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Houston, TX, United States

Gregoric I.D.,Center for Cardiac Support | Radovancevic R.,Center for Cardiac Support | Patel M.,Center for Cardiac Support | Fenik Y.,Center for Cardiac Support | And 2 more authors.
ASAIO Journal | Year: 2014

Gelatin-impregnated nonporous sealed grafts were introduced in the inflow and outflow conduits for use with the HeartMate II (HMII) to eliminate preclotting procedures and to reduce operative bleeding. We compared results of 67 patients who received first-time left ventricular assist devices (LVADs) with sealed inflow and outflow grafts (S-graft group) with a preceding 65 patients who received an LVAD with nonsealed grafts (NS-graft group). Overall, the amount of blood product transfusions was less in the S-graft group than that in the NS-graft group (red blood cells, 4.9 ± 4.5 vs. 8.0 ± 9.4 units, p = 0.022; fresh-frozen plasma, 5.0 ± 3.0 vs. 8.7 ± 9.3 units, p = 0.004; platelets, 2.9 ± 1.1 vs. 4.5 ± 3.5 units, p = 0.001; and cryoprecipitate, 1.2 ± 0.9 vs. 2.01 ± 1.9 units, p = 0.002). Within a follow-up period of 6 months, no device-related infections or strokes occurred in the S-group, but the NS-group had one (1.5%) driveline infections and four (6%) strokes. The 30 days survival rate was not significantly different between groups (p = 0.053), but favored the S-group (97%) over the NS-group (88%). Use of a HMII with a sealed graft on the inflow and outflow conduits is associated with less postoperative bleeding and may have helped to decrease the frequency of postoperative adverse events. © 2014 by the American Society for Artificial Internal.

Gregoric I.D.,Center for Cardiac Support | Mesar T.,Center for Cardiac Support | Kar B.,Center for Cardiac Support | Nathan S.,Center for Cardiac Support | And 3 more authors.
Heart Surgery Forum | Year: 2013

We describe the case of a 54-year-old woman with a postinfarction ventricular septal defect (VSD) and ventricular free wall rupture who was stabilized with a percutaneous ventricular assist device (pVAD) to allow for myocardial infarct stabilization. Following the rupture of the right ventricular free wall and cardiopulmonary arrest on hospital day 10, pVAD support was promptly converted to extracorporeal membrane oxygenation (ECMO) support for stabilization. After surgical repair was completed, pVAD support was continued for 4 days to allow recovery. The patient was discharged on postoperative day 11 and is alive and well 4 years later. Postinfarction VSD with free wall rupture may be salvaged with pVAD and ECMO support. © 2013 Forum Multimedia Publishing, LLC.

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