Internal bleeding higher with popular heart device than earlier model
The incidence of internal bleeding was higher in the most commonly implanted heart device than in an earlier model, according to two studies at Henry Ford Hospital in Detroit.
The HeartMate II, a left ventricular assist device (LVAD) is a continuous-flow mechanical pump connected to the patient's heart that takes over the pumping of the weakened heart's left ventricle.
"Although there were more instances of bleeding in the skull and gastrointestinal track with the HeartMate II, as opposed to the earlier model, there was no increase in mortality," says lead author Jeffrey A. Morgan, M.D., associate director of Mechanical Circulatory Support in the Edith and Benson Ford Heart &Vascular Institute at Henry Ford.
Dr. Morgan will present the studies on June 11 at the annual conference of the American Society of Artificial Internal Organs in Washington, D.C.
From March 2006 through May 2010, 64 patients with chronic heart failure underwent implantation of a HeartMate II LVAD as a bridge to transplant or a permanent therapy for those ineligible for transplants.
The incidence of gastrointestinal bleeding or adverse neurological events (ANE) was evaluated to determine their impact on survival and identify predictors of occurrence.
The overall incidence of gastrointestinal bleeding was nearly 22 percent, and the incidence of major ANEs was eight percent. Patients with an ANE were significantly older, with a higher incidence of chronic renal insufficiency. They also had higher International Normalized Ratios (INRs), a lab test that measures the time it takes for blood to clot, and compares it to an average, at the time of the event. The higher the INR, the longer it takes blood to clot.
No complications due to blood clots occurred in those with gastrointestinal bleeding, but for patients with an ANE, there were four intracranial hemorrhages and one thromboembolic stroke.
There was no significant difference in gender, race, cause of heart failure, diabetes, or body mass index (BMI) between patients who had post-operative bleeding and those who did not.
Study co-author Robert J. Brewer, M.D., surgical director of the Mechanical Circulatory Support Program at Henry Ford, believes that as data accumulates on the relatively low incidence of thromboembolic events with the HeartMate II for patients on low-dose or no anticoagulation, it may be prudent to lower the goal INR, with the intent of lowering bleeding complications.
The HeartMate II is smaller, with fewer moving parts, than the previous model, the HeartMate I XVE, and requires less invasive surgery. Its size makes it available to a larger number of advanced-stage heart failure patients, and it has been predicted to greatly increase patients' quality of life. The device can cover the full output of a healthy heart. Studies have shown that continuous-flow pumps last much longer than pulsing pumps before they must be replaced.
Usage of LVADs has increased in the United States, where heart failure affects five million people, but there are less than 3,000 donor organs available annually worldwide. Last year, nearly 2500 patients were implanted with the device in the United States, which is used chiefly for those waiting for a heart transplant due to the chronic donor shortage. In other cases, it is used for long-term support in patients who are not candidates for a heart transplant.
Provided by Henry Ford Health System
- Study: Fewer infections with new heart-pump implant May 27, 2010 | not rated yet | 0
- Non-cardiac surgery: Safe for patients with heart device Apr 15, 2011 | not rated yet | 0
- Henry Ford Hospital: New left-side heart pump improves right-side heart function May 27, 2010 | not rated yet | 0
- New patient guidelines for heart devices Apr 17, 2011 | not rated yet | 0
- First heart patients implanted with next-generation mechanical heart pump Jun 02, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Dipole term in multipole expansion
1 hour ago Hi. I'm having some difficult in understanding something about the dipole term in a multipole expansion. Griffiths writes the expansion as a sum of...
Bubbles in a Pre-Boiling/Boiling pot of water
2 hours ago How is it that bubbles form on the bottom of a surface of a pot of boiling water? I think that there is probably an elementary answer to this...
Assumptions of Griffith's fracture theory
13 hours ago Any experts on Griffith's fracture theory? I am studying the subject and I am having hard time finding out if the theory is valid for all possible...
Current leading voltage or vice versa concept
14 hours ago Hello, I was wondering if there is a conceptual explanation for when current leads voltage or vice versa for capacitors or inductors with AC...
Angular Frequency of AC voltage
17 hours ago Hello, I am wondering, what is the physical interpretation of the angular frequency of AC voltage? I don't see the physicality of what the angle...
Modeling Rigid Body - Unsure about Euler angles and angular velocity
18 hours ago I'm modeling a single 3D rigid body in preparation for some more complicated modeling in order to gain a better understanding of Euler angles, the...
- More from Physics Forums - Classical Physics
More news stories
(Medical Xpress)—In a recent subgroup analysis of the largest blood pressure treatment trial in history, University of Alabama at Birmingham (UAB) researchers found that women and men react the same to ...
Cardiology 6 hours ago | 5 / 5 (1) | 0
Over the past few decades, scientists have developed many devices that can reopen clogged arteries, including angioplasty balloons and metallic stents. While generally effective, each of these treatments ...
Cardiology 7 hours ago | 4.8 / 5 (4) | 0 |
(Medical Xpress)—Cardiologists have identified a trio of biomarkers that may predict which patients with heart disease have a high risk of heart attack or death in the next two years.
Cardiology 8 hours ago | 4 / 5 (1) | 0 |
Hospitals with the highest rates of cardiac arrests tend to have the poorest survival rates for those cases, new University of Michigan Health System research shows.
Cardiology 23 hours ago | not rated yet | 0
A clinical trial of 75 patients hospitalized with acute decompensated heart failure (ADHF) suggests that aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at three days but was associated ...
Cardiology 23 hours ago | not rated yet | 0
Researchers at USC have found that a class of pharmaceuticals can both prevent and treat Alzheimer's Disease in mice.
48 minutes ago | not rated yet | 0 |
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
3 hours ago | 4 / 5 (3) | 0 |
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
1 hour ago | 4.7 / 5 (3) | 0 |
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
3 hours ago | 4.5 / 5 (2) | 0 |
Children with autism showed significant improvement after six months of simple sensory exercises at home using everyday items such as scents, spoons and sponges, according to UC Irvine neurobiologists.
1 hour ago | not rated yet | 0 |
Researchers at Emory University have identified a protein that stimulates a pair of "orphan receptors" found in the brain, solving a long-standing biological puzzle and possibly leading to future treatments for neurological ...
3 hours ago | not rated yet | 0 |