Relevant bibliographies by topics / Left Ventricular Assist Device (LVAD)

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Academic literature on the topic 'Left Ventricular Assist Device (LVAD)'

Author: Grafiati
Published: 4 June 2021
Last updated: 9 February 2022

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Journal articles on the topic "Left Ventricular Assist Device (LVAD)"

1

Aissaoui, Nadia, Jerome Jouan, Melissa Gourjault, Benoit Diebold, Sofia Ortuno, Amer Hamdan, Christian Latremouille, Romain Pirracchio, and Michiel Morshuis. "Understanding Left Ventricular Assist Devices." Blood Purification 46, no. 4 (2018): 292–300. http://dx.doi.org/10.1159/000491872.

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Background/Aims: Long-term mechanical assist devices are now commonly used in the treatment of severe heart failure to unload the failing ventricle, maintain sufficient end-organ perfusion and improve functional capacity. Depending on the assisted ventricles, 3 categories of long-term assist devices are available: left ventricular assist device (LVAD), biventricular assist device and total artificial heart. Improvements in technology, especially the advent of smaller, durable continuous flow pumps, have led to the use of LVADs in a much broader population of patients in the last 10 years. Both the number of patients living with LVADs and the life expectancy of these patients are increasing. Regarding this growing number of patients with LVAD, intensivists need to understand the physiology of the devices, their functioning, potential complications and their management. Methods: We performed a narrative review of relevant medical literature regarding the physiology of patients with LVAD and management of common complications relevant to the critical care physicians. Results: The most frequent complications occurring in the LVAD patients after the post-operative period are bleeding, driveline infections, thrombosis, device malfunction, right ventricular failure and arrhythmias. Bleeding is the most frequent adverse event in LVAD due to a combination of anticoagulation and acquired von Willebrand disease secondary to shear stress produced within the pump. Their management includes antiplatelet therapy arrest, reduction of the anticoagulation regimen and specific therapy if feasible. Infection is the second most common cause of death after cardiac failure in LVAD patients. All infections must be aggressively treated to avoid seeding the device. Device thrombosis can develop even when patients are adequately anticoagulated and taking antiplatelet therapy because the LVAD is responsible for a chronic hypercoagulable state. Conclusion: Management of these unique patients in the ICU is best accomplished with a multidisciplinary team that includes specialists in advanced heart failure, LVAD nurse coordinators and intensivists.
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Gwyn, Jennifer CV. "Left ventricular assist devices." Journal of the Intensive Care Society 21, no. 4 (June 8, 2020): 355–58. http://dx.doi.org/10.1177/1751143720930583.

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Background There is a growing population of patients in the UK with advanced heart failure who are receiving a left ventricular assist device (LVAD) as a bridge to transplant. This is due to the plateauing number of heart transplantations and the increasing evidence of the effectiveness of these devices. It is, therefore, important that all clinicians working in an intensive care setting have an understanding of how LVADs work, whether as a district general physician referring a patient for consideration of implantation or a tertiary centre healthcare professional managing the complications. Presentation This case study describes the journey of a patient presenting with decompensated heart failure who failed to improve despite maximal medical intervention. The patient was not eligible for a heart transplant at the time, so an LVAD was inserted as a bridge to recovery of organ dysfunction and then eventual cardiac transplantation. Discussion This article will focus on providing an overview of the indications and anatomy of LVADs as well as the evidence behind their use so that intensive care professionals are aware of the potential of these devices. There will also be further discussion around complications of these devices and practical points to consider when managing a patient who has an LVAD in situ.
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Angud, Marc. "Left Ventricular Assist Device Driveline Infections." AACN Advanced Critical Care 26, no. 4 (October 1, 2015): 300–305. http://dx.doi.org/10.4037/nci.0000000000000108.

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Heart failure is a chronic progressive disease that affects millions of people in the United States. Although medical management of heart failure has helped improve quality of life and survival, end-stage heart failure ultimately requires a heart transplant or long-term left ventricular assist device (LVAD) support. With more patients awaiting transplant, the demand for hearts outweighs the supply of donor hearts. The use of LVADs is increasing in patients with advanced heart failure as a treatment option for those awaiting a heart transplant or as a long-term solution if they are ineligible for a transplant. Although the LVAD is a marvel of modern medicine, infection is a cause of concern because today’s LVADs are powered externally through a percutaneous driveline that can be a major source of infection.
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Puhlman, Mark. "Continuous-Flow Left Ventricular Assist Device and the Right Ventricle." AACN Advanced Critical Care 23, no. 1 (January 1, 2012): 86–90. http://dx.doi.org/10.4037/nci.0b013e31823ef240.

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Left ventricular assist devices (LVADs) have become accepted as treatment for heart failure as a result of improvements in diagnosing and treating left ventricular failure and limited donor availability. In the Pivotal Study of the HeartMate II in the bridge to transplantation population, the incidence of right ventricular failure without the implantation of a right ventricular assist device was 14%, with an additional 6% of the participants ill enough that they required implantation of a right ventricular assist device. This complication increases mortality, cost, and length of stay. This article reviews the screening of LVAD candidates for the probability of right ventricular failure postoperatively, the evaluation of right ventricular function in LVAD candidates, and the optimal management of the right ventricle during the perioperative care of LVAD patients.
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Cheung, Anson, Jia-Lin Soon, Jamil Bashir, Annemarie Kaan, and Andrew Ignaszewski. "Minimal-Access Left Ventricular Assist Device Implantation." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 9, no. 4 (July 2014): 281–85. http://dx.doi.org/10.1097/imi.0000000000000086.

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Objective The left ventricular assist device (LVAD) is typically implanted through a full sternotomy on cardiopulmonary bypass (CPB). Minimally invasive surgery (MIS) modifications include multiple smaller incisions, using “virgin” territory, and minimized CPB time. Methods Forty-two LVAD implantations were retrospectively reviewed. Twenty-five minimally invasive implantations (MIS, 20 HeartMate II and 5 HeartWare) were compared with 17 sternotomy implantations (12 HeartMate II and 5 HeartWare). The choice of MIS incisions was device dependent: (1) three separate incisions for the HeartMate II or (2) two incisions for the HeartWare device. Four HeartWare LVADs were implanted off-pump (three using the MIS approach). Results The median patient age was 52 years (range, 18–69 years). Overall survival was 81% at a mean (SD) follow-up of 495 (375) days. Thirty-day mortality was 9.5% (one MIS and three sternotomy patients). Five patients (11.9%) died while on LVAD, 18 (42.9%) underwent transplantation, 6 (14.3%) underwent weaning and explantation, and 13 (31.0%) remained on support. Preoperative ventilatory and circulatory supports were more common in the sternotomy group. The MIS patients had shorter CPB time [51.4 (34.9) vs 83.6 (40.4) minutes, P = 0.014] and showed a trend toward lower red blood cell and platelet transfusion requirement. The durations of hospitalization, inotropic support, intensive care unit stay, and LVAD support were not significantly different. Conclusions Minimally invasive surgery LVAD implantation is feasible. The shorter CPB duration and off-pump approach may be advantageous. Avoiding sternotomy may also reduce adhesions encountered during subsequent cardiac transplantation.
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Ross, Daniel W., Gerin R. Stevens, Rimda Wanchoo, David T. Majure, Sandeep Jauhar, Harold A. Fernandez, Massini Merzkani, and Kenar D. Jhaveri. "Left Ventricular Assist Devices and the Kidney." Clinical Journal of the American Society of Nephrology 13, no. 2 (October 25, 2017): 348–55. http://dx.doi.org/10.2215/cjn.04670417.

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Left ventricular assist devices (LVADs) are common and implantation carries risk of AKI. LVADs are used as a bridge to heart transplantation or as destination therapy. Patients with refractory heart failure that develop chronic cardiorenal syndrome and CKD often improve after LVAD placement. Nevertheless, reversibility of CKD is hard to predict. After LVAD placement, significant GFR increases may be followed by a late return to near baseline GFR levels, and in some patients, a decline in GFR. In this review, we discuss changes in GFR after LVAD placement, the incidence of AKI and associated mortality after LVAD placement, the management of AKI requiring RRT, and lastly, we review salient features about cardiorenal syndrome learned from the LVAD experience. In light of the growing number of patients using LVADs as a destination therapy, it is important to understand the effect of these devices on the kidney. Additional research and long-term data are required to better understand the relationship between the LVAD and the kidney.
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Clement, Alexandra, Larisa Anghel, Radu Sascău, and Cristian Stătescu. "Left Ventricular Assist Device-Related Complications." Journal Of Cardiovascular Emergencies 6, no. 3 (September 1, 2020): 50–58. http://dx.doi.org/10.2478/jce-2020-0014.

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AbstractLeft ventricular assist device (LVAD) has emerged as a safe, durable, and revolutionary therapy for end-stage heart failure patients. Despite the appearance of newer-generation devices that have improved patient outcomes, the burden of adverse events remains significant. Although the survival rate for patients with LVAD is appreciated to be 81% at 1 year and 70% at 2 years, the incidence of adverse events is also high. Over time, both early and late postimplant complications have diminished in terms of prevalence and impact; however, complications, such as infections, bleeding, right heart failure, pump thrombosis, aortic insufficiency, or stroke, continue to represent a challenge for the practitioner. Therefore, the aim of this review is to highlight the most recent data regarding the current use of LVAD in the treatment of end-stage heart failure, with a specific focus on LVAD-related complications, in order to improve device-related outcomes. It will also revise how to mitigate the risk and how to approach specific adverse events. Withal, understanding the predisposing risk factors associated with postimplant complications, early recognition and appropriate treatment help to significantly improve the prognosis for patients with end-stage heart failure.
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Kakino, Takamori, Keita Saku, Takafumi Sakamoto, Kazuo Sakamoto, Takuya Akashi, Masataka Ikeda, Tomomi Ide, Takuya Kishi, Hiroyuki Tsutsui, and Kenji Sunagawa. "Prediction of hemodynamics under left ventricular assist device." American Journal of Physiology-Heart and Circulatory Physiology 312, no. 1 (January 1, 2017): H80—H88. http://dx.doi.org/10.1152/ajpheart.00617.2016.

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Left ventricular assist device (LVAD) saves lives in patients with severe left ventricular (LV) failure. However, predicting how much LVAD boosts total cardiac output (CO) remains difficult. This study aimed to develop a framework to quantitatively predict the impact of LVAD on hemodynamics. We adopted the circulatory equilibrium framework and incorporated LVAD into the integrated CO curve to derive the circulatory equilibrium. In anesthetized dogs, we ligated left coronary arteries to create LV failure and inserted a centrifugal pump as LVAD. Using CO and right (PRA) and left atrial pressure (PLA) measured before LVAD support, we predetermined the stressed volume (V) and logarithmic slope of right heart CO curve (SR). Next, we initiated LVAD at maximum level and then decreased LVAD flow stepwise while monitoring hemodynamic changes. We predicted LVAD-induced CO and PRA for given PLA from the predetermined SR and V and compared with those measured experimentally. The predicted CO [ r2 = 0.907, SE of estimate (SEE) = 5.59 ml·min−1·kg−1, P < 0.001] and PRA ( r2 = 0.967, SEE = 0.307 mmHg, P < 0.001) matched well with measured values indicating the validity of the proposed framework. We further conducted simulation using the validated framework to analyze the impact of LVAD on PRA under various right ventricular (RV) functions. It indicated that PRA is relatively insensitive to changes in RV end-systolic elastance or pulmonary arterial resistance, but sensitive to changes in V. In conclusion, the circulatory equilibrium framework predicts quantitatively the hemodynamic impact of LVAD. This knowledge would contribute to safe management of patients with LV failure undergoing LVAD implantation. NEW & NOTEWORTHY Hemodynamic response to left ventricular assist device (LVAD) has not been quantitatively investigated. This is the first report of quantitative prediction of the hemodynamics on LVAD using circulatory equilibrium framework. The validated framework allows us to simulate the impact of LVAD on right atrial pressure under various right ventricular functions.
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Cheung, Anson, and Jia-Lin Soon. "Minimal-Access Left Ventricular Assist Device Explantation." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 7, no. 4 (July 2012): 300–302. http://dx.doi.org/10.1097/imi.0b013e3182746a6e.

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Patients on left ventricular assist device (LVAD) support can be successfully bridged to recovery. A novel explantation technique is reviewed. Six HeartMate II patients were successfully explanted off-pump through a combination of a left anterior minithoracotomy and a subxiphoid incision. A retrospective review of the institutional LVAD database was performed. The median LVAD support duration was 191 days (range, 69–307 days). There was no procedural or 30-day mortality associated with the LVAD explantation, and all patients are in New York Heart Association I to II at a median follow-up of 688 days (range, 127–1033 days). This procedure was associated with minimal blood transfusion and short intensive care unit stay (median, 1 day; range, 1–5 days) and hospitalization (median, 4.5 days; range, 3–19 days). One postexplant embolic cerebral infarct occurred. The HeartMate II LVAD can be safely explanted through a less conventional minimal-access approach.
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Camp, Debi. "The Left Ventricular Assist Device (LVAD)." Critical Care Nursing Clinics of North America 12, no. 1 (March 2000): 61–68. http://dx.doi.org/10.1016/s0899-5885(18)30124-2.

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Dissertations / Theses on the topic "Left Ventricular Assist Device (LVAD)"

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Klotz, Stefan. "Left ventricular assist device (LVAD) induced reverse remodeling." Münster Schüling, 2006. http://deposit.d-nb.de/cgi-bin/dokserv?id=2959073&prov=M&dok_var=1&dok_ext=htm.

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Wang, Yu. "A NEW DEVELOPMENT OF FEEDBACK CONTROLLER FOR LEFT VENTRICULAR ASSIST DEVICE." Master's thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/2386.

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The rotary Left Ventricular Assist Device (LVAD) is a mechanical pump surgically implanted in patients with end-stage congestive heart failure to help maintain the flow of blood from the sick heart. The rotary type pumps are controlled by varying the impeller speed to control the amount of blood flowing through the LVAD. One important challenge in using these devices is to prevent the occurrence of excessive pumping of blood from the left ventricle (known as suction) that may cause it to collapse due to the high pump speed. The development of a proper feedback controller for the pump speed is therefore crucial to meet this challenge. In this thesis, some theoretical and practical issues related to the development of such a controller are discussed. First, a basic nonlinear, time-varying cardiovascular-LVAD circuit model that will be used to develop the controller is reviewed. Using this model, a suction index is tested to detect suction. Finally we propose a feedback controller that uses the pump flow signal to regulate the pump speed based on the suction index and an associated threshold. The objective of this controller is to continuously update the pump speed to adapt to the physiological changes of the patient while at the same time avoiding suction. Simulation results are presented under different conditions of the patient activities. Robustness of the controller to measurement noise is also discussed.
M.S.E.E.
School of Electrical Engineering and Computer Science
Engineering and Computer Science
Electrical Engineering MSEE
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Wang, Yu. "Suction Detection and Feedback Control for the Rotary Left Ventricular Assist Device." Doctoral diss., University of Central Florida, 2013. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/6032.

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The Left Ventricular Assist Device (LVAD) is a rotary mechanical pump that is implanted in patients with congestive heart failure to help the left ventricle in pumping blood in the circulatory system. The rotary type pumps are controlled by varying the pump motor current to adjust the amount of blood flowing through the LVAD. One important challenge in using such a device is the desire to provide the patient with as close to a normal lifestyle as possible until a donor heart becomes available. The development of an appropriate feedback controller that is capable of automatically adjusting the pump current is therefore a crucial step in meeting this challenge. In addition to being able to adapt to changes in the patient's daily activities, the controller must be able to prevent the occurrence of excessive pumping of blood from the left ventricle (a phenomenon known as ventricular suction) that may cause collapse of the left ventricle and damage to the heart muscle and tissues. In this dissertation, we present a new suction detection system that can precisely classify pump flow patterns, based on a Lagrangian Support Vector Machine (LSVM) model that combines six suction indices extracted from the pump flow signal to make a decision about whether the pump is not in suction, approaching suction, or in suction. The proposed method has been tested using in vivo experimental data based on two different LVAD pumps. The results show that the system can produce superior performance in terms of classification accuracy, stability, learning speed, and good robustness compared to three other existing suction detection methods and the original SVM-based algorithm. The ability of the proposed algorithm to detect suction provides a reliable platform for the development of a feedback control system to control the current of the pump (input variable) while at the same time ensuring that suction is avoided. Based on the proposed suction detector, a new control system for the rotary LVAD was developed to automatically regulate the pump current of the device to avoid ventricular suction. The control system consists of an LSVM suction detector and a feedback controller. The LSVM suction detector is activated first so as to correctly classify the pump status as No Suction (NS) or Suction (S). When the detection is “No Suction”, the feedback controller is activated so as to automatically adjust the pump current in order that the blood flow requirements of the patient's body at different physiological states are met according to the patient's activity level. When the detection is “Suction”, the pump current is immediately decreased in order to drive the pump back to a normal No Suction operating condition. The performance of the control system was tested in simulations over a wide range of physiological conditions.
Ph.D.
Doctorate
Electrical Engineering and Computer Science
Engineering and Computer Science
Electrical Engineering
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McCormick, Matthew. "Ventricular function under LVAD support." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:0d49ba30-b508-4c69-9ba6-b398d4338c01.

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This thesis presents a finite element methodology for simulating fluid–solid interactions in the left ventricle (LV) under LVAD support. The developed model was utilised to study the passive and active characteristics of ventricular function in anatomically accurate LV geometries constructed from normal and patient image data. A non–conforming ALE Navier–Stokes/finite–elasticity fluid–solid coupling system formed the core of the numerical scheme, onto which several novel numerical additions were made. These included a fictitious domain (FD) Lagrange multiplier method to capture the interactions between immersed rigid bodies and encasing elastic solids (required for the LVAD cannula), as well as modifications to the Newton–Raphson/line search algorithm (which provided a 2 to 10 fold reduction in simulation time). Additional developments involved methods for extending the model to ventricular simulations. This required the creation of coupling methods, for both fluid and solid problems, to enable the integration of a lumped parameter representation of the systemic and pulmonary circulatory networks; the implementation and tuning of models of passive and active myocardial behaviour; as well as the testing of appropriate element types for coupling non–conforming fluid– solid finite element models under high interface tractions (finding that curvilinear spatial interpolations of the fluid geometry perform best). The behaviour of the resulting numerical scheme was investigated in a series of canonical test problems and found to be convergent and stable. The FD convergence studies also found that discontinuous pressure elements were better at capturing pressure gradients across FD boundaries. The ventricular simulations focused firstly on studying the passive diastolic behaviour of the LV both with and without LVAD support. Substantially different vortical flow features were observed when LVAD outflow was included. Additionally, a study of LVAD cannula lengths, using a particle tracking algorithm to determine recirculation rates of blood within the LV, found that shorter cannulas improved the recirculation of blood from the LV apex. Incorporating myocardial contraction, the model was extended to simulate the full cardiac cycle, converging on a repeating pressure–volume loop over 2 heart beats. Studies on the normal LV geometry found that LVAD implementation restricts the recirculation of early diastolic inflow, and that fluid–solid coupled models introduce greater heterogeneity of myocardial work than was observed in equivalent solid only models. A patient study was undertaken using a myocardial geometry constructed using image data from an LVAD implant recipient. A series of different LVAD flow regimes were tested. It was found that the opening of the aortic valve had a homogenising effect on the spatial variation of work, indicating that the synchronisation of LVAD outflow with the cardiac cycle is more important if the valve remains shut. Additionally, increasing LVAD outflow during systole and decreasing it during diastole led to improved mixing of blood in the ventricular cavity – compared with either the inverse, or holding outflow constant. Validation of these findings has the potential to impact the treatment protocols of LVAD patients.
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Kazui, Toshinobu, Phat L. Tran, Tia R. Pilikian, Katie M. Marsh, Raymond Runyan, John Konhilas, Richard Smith, and Zain I. Khalpey. "A dual therapy of off-pump temporary left ventricular extracorporeal device and amniotic stem cell for cardiogenic shock." BIOMED CENTRAL LTD, 2017. http://hdl.handle.net/10150/625812.

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Background: Temporary mechanical circulatory support device without sternotomy has been highly advocated for severe cardiogenic shock patient but little is known when coupled with amniotic stem cell therapy. Case presentation: This case reports the first dual therapy of temporary left ventricular extracorporeal device CentriMag with distal banding technique and human amniotic stem cell injection for treating a severe refractory cardiogenic shock of an 68-year-old female patient. A minimally-invasive off-pump LVAD was established by draining from the left ventricle and returning to the right axillary artery with distal arterial banding to prevent right upper extremity hyperperfusion. Amniotic stem cells were injected intramyocardially at the left ventricular apex, lateral wall, inferior wall, and right subclavian vein. Conclusion: The concomitant use of the temporary minimally-invasive off-pump CentriMag placement and stem cell therapy not only provided an alternative to cardiopulmonary bypass and full-median sternotomy procedures but may have also synergistically enhanced myocardial reperfusion and regeneration.
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Wong, Alissa Kei. "Efficiency Evaluation of a Left Ventricular Assist Device." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd_retro/64.

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Most current designs for Left Ventricular Assist Devices (LVAD) are based on rotary pumps due to their small size and lack of valves. However, the majority of FDA approved LVADs are larger, positive displacement pumps. One reason for this may be because positive displacement pumps produce pulsatile flow, similar to that of the natural heart, while rotary pumps produce continuous flow. Continuous flow has been shown to support the circulation for short periods of time during open-heart surgery, but it has seen limited success with long-term support. It is thought that pulsatile flow provides many metabolic advantages to patients with high total peripheral resistance (TPR) and lower flowrates. This study focused on modifying a continuous flow multiple disk centrifugal pump (MDCP) into a pulsatile pump, to allow for the combined benefits of the pulsatility from positive displacement pumps and the small size and valveless design of rotary pumps. An efficiency study was carried out by evaluating the hydraulic work output and the power requirements of the pump. The pump was evaluated in both pulsatile and continuous flow modes. In continuous mode, the pump was able to maintain a flow of 5.5 L/min against a pressure head of 60mmHg at 1155rpm. Other LVADs have reported rotational speeds around 2400rpm for centrifugal and 10,000rpm for axial pumps to produce flows around 5 L/min. This indicates that the MDCP is capable of producing flowrates at lower rotational speeds than other LVADs, lessening the mechanical wear of the parts, thus potentially increasing the device's lifespan. In pulsatile mode, cardiac outputs of 5 L/min were achieved against a 55/27mmHg outlet pressure. Higher pressures were unattainable with our current testing apparatus, but the results from the pulsatile tests prove that the MDCP can be operated in a pulsatile fashion and produce normal flowrates at low pressures. The pump efficiency was lower than expected, around 0.7-9% in continuous mode and 3-18% in pulsatile mode, consuming 3.5-28W and 0.5-2.3W, respectively. Utilizing a smaller motor may produce higher efficiencies, since the power requirements will be less without decreasing the flowrates, but a further study should be conducted in order to verify this.
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Falls, Candice. "FRAILTY IN PATIENTS UNDERGOING LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION." UKnowledge, 2019. https://uknowledge.uky.edu/nursing_etds/47.

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Heart failure is a progressive condition that affects over 5.7 million Americans and costs associated with heart failure account for 2-3 % of the national health care budget. The high rates of morbidity and mortality along with increased costs from readmissions associated with advanced heart failure have led to the exploration of advanced treatments such as left ventricular assist devices (LVADs). LVADS have demonstrated morbidity and mortality benefit but cost remains extensive with costs per quality-adjusted years > $400,000. With this in mind, it is important to identify those who are most likely to benefit from an LVAD to avoid unfavorable outcomes and cost. Although general guidelines and criteria for patient eligibility have been established, choosing patients for LVAD implantation remains challenging. A new focus on patient selection involves the presence of frailty. While frailty has been studied in the elderly population and in patients undergoing cardiac surgery, frailty in patients undergoing left ventricular assist device (LVAD) remains controversial. The purpose of this dissertation was to examine measures of frailty in patients undergoing LVAD implantation. The specific aims of this dissertation were to: (1) identify a feasible frailty measure in adults with end-stage heart failure who underwent LVAD implantation by testing the hypothesis that frailty would predict 30 day rehospitalization rates using Fried’s criteria, Short Physical Performance Battery test, handgrip strength, serum albumin and six minute walk test (2) Determine whether frailty measures improve 3 months post LVAD implantation (3) compare sensitivity of these three measures to change in frailty. Surgical approaches, including heart transplantation and LVAD implantation, for patients with end-stage heart failure was discussed in this dissertation. Data from two subsets of participants who underwent LVADS at the University of Kentucky between 2014 and 2017 were included in the analysis for this dissertation. In the first study, we found that none of the measures are good predictors of frailty in patients with advanced heart failure who undergo LVAD implantation. Handgrip was the only marker of frailty that predicted 30 day readmission but the relationship was a negative association. In the second study, six-minute walk and low serum albumin levels reflect short-term improvement in frailty. These simple measures may be used to determine those patients who are responsive to LVAD implantation. The findings of these studies filled some gaps in our understanding of markers of frailty in patients undergoing LVADs. We gained a better understanding of which markers of frailty are likely to improve in most people after LVAD implantation and thus frailty should not preclude candidate selection for an LVAD. Subsequently, more research is needed to investigate these markers and outcomes.
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Vedi, Manmeet Singh. "Design and construction of a left ventricular cardiovascular assist device." Thesis, Texas A&M University, 2004. http://hdl.handle.net/1969.1/1131.

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Congestive heart failure (CHF) is a debilitating condition that afflicts 4.8 million Americans with an increasing incidence. Each year, there are an estimated 400,000 new cases. The incidence is on the rise as the age of the population is increasing and because most people are surviving their first heart attack. Pharmacological therapies are improving, yet many patients still reach end-stage heart failure and there are too few donor hearts available. This thesis is presented as a first small step in a long process in the design and development of a novel cardiac assist device that would ultimately heal a diseased heart by the process of ventricular recovery. The device acts to restore the kinematics of a diseased heart by modulating the extra ventricular displacements. The first surgery / trial were conducted on a bovine at the Veterinary School at Texas A&M University. Main objectives of the surgery were to test the method of attachment of the device and power requirements of the device. Details regarding the design and construction of the device have been presented in the thesis.
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Akbari, Arvin. "INVERKAN AV LEFT VENTRICULAR ASSIST DEVICE PÅ HÖGERKAMMARFUNKTION EFTER HJÄRTTRANSPLANTATION." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26348.

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Då ingen medicinsk behandling längre är tillräcklig anses hjärttransplantation vara det slutliga alternativet för patienter med svår hjärtsvikt (stadie IV). Dock ges endast ett fåtal patienter möjligheten till att få ett nytt hjärta, vilket bland annat beror på organbrist, långa väntetider och annan komorbiditet. Allt fler i denna patientgrupp får stöd av en inopererad hjärtpump; Left Ventricular Assist Device (LVAD) i väntan på transplantation. Syftet med denna studie var att med transthorakal ekokardiografi undersöka om förbehandling med LVAD kan inverka positivt på högerkammarfunktionen även efter hjärttransplantation och huruvida denna effekt är bestående under längre tid. Totalt 31 patienter (27 män) med medelåldern 53 ± 12 år inkluderades i studien varav 13 stycken förbehandlats med LVAD innan hjärttransplantation. Data samlades in prospektivt. All patientdata är tagen från Lunds universitetssjukhus databaser. I studien undersöktes om högerkammarfunktionen skiljer sig åt hos hjärttransplanterade vid 1 månad och 12 månader efter transplantation beroende på om de förbehandlats med LVAD eller inte. De konventionella parametrarna för bedömning av högerkammarfunktion som värderades var tricuspid annular plane systolic excursion (TAPSE), högerkammar systolisk vävnadsdoppler (RVS’), right ventricular fractional area change (RVFAC), samt tvådimensionell högerkammarstrain med hjälp av speckle tracking. Resultatet visade statistiskt signifikanta skillnader för högerkammar- globala longitudinell strain (RVGLS) och högerkammarens fria vägg strain efter 1 månad (RVFS) mellan grupperna (för båda parametrarna p-värde < 0,01). Efter 12 månader uppvisade grupperna ingen signifikant skillnad. För övriga parametrar: TAPSE, RVS’, RVFAC påvisades inga statistisk signifikanta skillnader mellan grupperna efter 1 månad och 12 månader.
Heart transplantation is considered to be the most appropriate end-stage option in treating patients with severe heart failure. However, lack of organs, long waiting times and other comorbidities reduce the number of patients eligible for this treatment. In order to reduce mortality of this patient group, increasing numbers of patients with severe heart failure receive support from an inoperative cardiac pump (i.e. Left Ventricular Assist Device; LVAD) awaiting transplantation. The purpose of this study was to investigate with transthoracic echocardiography if pretreatment with LVAD may positively affect right ventricular function after cardiac transplantation and whether this effect lasts for a long time. A total of 31 patients were included in this study, where of 13 patients were pretreated with LVAD before cardiac transplantation. The majority of patients were men (n=27) with mean age of 53 ± 12 years. Data has been collected prospectively. All patient data used in this study were taken from Lund University Hospital databases. It was investigated whether right ventricular function differs in cardiac transplanted patients 1 month and 12 months after transplantation based on if patients where pretreated with LVAD and not. The parameters for evaluation of RV function were tricuspid annular plane systolic excursion (TAPSE), right ventricular systolic tissue velocity (RVS'), right ventricular fractional area change (RVFAC) and two-dimensional RV strain with speckle tracking. Results showed statistically significant differences between the groups 1 months after transplantation for right ventricular global longitudinal strain (RVGLS) and the RV free wall strain (RVFS), both parameters p-value < 0.01. This difference were not detectable after 12 months. For the parameters TAPSE, RVS ', RVFAC, no statistically significant differences were observed between the groups at either time point.
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Osorio, Andres F. "Computational analysis of alternative aortic bypass for left ventricle assistant device (LVAD)." Honors in the Major Thesis, University of Central Florida, 2008. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1122.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.
Bachelors
Engineering and Computer Science
Mechanical Engineering
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Books on the topic "Left Ventricular Assist Device (LVAD)"

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Katritsis, Demosthenes G., Bernard J. Gersh, and A. John Camm. Chronic heart failure. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199685288.003.0754_update_004.

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The diagnosis and management of chronic heart failure are discussed. Medical therapy and indications for cardiac resynchronization therapy (CRT), implantable cardioverter-defibrillators (ICD), left ventricular assist devices (LVAD), and transplantation are presented. Recommendations by the ACC/AHA and ESC on the management of patients with heart failure have been summarized and tabulated.
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Dunn, Lauren E., Joshua Z. Willey, and Ronald M. Lazar. Neuroprotection for Mechanical Circulatory Support. Edited by David L. Reich, Stephan Mayer, and Suzan Uysal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190280253.003.0012.

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This chapter examines the adverse neurological events associated with mechanical circulatory support (MCS), which includes left ventricular assist devices (LVAD) and percutaneous devices for cardiac disease. The most frequently encountered neurological events are ischemic and hemorrhagic stroke, as well as intracerebral hemorrhage (ICH), heart failure and cardiovascular disease. The management of acute cerebrovascular conditions in this population poses unique challenges, given concomitant anticoagulation usage, hemodynamically unstable patients, and lack of randomized controlled trials investigating these clinical scenarios. Other acute neurological events include cerebral hyperperfusion and cerebral air embolism. This chapter describes these complications and their risk factors, and the available evidence-based and institutional management strategies.
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Book chapters on the topic "Left Ventricular Assist Device (LVAD)"

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Davis, James W., Dana Forman, La Scienya M. Jackson, James W. Davis, Javier Garau, David N. O’Dwyer, Elisa Vedes, et al. "Left Ventricular Assist Device (LVAD)." In Encyclopedia of Intensive Care Medicine, 1324. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_1819.

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Attali, Ami, Ashley Taylor, and Michael Isley. "Left Ventricular Assist Devices (LVAD)." In Consults in Obstetric Anesthesiology, 347–49. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-59680-8_96.

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McKeown, Peter P., Stephen G. Kovacs, Masahiro Aiba, Leo E. Ondrovic, George Koroknai, Yukifusa Yokoyama, and Dimitri Novitzky. "Magnetically Actuated Left Ventricular Assist Device (LVAD): Acute Animal Test Results." In Heart Replacement, 295–99. Tokyo: Springer Japan, 1993. http://dx.doi.org/10.1007/978-4-431-67023-0_40.

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Gomes, J. Anthony. "Ventricular Tachycardia Associated with Left Ventricular Assist Device." In Heart Rhythm Disorders, 221–28. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-45066-3_15.

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Bitar, Abbas, and Dmitry Abramov. "Right Ventricular Failure Post Left Ventricular Assist Device Implantation." In Ventricular-Assist Devices and Kidney Disease, 143–60. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74657-9_10.

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Sheridan, Brett C., and Jason N. Katz. "Hemodynamics of left ventricular assist device implantation." In Cardiovascular Hemodynamics for the Clinician, 266–75. Chichester, UK: John Wiley & Sons, Ltd, 2016. http://dx.doi.org/10.1002/9781119066491.ch22.

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Okada, Masayoshi, Maki Kubota, Masanao Imai, Yoshimi Koyama, and Kazuo Nakamura. "Left ventricular assist device: Experimental and clinical study." In Artificial Heart 2, 195–203. Tokyo: Springer Japan, 1988. http://dx.doi.org/10.1007/978-4-431-65964-8_21.

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Imanishi, Kaoru, Kou Imachi, Takashi Isoyama, Yusuke Abe, Tsuneo Chinzei, Kunihiko Mabuchi, Nobumasa Tsutsui, et al. "A Percutaneously Accessible Pulsatile Left Ventricular Assist Device." In Heart Replacement, 367–70. Tokyo: Springer Japan, 1996. http://dx.doi.org/10.1007/978-4-431-67020-9_54.

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Viganò, M., M. Rinaldi, F. Pagani, G. Minzioni, A. M. D’Armini, and E. Ardemagni. "Left Ventricular Assist Device as Bridge to Transplantation." In Advances in Cardiomyopathies, 303–12. Milano: Springer Milan, 1998. http://dx.doi.org/10.1007/978-88-470-2155-6_35.

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Venkataramani, Ranjani, Michael Zhen-Yu Tong, and Shiva Sale. "Perioperative Considerations in Left Ventricular Assist Device Placement." In Mechanical Support for Heart Failure, 151–69. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-47809-4_11.

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Conference papers on the topic "Left Ventricular Assist Device (LVAD)"

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Wang, Yajuan, Antonio Ferreira, Bradley B. Keller, Marc Simon, and James F. Antaki. "Effect of Continuous-Flow Left Ventricular Assist Device on Cardiac Function: Simulation Study With a Biventricular Computer Model." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53784.

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Left ventricular assist device (LVAD) therapy has become an established treatment for patients with end-stage heart failure as either a bridge to transplant (BTT) or as permanent support (destination therapy: DT) [1]. For a small portion of patients, LVAD could be used as a bridge to cardiac recovery (BTR). Recent clinical studies have demonstrated the advantages of continuous-flow LVADs over pulsatile-flow counterparts with respect to higher survival rates and lower incidence of major adverse events [2]. However, the control challenge of continuous-flow LVADs has been not fully addressed: most of the devices are driven at a constant speed, which does not take into account changes in patient physiologic demands [3, 4].
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Ramirez, David A., Mikayle A. Holm, Andrew Shaffer, and Paul A. Iaizzo. "Computationally Sizing a Left Ventricular Assist Device Graft: A Pre-Procedural Tool to Improve Surgical Outcomes." In 2020 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/dmd2020-9055.

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Abstract Implanting Left ventricular assist devices (LVADs) can be life saving therapies that improve life expectancy for the patients that receive it. The target patient population suffer from end-stage heart failure and are therefore susceptible to morbidities arising from a less than ideal surgical implantation. Importantly, the graft that carries the blood from the LVAD pump to the aorta needs to be sized accordingly so as to not cause any compounding complications. The current typical surgical method, is to perform a visual estimation at the time of implantation. This present study proposes a computational tool that utilizes pre-procedural imaging to better calculate the personalized, ideal, LVAD graft length.
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Peterson, Sherket B., Branislav Radovancevic, Antonietta Hernandez, Rajko Radovancevic, Allison Droddy, Sylvia Carranza, Raymond Stainback, and K. Jane Grande-Allen. "Diastolic Dysfunction Persists After Unloading by Left Ventricular Assist Device (LVAD) Support." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176158.

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Left Atrium (LA) size has prognostic importance in a variety of cardiac conditions [1] and is known to be enlarged with decreased contractile function in patients with congestive heart failure (CHF) [2]. Nearly 5 million Americans have CHF [3] and a majority of these patients display diastolic dysfunction, which is an abnormality in the left ventricle (LV) myocardial relaxation and/or compliance that alters the ease with which the blood is accepted into the LV from the LA during diastole [4]. Due to abnormal LV filling, the LA experiences intense stress and elevated pressures. In fact, the left atrium is exposed directly to the LV diastolic pressure through the open mitral valve (MV) and because of its thin wall structure it tends to dilate with increasing pressure [5]. This augmented LA size and increased contractility and booster function are some of the mechanisms compensating for decreased early filling in patients with reduced LV compliance [6]. Over time, the LA compensatory contribution decreases, this may lead to intrinsic left atrium dysfunction [7]. This in turn results in a progressive decline in health unless the hearts’ inadequate blood flow is augmented by a left ventricular assist device (LVAD). Although LVAD implantation rest the heart, restores function to the ventricle [8], and improve overall function [9], its effects on the left atrium remain unclear. The purpose of the present study was to use 2D and Doppler echocardiography to define the parameters for assessing LVAD unloading and determine its effect on LA diameter, area, volume, and pressure in patients prior to and following LVAD implantation.
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Orlando, S., A. Apostolo, F. Ferretti, F. Branchi, F. Righini, M. Vecchi, and L. Elli. "DOUBLE-BALLOON ENTEROSCOPY IN PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICE (LVAD)." In ESGE Days 2018 accepted abstracts. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1637486.

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Fan, Y., G. D. Tansley, H. Fan, and J. Niu. "The Application of Laser Welding on Left Ventricular Assist Device (LVAD)." In 2011 Symposium on Photonics and Optoelectronics (SOPO 2011). IEEE, 2011. http://dx.doi.org/10.1109/sopo.2011.5780642.

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Navitsky, Michael A., Jason C. Nanna, Stephen R. Topper, Steven Deutsch, and Keefe B. Manning. "A Particle Image Velocimetry Study of the Penn State 50cc Left Ventricular Assist Device: The Impact of Varying Heart Rate." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53207.

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Approximately 5.7 million Americans are afflicted with heart failure, with a reported 670,000 new diagnoses each year [1]. Left ventricular assist devices (LVADs) function as a bridge to transplant therapy for advanced staged heart failure patients awaiting a donor heart. A pulsatile 50cc LVAD, Figure 1, is currently under development for cardiac support of patients with limited chest cavity size. Although the 50cc LVAD is functional in assisting a failing ventricle, complications such as thrombus formation may limit long term usage.
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Osorio, Andres F., Alain J. Kassab, Eduardo A. Divo, I. Ricardo Argueta-Morales, and William M. DeCampli. "Computational Fluid Dynamics Analysis of Surgical Adjustment of Ventricular Assist Device Implantation to Minimize Stroke Risk." In ASME 2009 International Mechanical Engineering Congress and Exposition. ASMEDC, 2009. http://dx.doi.org/10.1115/imece2009-12813.

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Presently, mechanical support is the most promising alternative to cardiac transplantation. Ventricular Assist Devices (VADs) were originally used to provide mechanical circulatory support in patients waiting planned heart transplantation (“bridge-to-transplantation” therapy). The success of short-term bridge devices led to clinical trials evaluating the clinical suitability of long-term support (“destination” therapy) with left ventricular assist devices (LVADs). The first larger-scale, randomized trial that tested long-term support with a LVAD reported a 44% reduction in the risk of stroke or death in patients with a LVAD. In spite of the success of LVADs as bridge-to-transplantation and long-term support. Patients carrying these devices are still at risk of several adverse events. The most devastating complication is caused by embolization of thrombi formed within the LVAD or inside the heart into the brain. Prevention of thrombi formation is attempted through anticoagulation management and by improving LVADs design; however there is still significant occurrence of thromboembolic events in patients. Investigators have reported that the incidence of thromboembolic cerebral events ranges from 14% to 47% over a period of 6–12 months. An alternative method to reduce the incidence of cerebral embolization has been proposed by one of the co-authors, namely William DeCampli M.D., Ph.D. The hypothesis is that it is possible to minimize the number of thrombi flowing into the carotid arteries by an optimal placement of the LVAD outflow conduit, and/or the addition of aortic bypass connecting the ascending aorta (AO) and the innominate artery (IA), or left carotid artery (LCA). This paper presents the computational fluid dynamics (CFD) analysis of the aortic arch hemodynamics using a representative geometry of the human aortic arch and an alternative aortic bypass. The alternative aortic bypass is intended to reduce thrombi flow incidence into the carotid arteries in patients with LVAD implants with the aim to reduce thromboembolisms. In order to study the trajectory of the thrombi within the aortic arch, a Lagrangian particle-tracking model is coupled to the CFD model. Results are presented in the form of percentage of thrombi flowing to the carotid arteries as a function of LVAD conduit placement and aortic bypass implantation, revealing promising improvement.
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Lagasco, F. "Numerical modeling of the haemodynamics of a left ventricular assist device (LVAD) prototype." In BIOMEDICINE 2003, edited by M. Castelanelli, G. Vezzani, and M. Ercolani. Southampton, UK: WIT Press, 2003. http://dx.doi.org/10.2495/bio030231.

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Secord, Thomas, and Milad Audi. "A High Efficiency Tunable Resonance Pump for Biomedical Applications." In 2018 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/dmd2018-6917.

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Medical devices utilize pumps in several different application domains including medicine dispensing systems, drug and fluid infusion systems, perfusion equipment, and left ventricular assist devices (LVADs). In this paper, we propose a novel pump design for applications where continuous flow at high efficiency is the functional goal, such as in an LVAD.
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Day, Steven W., James C. McDaniel, Phillip P. Lemire, and Houston G. Wood. "Measurements of Mean Velocity and Turbulent Statistics in a Centrifugal Blood Pump." In ASME 2002 International Mechanical Engineering Congress and Exposition. ASMEDC, 2002. http://dx.doi.org/10.1115/imece2002-32517.

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An estimated 150,000 patients in the Western World require heart transplantation every year, while only 4,000 (2.5%) of them actually receive a donor heart [1]. This lack of available donors for heart transplantation has led to a large effort since the 1960s to develop an artificial mechanical heart as an alternative to heart transplant. Most end stage cardiac failures result from cardiac disease or tissue damage of the left ventricle. After this failure, the ventricle is not strong enough to deliver an adequate supply of oxygen to critical organs. A left ventricular assist device (LVAD) is a mechanical pump that does not replace the native heart, but rather works in concert with it. An LVAD can effectively relieve some strain from a native heart, which has been weakened by disease or damage, and increase blood flow supplied to the body to maintain normal physiologic function. The inlet to the LVAD is attached to the native left ventricle, and the output of the assist pump rejoins the output of the native heart at the aorta, as shown in Figure 1. Blood flow from both the aortic valve and the assist pump combine and flow through the body. The clinical effectiveness of LVADs has been demonstrated; however, all of the currently available pumps have a limited life because of either the damage that they cause to blood or their limited mechanical design life.
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Reports on the topic "Left Ventricular Assist Device (LVAD)"

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Allen, Larry, Colleen McIlvennan, Jocelyn Thompson, Shannon Dunlay, Shane LaRue, Eldrin Lewis, Chetan Patel, et al. Supporting Shared Decision Making for Patients With Heart Failure Offered a Left Ventricular Assist Device: The DECIDE-LVAD Trial. CDR-1310-06998, April 2020. http://dx.doi.org/10.25302/04.2020.cdr.131006998.

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Allen, Larry, Colleen McIlvennan, Jocelyn Thompson, Shannon Dunlay, Shane LaRue, Eldrin Lewis, Chetan Patel, et al. Supporting Shared Decision Making for Patients With Heart Failure Offered a Left Ventricular Assist Device: The DECIDE-LVAD Trial. Patient-Centered Outcomes Research Institute (PCORI), April 2020. http://dx.doi.org/10.25302/04.2020cdr.131006998.

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Zhang, Bufan, Shaohua Guo, and Zhigang Liu. Less invasive versus conventional left ventricular assist device exchange: A protocol for systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2021. http://dx.doi.org/10.37766/inplasy2021.8.0110.

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