  
Alessandro Imparato ◽  
Klara Komici ◽  
Ugo Corrà

Background Exercise oscillatory ventilation is an ominous outcome sign in heart failure due to reduced left ventricular ejection fraction; currently, the prevalence of exercise oscillatory ventilation is unknown in left ventricular assist device recipients. Methods We studied cardiopulmonary exercise testing in heart failure due to reduced left ventricular ejection fraction or left ventricular assist device patients and exercise oscillatory ventilation was defined according to Kremser's criteria. Results The occurrence of exercise oscillatory ventilation was similar in either heart failure due to reduced left ventricular ejection fraction (192 patients, 8%) or left ventricular assist device patients (85 recipients, 10%), even though the mean peak oxygen consumption and elevated ventilatory response to exercise slope was lower and higher in left ventricular assist device recipients, respectively, but the occurrence of exercise oscillatory ventilation was comparable among heart failure patients due to reduced left ventricular ejection fraction and left ventricular assist device, if those with impaired exercise capacity were considered. Of note, left ventricular assist device recipients with exercise oscillatory ventilation had a higher end-diastolic left ventricular volume and systolic pulmonary artery pressure at rest. Conclusions Using the largest cohort of left ventricular assist device patients performing cardiopulmonary exercise testing, we demonstrated that the occurrence of exercise oscillatory ventilation is similar in heart failure due to reduced left ventricular ejection fraction and left ventricular assist device patients. Recipients with exercise oscillatory ventilation might have haemodynamic and ventilatory dysfunction during exercise, but other factors could play a role, i.e. the duration and severity of heart failure before left ventricular assist device implantation together with the coexistence of morbidity.


2018 ◽  
pp. bcr-2018-225877 ◽  
Author(s):  
Andree H Koop ◽  
Ryan E Bailey ◽  
Philip E Lowman

A 63-year-old man was admitted for severe acute pancreatitis. On day 3 of hospitalisation, he developed shortness of breath and acute pulmonary oedema. Echocardiogram revealed global hypokinesis with a left ventricular ejection fraction of 20%, and he was diagnosed with takotsubo cardiomyopathy. He developed cardiogenic shock which was treated successfully with a percutaneous left ventricular assist device. His left ventricular ejection fraction improved by hospital follow-up 3 weeks later.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Gigli ◽  
M Merlo ◽  
S Graw ◽  
G Barbati ◽  
T Rowland ◽  
...  

Abstract Background Genotype-phenotype correlations in dilated cardiomyopathy (DCM) and in particular the effects of gene variants on clinical outcomes remain poorly understood. Purpose To investigate the prognostic role of genetic variant carrier status in a large cohort of DCM patients. Methods We analyzed 487 DCM patients by next-generation sequencing and categorized the disease genes into functional gene groups. The following composite outcome measures were assessed: 1) all-cause mortality, heart transplantation or left ventricular assist device (D/HTx/VAD); 2) sudden cardiac death or malignant ventricular arrhythmias (SCD/MVAs); 3) heart failure related death, heart transplantation or left ventricular assist device implantation (DHF/HTx/VAD). Results A total of 187 pathogenic/likely pathogenic variants were found in 180 patients (37%): 55 (11%) TTN; 19 (4%) LMNA; 24 (5%) structural cytoskeleton-Z disk genes; 16 (3%) desmosomal genes; 47 (10%) sarcomeric genes; 8 (2%) ion channels genes; 11 (2%) other genes. The occurrence of D/HTx/VAD was no different between variant carriers and non-carriers (p=0.17). However, carriers of desmosomal and LMNA variants experienced the highest rate of SCD/MVA, which was independent of the left ventricular ejection fraction. Conclusions Desmosomal and LMNA gene variants identify the subset of DCM patients at greatest risk for SCD and life-threatening ventricular arrhythmias, regardless the left ventricular ejection fraction. Acknowledgement/Funding National Institutes of Health grants R01 HL69071, HL116906, and AHA17GRNT33670495


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