21 Any distinctive symptom clusters among patients with advanced heart failure?
Conclusion
This study identified the distinctive symptom clusters among patients with advanced HF. The results shed light on the need to develop palliative care interventions for optimising symptom control for this life-limiting disease. (Source: Heart Asia)
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Yu, D. Tags: APAHFF Abstracts 2017 Source Type: research
20 Chinese translation and validation of scales for left ventricular assist device (LVAD) self-efficacy and adherence
Left ventricular assist device (LVAD) is an alternative therapy for patients with end-stage heart failure. Patients with LVADs must manage a complex regimen of care, including activities regarding self-care maintenance (e.g., activities related to lifestyle and LVAD system operation), self-care monitoring (e.g. monitoring for LVAD device/system and complications), self-care management (e.g. handling alarms).
Emerging data have indicated the increasing use of LVAD among patients in the Chinese-speaking population. Instruments that specifically measure self-efficacy for and adherence to LVAD care regimen are required to iden...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Cheng, L. L., Sit, J. W. Tags: APAHFF Abstracts 2017 Source Type: research
19 Aortic valve replacement for severe aortic stenosis with low ejection fraction
In patients with severe aortic stenosis (AS) requiring aortic valve replacement (AVR), a reduced pre-operative left ventricular ejection fraction (LVEF) is one of the most meaningful risk indicators of early and late mortality.1 Despite this fact, AVR seems to be beneficial in the majority of patients with low LVEF.2
From 2009 to 2016, we performed 304 cases of isolated AVR for severe AS. Among them, the patients with LVEF <35% (14 cases) were analysed. The pre-operative baseline characteristics of these patients were as follows: mean age 67 years±10.2; n=9 male patients (64.3%); n=8 were in NYHA functional clas...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Kato, T., Tsunekawa, T., Motoji, Y., Kinoshita, T., Okawa, Y., Tomita, S. Tags: APAHFF Abstracts 2017 Source Type: research
18 Principles of extracorporeal life support (ECLS)
Based on the principle of cardiopulmonary bypass (CPB), short-term circulatory support was developed to supplement cardiac and/or respiratory failure. Extra Corporeal Life Support (ECLS) involve the use of mechanical devices to temporarily support heart or lung function during cardiopulmonary failure, leading to organ recovery or replacement. Though the circuitry setup configurations represented by the different techniques are closely related, extracorporeal membrane oxygenation (ECMO) aims to supplement the failing lungs, while extracorporeal life support (ECLS) aims to support the failing heart. ECMO primarily affect oxy...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Choi, G. Y. Tags: APAHFF Abstracts 2017 Source Type: research
17 Imaging of LVAD complications: experience from mayo clinic
Left ventricular assist devices (LVADs) are mechanical support devices for patients with end-stage heart failure. Echocardiography plays a pivotal role in different aspects including patient selection, perioperative imaging guidance, management of complication, optimisation of LVAD efficacy and assessment of ventricular recovery.1
Post-surgical transthoracic echocardiography (TTE) evaluation should be performed for assessing overall structure and haemodynamics of left and right heart, valvular regurgitation, inflow and outflow cannula evaluation and intracardiac thrombus detection. Small LV dimensions post LVAD support, a...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Kam, K. K. Tags: APAHFF Abstracts 2017 Source Type: research
16 Perioperative care of LVAD
Introduction
Continuous-flow left ventricular assist devices (LVAD) have emerged as the standard of care for advanced heart failure patients requiring long-term mechanical circulatory support or as bridge to transplant. Evidence-based clinical management of LVAD is becoming increasingly important for optimising outcomes.
Preoperative management
Pre-implant optimisation of comorbid conditions is vital in minimising the incidence and severity of post-operative adverse events and for enhancing survival.1 This includes psychosocial and behavioural screening prior to surgery. Pre-operative education will prepare patient to be ...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Kerk, K. L. Tags: APAHFF Abstracts 2017 Source Type: research
15 Heart failure in cancer patients: management through ONCO-cardiology
Heart failure (HF) is one of the most dreaded complications of cancer therapy that can significantly impact morbidity and mortality. With new treatment modalities in oncology with potential cardiotoxicity and a high prevalence of cardiovascular disease in cancer patients, the risk of developing HF is significantly increased. HF can occur acutely during chemotherapy administration, or it can manifest years after the completion of cancer treatment. Cancer survivors may develop chemotherapy-induced HF several years after completing anthracycline-based treatment. Timely diagnosis, intervention and surveillance of cancer patien...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Fadol, A. Tags: APAHFF Abstracts 2017 Source Type: research
14 Interventions to prevent right heart failure in PAH
Initial treatment strategy for pulmonary arterial hypertension (PAH) has changed from monotherapies to upfront combination therapies. Data from Japan Pulmonary Hypertension Registry (JAPHR), the first organised multi-centre registry for PAH in the country, provide data on real-world treatments and outcomes in Japanese patients.
From April 2008 to March 2013, 189 consecutive patients (108 treatment-naïve and 81 background-therapy patients) with PAH were enrolled at 8 centres. We performed retrospective survival analyses and studied the association between upfront combination therapy and haemodynamic improvement, adj...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Tamura, Y. Tags: APAHFF Abstracts 2017 Source Type: research
13 Heart failure and rheumatic heart disease in india
Though rheumatic heart disease (RHD) is on the decline, it remains an important cause of heart failure (HF) in many developing countries including India. It is estimated that about 10%–15% of all HF in India is attributable to RHD. Indirect estimates from the recent Global Burden of Disease (GBD) Study indicate that the absolute number of patients with moderate to severe HF due to RHD is likely to be about 3 50 000 in India. Heart failure in RHD is due mainly to severe left-sided valve lesions or due to reactive pulmonary artery hypertension as a result of chronic and severe elevation of pulmonary venous pressures. O...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Karthikeyan, G. Tags: APAHFF Abstracts 2017 Source Type: research
12 Effectiveness of simultaneous cardiac resynchronisation therapy in surgical valvular patients with severe heart failure
Conclusions
The acceptable outcome was demonstrated with our concept to recover the intraventricular and atrio-ventrucular synchrony. Although difficult to establish the patient selection criteria for concomitant CRT and valvular surgery, our strategy is considered to be a feasible procedure to improve morbidity and mortality in patients with severe HF due to VHD. (Source: Heart Asia)
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Uchida, T. Tags: APAHFF Abstracts 2017 Source Type: research
11 Success with MCS - starting from patient selection
Since the introduction of continuous flow (CF-)VADs a decade ago,1 early and mid-term survival rates have dramatically improved with 1 year survival of 85% or higher.2 3 These better survival rates should not only be attributed to improvement in technology and patient management but also to better patient selection and better timing of implantation.1From the REMATCH study (2001) with the pulsatile HeartMate 1 LVAS we learned that the high 6 month mortality of 40% was mainly a result of poor selection of patients. Since the introduction of CF-VADs in 2008, the INTERMACS registry has shown a significant reduction in INTERMAC...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Lahpor, J. R. Tags: APAHFF Abstracts 2017 Source Type: research
10 Pre-operative multimodality imaging for LVAD
Cardiac imaging, particularly echocardiography, plays a critical role in patient selection and in predicting post-operative complications. There are several pre-implantation imaging red flags that guide intraoperative concomitant procedures consideration and may predict post-operative outcomes.
The pre-operative imaging should include assessment of the left ventricle (LV), especially with attention to the LV cavity size, the presence of prominent trabecular or LV thrombus which may lead to LV assist device (LVAD) suction events, inflow cannula obstruction or thromboembolic events.
Assessment of right ventricular (RV) funct...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Yingchoncharoen, T. Tags: APAHFF Abstracts 2017 Source Type: research
9 understanding and managing CRT non-responders
Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
Cardiac resynchronization therapy (CRT) has been shown to improve morbidity and mortality for patient with widened QRS complex and congestive heart failure, however the responder rate in terms of clinical outcome as well as surrogate improvement, mainly in term of left ventricle reverse remodelling and left ventricular ejection fraction has been in the range of 60% to 70%. Pre-implant factors including aetiology of heart failure, width of QRS complex, type of conduction abnormality, ...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: YS Chan, J. Tags: APAHFF Abstracts 2017 Source Type: research
8 Heart transplantation and mechanical circulatory support: past, present and future
Heart transplantation
From 1987 to October 2017, more than 1000 cases of heart transplantation (HTx) have been done in Taiwan. Among these, our heart team had performed 487 in the past 29 years. Actuarial survival rates at 1, 5 and 10 years were 85.3%, 73.5% and 57.3%, respectively; comparable with international figures published by ISHLT. Recipients (n=103) receiving marginal donor hearts have a 20 year cumulative mortality rate of 22%. We use bi-atrial anastomosis technique for all patients, among whom only 2 (out of 487) needed permanent pacemaker implantation.
The top cause of death was allograft rejection (n=73), foll...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Wei, J. Tags: APAHFF Abstracts 2017 Source Type: research
7 Early experience with implantable LVAD at samsung medical centre, seoul
The number of heart transplantation in Korea has been growing steadily. However, the waiting time for transplantation is also increasing. For 6 years, we have been implanting left ventricular assist devices (LVAD). Up to October 2017, 15 patients have had LVAD implanted at Samsung Medical Centre (see table 1). There were 5 bridge-to-candidacy patients and 10 destination therapy (DT) patients. Age range was 47 to 81 years. Six patients (40%) were on extracorporeal membrane oxygenation (ECMO) support and 4 were on dialysis preoperatively. Three patients required post-operative temporary right VAD support. There were no early...
Source: Heart Asia - April 9, 2018 Category: Cardiology Authors: Yang-Hyun, C. Tags: APAHFF Abstracts 2017 Source Type: research
