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Thyroidectomy In Mechanical Circulatory Support - A Salvage Treatment For Thyrotoxicosis-Induced Cardiogenic Shock: Case Series, Rody G. Bou Chaaya, Lauren M. Saint, Onyedika J. Ilonze Md, Mph

The VAD Journal

Amiodarone is frequently used to treat arrhythmias in patients supported with left ventricular assist devices. Long term amiodarone use can cause hyperthyroidism ultimately leading to cardiomyopathy and sometimes thyrotoxicosis-induced cardiogenic shock (CS). We describe two cases of thyrotoxicosis-induced CS rescued by successful thyroidectomy under mechanical circulatory support (MCS) – one with a Heartmate III (Abbott Laboratories) and another supported with veno-arterial extracorporeal membrane oxygenation (V-A ECMO). In refractory CS, the initiation of V-A ECMO as a bridge to recovery is critical. In thyrotoxicosis-induced CS that is refractory to medical therapy requiring MCS, thyroidectomy is feasible, and a growing body of …

Caregiver Health-Related Quality Of Life, Burden, And Patient Outcomes In Ambulatory Advanced Heart Failure: A Report From Revival., Nisha A. Gilotra, Salpy V. Pamboukian, Maria Mountis, Shawn W. Robinson, Michelle Kittleson, Keyur B. Shah, Rhondalyn C. Forde-Mclean, Donald C. Haas, Douglas A. Horstmanshof, Ulrich P. Jorde, Stuart D. Russell, Wendy C. Taddei-Peters, Neal Jeffries, Shokoufeh Khalatbari, Catherine A. Spino, Blair Richards, Matheos Yosef, Douglas L. Mann, Garrick C. Stewart, Keith D. Aaronson, Kathleen L. Grady

Abington Jefferson Health Papers

Background

Heart failure (HF) imposes significant burden on patients and caregivers. Longitudinal data on caregiver health‐related quality of life (HRQOL) and burden in ambulatory advanced HF are limited.

Methods and Results

Ambulatory patients with advanced HF (n=400) and their participating caregivers (n=95) enrolled in REVIVAL (Registry Evaluation of Vital Information for VADs [Ventricular Assist Devices] in Ambulatory Life) were followed up for 24 months, or until patient death, left ventricular assist device implantation, heart transplantation, or loss to follow‐up. Caregiver HRQOL (EuroQol Visual Analog Scale) and burden (Oberst Caregiving Burden Scale) did not change significantly from baseline to follow‐up. At …

Left Ventricular Assist Device Thrombosis Treated With Intravenous Tissue Plasminogen Activator In A Patient With Covid-19 Infection, Simone A. Jarrett, Jafar Alzubi, Savalan Babapoor-Farrokhran, Zaid Ammari, Mohammad Al-Sarie, Zachary Port, Farhan Hasni, Behnam Bozorgnia, Raphael Bonita

The VAD Journal

Left ventricular assist device (LVAD) implantation is an established treatment for patients with end-stage, systolic heart failure as a bridge to heart transplantation or destination therapy. LVAD pump thrombosis is a life-threatening complication than can be triggered by prothrombotic conditions such as infection. Management of pump thrombosis presents as both a diagnostic and therapeutic challenge that is associated with a high morbidity and mortality. We report a case of pump thrombosis in a patient with a HeartMate II (Abbott Laboratories, Chicago, IL) and coronavirus (COVID-19) infection that was treated successfully with an intravenous thrombolytic, tissue plasminogen activator.

Advantages Of Bridging To Durable Left Ventricular Assist Device With The Impella 5.0, Manish K. Patel

The VAD Journal

The mainstay therapy for patients in critical cardiogenic shock (CS) is temporary mechanical circulatory support. Although there is a trend toward use of durable left ventricular assist devices (LVAD) in patients that are less ill, we present our experience with using the Impella 5.0 (Abiomed) to illustrate the potential benefits of supporting patients with critical CS before durable LVAD implantation. Since 2012, our use of the Impella has increased from 5 to 38 per year. Mortality is highest early after LVAD implantation, but our long-term survival is better than data reported to the INTERMACS registry. Use of an Impella 5.0 …

A "Blinking" Left Ventricular Assist Device, Maya Guglin, Roopa Rao

The VAD Journal

A 61-year-old male with history of coronary artery disease and end stage ischemic cardiomyopathy underwent a successful implantation of a HeartMate 3 device with an uneventful recovery. However, after 6 months, he complained of increased fatigue, intermittent dizziness, and weakness after minor exertion. The pulsatility index was increased to 8, but the left ventricular assist device (LVAD) was otherwise functioning properly. No major changes in either medications or laboratory results were noted. The patient started getting low flow alarms seven months after the procedure and the dizziness increased. On the controller, a continuously changing (“blinking”) speed was noted (Supplemental Video …