INCOR. Unique Periodic Flow Change Algorithm Promoting Native Aortic Valve Function During INCOR Therapy
|
|
- Eileen Gallagher
- 7 years ago
- Views:
Transcription
1 INCOR Unique Periodic Flow Change Algorithm Promoting Native Aortic Valve Function During INCOR Therapy Patrycja Ganslmeier MD (Universitätsklinikum Klinik für Herz- und Gefäßchirurgie Regensburg, Germany) Prof. Christof Schmid MD (Universitätsklinikum Klinik für Herz- und Gefäßchirurgie Regensburg, Germany) Attilio Iacovoni MD (Azienda Ospedaliera Papa Giovanni XXIII Bergamo, Italy)
2 Aortic Valve Insufficiency in LVAD Therapy Continuous flow LVADs without Periodic Flow Change algorithm induce aortic valve insufficiency 1 π Development of aortic valve insufficiency (AI) 1 (mild to moderate) up to 52% during continuous flow (CF) LVAD support reported (no preoperative AI) 2 π Development of de novo AI during LVAD therapy is critical 4 and associated with: Exertion limitation Pulmonary congestion despite LVAD support Compromised net forward flow Possible surgical reintervention π Mortality doubled in patients with AI on continuous flow LVAD support (39% vs. 18%) 2 π Two potential mechanisms described that promote AI development: Aortic valve commissural fusion leads to valve fibrosis and degeneration² Aortic root dilatation with concomitant changes in wall elasticity and 3 chronically high diastolic aortic pressures π Independent risk factor for onset of AI: permanently closed aortic valve 2,3 2 1 Letsou et al., Is native aortic valve commissural fusion in patients with long-term left ventricular assist devices associated with clinically important aortic insufficiency?, J Heart Lung Transplant Apr;25(4): Aggarwal et al., The development of aortic insufficiency in continuous-flow left ventricular assist device-supported patients, Ann Thorac Surg Feb;95(2): Cowger et al., The development of aortic insufficiency in left ventricular assist devicesupported patients, Circ Heart Fail Nov;3(6): Park, Aortic Insufficiency in LVAD Patients, oral communication ASAIO 59 th Annual Conference Chicago Iacovoni, Influence of Long Term INCOR therapy on aortic valve function, oral communication DGTHG 42 nd Annual Conference Freiburg Connelly et al., Acquired commissural fusion of aortic valves in patients with left ventricular assist devices, J Heart Lung Transplant Dec;22(12): John et al., Aortic valve pathophysiology during left ventricular assist device support, J Heart Lung Transplant Dec;29(12):1321-9
3 Prevention of AI during LVAD therapy Acquired commissural fusion of aortic valves in patients on CF-LVAD support π Speed settings adjustment 4,5,7 π Blood pressure control 4,5 π Continuous echocardiography monitoring (M-mode interrogation of the aortic valve) FIGURE 1 Acquired commissural fusion of aortic valves in patients on CF-LVAD support (Adapted from Connelly, J Heart Lung Transplant Dec;22(12):1291-5) Closed valves are prone to fusion and degeneration from lack of mobility in the setting of concomitant valve stress mediated by high pressure and velocity blood flow. 3 π Observing exercise tolerance and patients individual findings π INCOR Periodic Flow Change (PFC) algorithm 5 3 Freedom Aortic Valve from Insufficiency Primary Endpoint LVAD Therapy
4 INCOR Periodic Flow Change (PFC) Algorithm Operating principle of the INCOR PFC algorithm Speed Interval Set speed Duration of reduction Speed reduction Slew time Rise time Time FIGURE 2 Operating principle of the INCOR PFC algorithm The speed is reduced at fixed time intervals. After a defined period of speed reduction, the set speed is reinstated. Berlin Heart GmbH 4
5 Aortic valve function during LVAD support FIGURE 3A LVAD support without PFC during systole If the aortic valve is closed, the blood is ejected only through the LVAD. Berlin Heart GmbH FIGURE 3B LVAD support with PFC during systole The PFC algorithm induces the opening of the aortic valve. Berlin Heart GmbH 5 INCOR Periodic Flow Change (PFC) Algorithm
6 Influence of INCOR PFC Algorithm on Aortic Valve Function π Study type: Retrospective, multicenter* data analysis π Study objective: Influence of INCOR PFC algorithm on aortic valve function π Patient population: 16 patients (09/ /2012) Follow-up at 6 month: 16 patients Follow-up at 12 month: 12 patients Pre-LVAD AI: 69% π *Trial sites: Universitätsklinikum Klinik für Herz- und Gefäßchirurgie Regensburg, Germany Azienda Ospedaliera Papa Giovanni XXIII Bergamo, Italy 6
7 Pressure difference [mmhg] Speed [rpm] Detection of aortic valve opening by analyzing pressure difference characteristic Pressure difference Flow rate Time [s] Speed Flow rate (l/min) Aortic valve closed Aortic valve open FIGURE 4 Detection of aortic valve opening by analyzing pressure difference characteristic Data of an INCOR patient was analyzed who presented aortic valve opening only during PFC algorithm. The speed characteristic displays the PFC algorithm. Opening of the aortic valve can be monitored by analyzing the pressure difference curve. Aortic valve open: If the aortic valve opens during systole, an instant pressure drop in the left ventricle is seen. The pressure difference curve increased displaying the rapidly increasing pressure difference between the aorta and the left ventricle. After the aortic valve is closed, the pressure difference curve follows the primary characteristic. Aortic valve closed: If the aortic valve is closed, the pressure difference curve displays the pressure increase and decrease in the left ventricle. Blood is pumped only through the INCOR system. Berlin Heart GmbH 7 Influence of INCOR PFC Algorithm on Aortic Valve Function
8 Patient characteristics Demographic data Primary cardiac diagnosis INTERMACS level Characteristics Value Mean age [years] (range) 49.6 (19-68) Mean weight [kg] (range) 75.0 (60-103) Mean BMI [kg/m 2 ] (range) 24.3 ( ) Mean BSA [m 2 ] (range) 1.9 ( ) Gender All male Other 19% Ischemic cardiomyopathy 12% Dilative cardiomyopathy 69% INTERMACS level 3 25% INTERMACS level 1 6% INTERMACS level 2 69% FIGURE 5 Primary cardiac diagnosis FIGURE 6 INTERMACS level 75% of the patients presented with INTERMACS level 1 or 2. 8
9 Results Overall outcome Percentage of patients % 69% 25% 6% Time on device [month] FIGURE 7 Overall outcome 1-year survival was 94%, thereof 25% of the patients have been transplanted and 69% are still on support. Survival on system Transplanted Deceased Aortic valve insufficiency (AI) AI [Percentage of patients] % 69% 19% 81% 31% 69% 67% 25% pre-op at discharge 6 month 12 month FIGURE 8 Aortic valve insufficiency (AI) At 6 months on LVAD support, no AI was detected in 31% of the patients compared to 19% during check-up at discharge. At 12 months, 8% of the patients developed a moderate AI. No severe AI developed in any patient. Reduction of early onset of AI during INCOR support with PFC 0 (none) 1 (mild) 8% 2 (moderate) 3 (severe) 9 Influence of INCOR PFC Algorithm on Aortic Valve Function
10 Opening of the aortic valve Aortic valve free of fusion after INCOR therapy Opening of aortic valve [% of patients] % 50% 50% 42% 31% 25% 25% 13% 8% Echo at discharge Follow-up 6 months Follow-up 12 months FIGURE 9 Opening of the aortic valve Full opening of the aortic valve increased during LVAD support to 31% of the patients within the first 6 months and decreased slightly during the next 6 months to 42% of the patients. Full opening Intermittent opening Full closure FIGURE 10 Aortic valve free of fusion after INCOR therapy (by courtesy of Dr. A. Iacovoni) No aortic valve fusion was detected in the heart of an INCOR patient after transplantation (time on device 13 months). 10
11 Conclusion INCOR Periodic Flow Change (PFC) algorithm π promotes the opening of the aortic valve by modulating the speed at fixed intervals π reduces the early onset of AI during INCOR support, despite permanently closed aortic valve in 50% of the patients Detection of aortic valve opening by pressure difference trend analysis facilitates speed adjustment to further induce aortic valve opening. 11 Influence of INCOR PFC Algorithm on Aortic Valve Function
12 INCOR Periodic Flow Change (PFC) algorithm π promotes the opening of the aortic valve by modulating the speed at fixed intervals π reduces the early onset of AI during INCOR support, despite permanently closed aortic valve in 50% of the patients Berlin Heart GmbH Wiesenweg Berlin Germany Phone Fax Berlin Heart Inc. 200 Valleywood Road Suite B100 The Woodlands TX USA Phone Fax Version MFI21.0 September 2013 Berlin Heart GmbH
Note: The left and right sides of the heart must pump exactly the same volume of blood when averaged over a period of time
page 1 HEART AS A PUMP A. Functional Anatomy of the Heart 1. Two pumps, arranged in series a. right heart: receives blood from the systemic circulation (via the great veins and vena cava) and pumps blood
More informationMedical management of CHF: A New Class of Medication. Al Timothy, M.D. Cardiovascular Institute of the South
Medical management of CHF: A New Class of Medication Al Timothy, M.D. Cardiovascular Institute of the South Disclosures Speakers Bureau for Amgen Background Chronic systolic congestive heart failure remains
More informationExchange solutes and water with cells of the body
Chapter 8 Heart and Blood Vessels Three Types of Blood Vessels Transport Blood Arteries Carry blood away from the heart Transport blood under high pressure Capillaries Exchange solutes and water with cells
More informationNormal & Abnormal Intracardiac. Lancashire & South Cumbria Cardiac Network
Normal & Abnormal Intracardiac Pressures Lancashire & South Cumbria Cardiac Network Principle Pressures recorded from catheter tip Electrical transducer - wheatstone bridge mechanical to electrical waveform
More informationNormal Intracardiac Pressures. Lancashire & South Cumbria Cardiac Network
Normal Intracardiac Pressures Lancashire & South Cumbria Cardiac Network Principle Pressures recorded from catheter tip Electrical transducer - wheatstone bridge mechanical to electrical waveform display
More informationPHARMACOLOGICAL Stroke Prevention in Atrial Fibrillation STROKE RISK ASSESSMENT SCORES Vs. BLEEDING RISK ASSESSMENT SCORES.
PHARMACOLOGICAL Stroke Prevention in Atrial Fibrillation STROKE RISK ASSESSMENT SCORES Vs. BLEEDING RISK ASSESSMENT SCORES. Hossam Bahy, MD (1992 2012), 19 tools have been identified 11 stroke scores 1
More informationSteven J. Yakubov, MD FACC For the CoreValve US Clinical Investigators
Long-Term Outcomes Using a Self- Expanding Bioprosthesis in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery: Two-Year Results From the CoreValve US Pivotal Trial Steven J. Yakubov,
More informationNormal ranges of left ventricular global longitudinal strain: A meta-analysis of 2484 subjects
Normal ranges of left ventricular global longitudinal strain: A meta-analysis of 2484 subjects Teerapat Yingchoncharoen MD. Shikar Agarwal MD. MPH. Thomas H. Marwick MBBS. Ph.D. MPH. Cleveland Clinic Foundation
More informationClinical Commissioning Policy Statement: Percutaneous mitral valve leaflet repair for mitral regurgitation April 2013. Reference: NHSCB/A09/PS/b
Clinical Commissioning Policy Statement: Percutaneous mitral valve leaflet repair for mitral regurgitation April 2013 Reference: NHS Commissioning Board Clinical Commissioning Policy Statement: Percutaneous
More informationQuiz 5 Heart Failure scores (n=163)
Quiz 5 Heart Failure summary statistics The correct answers to questions are indicated by *. Students were awarded 2 points for question #3 for either selecting spironolactone or eplerenone. However, the
More informationMeasure #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care
Measure #236 (NQF 0018): Controlling High Blood Pressure National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS F INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of patients
More informationManagement of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery
Management of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery Srinivasan Rajagopal M.D. Assistant Professor Division of Cardiothoracic Anesthesia Objectives Describe the pathophysiology
More informationFunctional Improvement for Heart Failure Patients After Left Ventricular Assistive Device Placement in a Free Standing Rehabilitation Hospital
Functional Improvement for Heart Failure Patients After Left Ventricular Assistive Device Placement in a Free Standing Rehabilitation Hospital Vittal R. Nagar, M.D, PhDc PGY II Mentor: Robert Nickerson,
More informationBerlin Heart EXCOR Ventricular Assist Device
First transportation on a Berlin Heart LVAD as a bridge to transplantation to Arkansas Children s Hospital Dorothy Garbin, CCP Berlin Heart EXCOR Ventricular Assist Device Pediatric pulsatile assist device
More information4/7/2015. Cardiac Rehabilitation: From the other side of the glass door. Chicago, circa 1999. Objectives. No disclosures, no conflicts
Cardiac Rehabilitation: From the other side of the glass door No disclosures, no conflicts Charles X. Kim, MD, FACC, ABVM Objectives 1. Illustrate common CV benefits of CV rehab in real world practice.
More informationRATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY. Charles Jazra
RATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY Charles Jazra NO CONFLICT OF INTEREST TO DECLARE Relationship Between Atrial Fibrillation and Age Prevalence, percent
More informationRiociguat Clinical Trial Program
Riociguat Clinical Trial Program Riociguat (BAY 63-2521) is an oral agent being investigated as a new approach to treat chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary arterial hypertension
More informationPress conference: Rheumatic Heart Disease a forgotten but devastating disease
www.worldcardiocongress.org Chairpersons: Bongani M. Mayosi Jonathan Carapetis Press conference: Rheumatic Heart Disease a forgotten but devastating disease www.worldcardiocongress.org www.worldcardiocongress.org
More informationLow-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity
Low-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity Jean-Luc MONIN, MD, PhD Henri Mondor University Hospital Créteil, FRANCE Disclosures : None 77-year-old woman, mild dyspnea
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical
More informationType II Pulmonary Hypertension: Pulmonary Hypertension due to Left Heart Disease
Heart Failure Center Hadassah University Hospital Type II Pulmonary Hypertension: Pulmonary Hypertension due to Left Heart Disease Israel Gotsman MD The Heart Failure Center, Heart Institute Hadassah University
More informationINSTEAD at 5-year follow-up shifts the expectations for endovascular treatment
INSTEAD at 5-year follow-up shifts the expectations for endovascular treatment Christoph A. Nienaber, MD, FACC University Heart Center Rostock Department of Medicine I - Cardiology christoph.nienaber@med.uni-rostock.de
More informationSYNOPSIS. Risperidone: Clinical Study Report CR003274
SYNOPSIS Protocol No: CR003274 Title of Study: An Open-Label, Long-Term Trial of Risperidone Long-Acting Microspheres in the Treatment of Subjects Diagnosed with Schizophrenia Coordinating Investigator:
More informationSponsor Novartis Pharmaceuticals
Clinical Trial Results Database Page 1 Sponsor Novartis Pharmaceuticals Generic Drug Name Indacaterol Therapeutic Area of Trial Chronic Obstructive Pulmonary Disease (COPD) Indication studied: COPD Study
More informationHow should we treat atrial fibrillation in heart failure
Advances in Cardiac Arrhhythmias and Great Innovations in Cardiology Torino, 23/24 Ottobre 2015 How should we treat atrial fibrillation in heart failure Matteo Anselmino Dipartimento Scienze Mediche Città
More information1 Congestive Heart Failure & its Pharmacological Management
Harvard-MIT Division of Health Sciences and Technology HST.151: Principles of Pharmocology Instructor: Prof. Keith Baker 1 Congestive Heart Failure & its Pharmacological Management Keith Baker, M.D., Ph.D.
More informationMEDICAL POLICY SUBJECT: VENTRICULAR ASSIST DEVICES. POLICY NUMBER: 7.01.07 CATEGORY: Technology Assessment
MEDICAL POLICY SUBJECT: VENTRICULAR ASSIST DEVICES PAGE: 1 OF: 7 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including
More informationClinical Study Synopsis for Public Disclosure
abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis - which is part of the clinical
More informationINTRODUCTION TO EECP THERAPY
INTRODUCTION TO EECP THERAPY is an FDA cleared, Medicare approved, non-invasive medical therapy for the treatment of stable and unstable angina, congestive heart failure, acute myocardial infarction, and
More informationChronic Vagus Nerve Stimulation: A New Treatment Modality for Congestive Heart Failure
Chronic Vagus Nerve Stimulation: A New Treatment Modality for Congestive Heart Failure Gaetano M. De Ferrari, MD Dept. of Cardiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy for the CardioFit
More informationSurgeons Role in Atrial Fibrillation
Atrial Fibrillation Surgeons Role in Atrial Fibrillation Steven J Feldhaus, MD, FACS 2015 Cardiac Symposium September 18, 2015 Stages of Atrial Fibrillation Paroxysmal (Intermittent) Persistent (Continuous)
More informationINHERIT. The Lancet Diabetes & Endocrinology In press
INHibition of the renin angiotensin system in hypertrophic cardiomyopathy and the Effect on hypertrophy a Randomized Intervention Trial with losartan Anna Axelsson, Kasper Iversen, Niels Vejlstrup, Carolyn
More informationAdvanced Heart Failure & Transplantation Fellowship Program
Advanced Heart Failure & Transplantation Fellowship Program Curriculum I. Patient Care When on the inpatient Heart Failure and Transplant Cardiology service, the cardiology fellow will hold primary responsibility
More informationEducational Goals & Objectives
Educational Goals & Objectives The Cardiology rotation will provide the resident with an understanding of cardiovascular physiology and its broad systemic manifestations. The resident will have the opportunity
More informationTreating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC
Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG
More informationCurrent status of pediatric cardiac surgery
Current status of pediatric cardiac surgery Sabine H. Daebritz Dept. of Cardio-vascular Surgery Heart Center Duisburg, Germany Normal circulation 1 Complex cardiac lesions Stenoses Shunts Malconnections
More informationSection Four: Pulmonary Artery Waveform Interpretation
Section Four: Pulmonary Artery Waveform Interpretation All hemodynamic pressures and waveforms are generated by pressure changes in the heart caused by myocardial contraction (systole) and relaxation/filling
More informationTest Content Outline Effective Date: February 6, 2015. Cardiac-Vascular Nursing Board Certification Examination
Effective Date: February 6, 2015 Board Certification Examination There are 175 questions on this examination. Of these, 150 are scored questions and 25 are pretest questions that are not scored. Pretest
More informationManaging Mitral Regurgitation: Repair, Replace, or Clip? Michael Howe, MD Traverse Heart & Vascular
Managing Mitral Regurgitation: Repair, Replace, or Clip? Michael Howe, MD Traverse Heart & Vascular Mitral Regurgitation Anatomy Mechanisms of MR Presentation Evaluation Management Repair Replace Clip
More information1975 M.D. University of Maryland School of Medicine, Baltimore, Maryland. 1975-1976 Internship, University of Michigan Medical Center, Ann Arbor, MI
Timothy J, Byrnes, M.D. Assistant Professor of Internal Medicine Division of Cardiology Wayne State University, Detroit, MI Office Address: Harper University Hospital Division of Cardiology 3990 John R
More information2/20/2015. Cardiac Evaluation of Potential Solid Organ Transplant Recipients. Issues Specific to Transplantation. Kidney Transplantation.
DISCLOSURES I have no relevant financial relationships to disclose. Cardiac Evaluation of Potential Solid Organ Transplant Recipients Michele Hamilton, MD Director, Heart Failure Program Cedars Sinai Heart
More informationMinimally Invasive Mitral Valve Surgery
Minimally Invasive Mitral Valve Surgery Stanford Health Care offers leading, superior options in cardiac surgery, including the latest techniques and research for Minimally Invasive Cardiac surgery. Advanced
More informationDiagnostic and Therapeutic Procedures
Diagnostic and Therapeutic Procedures Diagnostic and therapeutic cardiovascular s are central to the evaluation and management of patients with cardiovascular disease. Consistent with the other sections,
More informationClinical Study Synopsis
Clinical Study Synopsis This Clinical Study Synopsis is provided for patients and healthcare professionals to increase the transparency of Bayer's clinical research. This document is not intended to replace
More informationHeart Report 2002. - Cardiology and Cardiac Surgery - for Germany including a Europe-wide Comparison
E R N S T B R U C K E N B E R G E R Heart Report 2002 - Cardiology and Cardiac Surgery - for Germany including a Europe-wide Comparison 2002 15. Heart Report 2002 Author: Dr Ernst Bruckenberger Lecturer,
More information5. Management of rheumatic heart disease
5. Management of rheumatic heart disease The fundamental goal in the long-term management of RHD is to prevent ARF recurrences, and therefore, prevent the progression of RHD, and in many cases allow for
More informationHYPERTROPHIC CARDIOMYOPATHY
HYPERTROPHIC CARDIOMYOPATHY Most often diagnosed during infancy or adolescence, hypertrophic cardiomyopathy (HCM) is the second most common form of heart muscle disease, is usually genetically transmitted,
More informationStaphyloccus aureus sepsis: follow- up practice guidelines
Staphyloccus aureus sepsis: follow- up practice guidelines March 17, 2012 National Study Day Hospital Antibiotic Stewardship prof. dr. Dirk Vogelaers, Ghent University Hospital apr. Franky Buyle, Ghent
More informationNon-Invasive Positive Pressure Ventilation in Heart Failure Patients: For Who, Wy & When?
REUNIÃO CONJUNTA DOS GRUPOS DE ESTUDO DE CUIDADOS INTENSIVOS CARDÍACOS E DE FISIOPATOLOGIA DO ESFORÇO E REABILITAÇÃO CARDÍACA O L H Ã O 2 7 e 2 8 d e J a n e i r o 2 0 1 2 Non-Invasive Positive Pressure
More informationSection 8: Clinical Exercise Testing. a maximal GXT?
Section 8: Clinical Exercise Testing Maximal GXT ACSM Guidelines: Chapter 5 ACSM Manual: Chapter 8 HPHE 4450 Dr. Cheatham Outline What is the purpose of a maximal GXT? Who should have a maximal GXT (and
More informationMitral Valve Repair versus Replacement for Severe Ischemic Mitral Regurgitation. Michael Acker, MD For the CTSN Investigators AHA November 2013
Mitral Valve Repair versus Replacement for Severe Ischemic Mitral Regurgitation Michael Acker, MD For the CTSN Investigators AHA November 2013 Acknowledgements Supported by U01 HL088942 Cardiothoracic
More informationStarling s Law Regulation of Myocardial Performance Intrinsic Regulation of Myocardial Performance
Regulation of Myocardial Performance Intrinsic Regulation of Myocardial Performance Just as the heart can initiate its own beat in the absence of any nervous or hormonal control, so also can the myocardium
More informationElevated heart rate at twelve months after heart transplantation is an independent predictor of long term mortality
Elevated heart rate at twelve months after heart transplantation is an independent predictor of long term mortality C. Tomas, MA Castel, E Roig, I. Vallejos, C. Plata, F. Pérez-Villa Cardiology Department,
More informationAcute heart failure may be de novo or it may be a decompensation of chronic heart failure.
Management of Acute Left Ventricular Failure Acute left ventricular failure presents as pulmonary oedema due to increased pressure in the pulmonary capillaries. It is important to realise though that left
More informationTreatment of Cardiac Device Infections
Treatment of Cardiac Device Infections Peter Ammann 2 2 40 yrs old patient Pocket infection after pacemaker change. Staph. aureus growing in blood cultures. Pacemaker dependent. Echo: no vegetations on
More informationVascular System The heart can be thought of 2 separate pumps from the right ventricle, blood is pumped at a low pressure to the lungs and then back
Vascular System The heart can be thought of 2 separate pumps from the right ventricle, blood is pumped at a low pressure to the lungs and then back to the left atria from the left ventricle, blood is pumped
More informationCurrent Renal Replacement Therapy in Korea - Insan Memorial Dialysis Registry, 2011 - ESRD Registry Committee, Korean Society of Nephrology*
Current Renal Replacement Therapy in Korea - Insan Memorial Dialysis Registry, 2011 - ESRD Registry Committee, Korean Society of Nephrology* =Abstracts= Registry committee of Korean Society of Nephrology
More informationPotential Causes of Sudden Cardiac Arrest in Children
Potential Causes of Sudden Cardiac Arrest in Children Project S.A.V.E. When sudden death occurs in children, adolescents and younger adults, heart abnormalities are likely causes. These conditions are
More informationEchocardiography Guided Cardiac Resynchronization Therapy in Patients with Symptomatic Heart Failure and Narrow QRS Complex
Echocardiography Guided Cardiac Resynchronization Therapy in Patients with Symptomatic Heart Failure and Narrow QRS Complex Johannes Holzmeister, M.D. University of Zurich, Zurich, Switzerland on behalf
More informationGuidance for Industry
Guidance for Industry Cancer Drug and Biological Products Clinical Data in Marketing Applications U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and
More informationListen to your heart: Good Cardiovascular Health for Life
Listen to your heart: Good Cardiovascular Health for Life Luis R. Castellanos MD, MPH Assistant Clinical Professor of Medicine University of California San Diego School of Medicine Sulpizio Family Cardiovascular
More informationAnatomi & Fysiologi 060301. The cardiovascular system (chapter 20) The circulation system transports; What the heart can do;
The cardiovascular system consists of; The cardiovascular system (chapter 20) Principles of Anatomy & Physiology 2009 Blood 2 separate pumps (heart) Many blood vessels with varying diameter and elasticity
More informationPractical class 3 THE HEART
Practical class 3 THE HEART OBJECTIVES By the time you have completed this assignment and any necessary further reading or study you should be able to:- 1. Describe the fibrous pericardium and serous pericardium,
More informationAortic Valve Stenosis and CAD
EUROECHO 14, Copenhagen 2010 Aortic Valve Stenosis and CAD Aleksandar N. Neskovic Clinical Hospital Center Zemun Belgrade University School of Medicine Aortic Stenosis and CAD Important facts Links AS/CAD
More informationgetemed Medizin- und Informationstechnik AG
getemed Medizin- und Informationstechnik AG Oderstraße 77 14513 Teltow Germany Ambulatory Monitoring of Physiological Parameters Robert Downes ehealth Conference, Berlin April 19, 2007 Contents Introduction
More informationHeart Sounds & Murmurs
Cardiovascular Physiology Heart Sounds & Murmurs Dr. Abeer A. Al-Masri MBBS, MSc, PhD Associate Professor Consultant Cardiovascular Physiologist Faculty of Medicine, KSU Detected over anterior chest wall
More informationHEART HEALTH WEEK 3 SUPPLEMENT. A Beginner s Guide to Cardiovascular Disease HEART FAILURE. Relatively mild, symptoms with intense exercise
WEEK 3 SUPPLEMENT HEART HEALTH A Beginner s Guide to Cardiovascular Disease HEART FAILURE Heart failure can be defined as the failing (insufficiency) of the heart as a mechanical pump due to either acute
More informationDERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT of Atrial Fibrillation (AF)
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT of Atrial Fibrillation (AF) Key priorities Identification and diagnosis Treatment for persistent AF Treatment for permanent AF Antithrombotic
More informationThe heart then repolarises (or refills) in time for the next stimulus and contraction.
Atrial Fibrillation BRIEFLY, HOW DOES THE HEART PUMP? The heart has four chambers. The upper chambers are called atria. One chamber is called an atrium, and the lower chambers are called ventricles. In
More informationHeart Failure EXERCISES. Ⅰ. True or false questions (mark for true question, mark for false question. If it is false, correct it.
Heart Failure EXERCISES Ⅰ. True or false questions (mark for true question, mark for false question. If it is false, correct it. ) 1. Heart rate increase is a kind of economic compensation, which should
More informationCope Sample Small. Jeffrey T. Cope, M.D., Susan L. Sample, MSN, CRNP, and Roy S. Small, M.D.
Mechanical Cardiac Assist in a Community Hospital without Transplantation Cope Sample Small Jeffrey T. Cope, M.D., Susan L. Sample, MSN, CRNP, and Roy S. Small, M.D. Cardiothoracic Surgery and Cardiology
More informationAdult Cardiac Surgery ICD9 to ICD10 Crosswalks
164.1 Malignant neoplasm of heart C38.0 Malignant neoplasm of heart 164.1 Malignant neoplasm of heart C45.2 Mesothelioma of pericardium 198.89 Secondary malignant neoplasm of other specified sites C79.89
More information2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY
Measure #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented National Quality Strategy Domain: Community / Population Health 2016 PQRS OPTIONS F INDIVIDUAL MEASURES:
More informationFeeding in Infants with Complex Congenital Heart Disease. Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014
Feeding in Infants with Complex Congenital Heart Disease Rachel Torok, MD Southeastern Pediatric Cardiology Society Conference September 6, 2014 Objectives Discuss common feeding issues in patients with
More informationThe P Wave: Indicator of Atrial Enlargement
Marquette University e-publications@marquette Physician Assistant Studies Faculty Research and Publications Health Sciences, College of 8-12-2010 The P Wave: Indicator of Atrial Enlargement Patrick Loftis
More informationCommon types of congenital heart defects
Common types of congenital heart defects Congenital heart defects are abnormalities that develop before birth. They can occur in the heart's chambers, valves or blood vessels. A baby may be born with only
More informationRecurrent AF: Choosing the Right Medication.
In the name of God Shiraz E-Medical Journal Vol. 11, No. 3, July 2010 http://semj.sums.ac.ir/vol11/jul2010/89015.htm Recurrent AF: Choosing the Right Medication. Basamad Z. * Assistant Professor, Department
More informationEAE TEACHING COURSE Aorta and aortic valve 2012
EAE TEACHING COURSE Aorta and aortic valve 2012 31th March 2012 Szczecin, Poland EP EAE TEACHING COURSE: aorta and aortic valve Szczecin, 31st March 2012 Prof. Luigi Badano, Italy Prof. Patrizio Lancellotti,
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Cardiology
Specific Basic Standards for Osteopathic Fellowship Training in Cardiology American Osteopathic Association and American College of Osteopathic Internists BOT 07/2006 Rev. BOT 03/2009 Rev. BOT 07/2011
More informationCOVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION
COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION Question: How should the EGBS Coverage Guidance regarding ablation for atrial fibrillation be applied to the Prioritized List? Question source: Evidence
More informationCase III. Disscussion. the UHP ultrasound protocol. Novel Ultrasound Approach to the Empiric Evaluation of the Undifferentiated Hypotensive Patient
The UHP Ultrasound Protocol: A Novel Ultrasound Approach to the Empiric Evaluation of the Undifferentiated Hypotensive Patient JOHN S. ROSE, MD,* AARON E. BAIR, MD,* DIKU MANDAVIA, MD, AND DONNA J. KINSER,
More informationHeart murmurs and heart disease
Heart murmurs and heart disease VETERINARY GUIDE 11 The heart is a muscle that pumps blood around the body, providing it with oxygen and nutrients. It is made up of four separate chambers an atrium and
More informationAll Patient Refined DRGs (APR-DRGs) An Overview. Presented by Treo Solutions
All Patient Refined DRGs (APR-DRGs) An Overview Presented by Treo Solutions Presentation Highlights History of inpatient classification systems APR-DRGs: what they are, how they work, and why they are
More informationEVALUATION OF MEDICAL RECORDS COMPLETENESS IN THE ADULT CARDIOLOGY CLINIC AT NORK MARASH MEDICAL CENTER
American University of Armenia Center for Health Services Research and Development Nork Marash Medical Center EVALUATION OF MEDICAL RECORDS COMPLETENESS IN THE ADULT CARDIOLOGY CLINIC AT NORK MARASH MEDICAL
More informationElectrocardiography Review and the Normal EKG Response to Exercise
Electrocardiography Review and the Normal EKG Response to Exercise Cardiac Anatomy Electrical Pathways in the Heart Which valves are the a-v valves? Closure of the a-v valves is associated with which heart
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical
More informationBASIC STANDARDS FOR RESIDENCY TRAINING IN CARDIOLOGY
BASIC STANDARDS FOR RESIDENCY TRAINING IN CARDIOLOGY American Osteopathic Association and the American College of Osteopathic Internists Specific Requirements For Osteopathic Subspecialty Training In Cardiology
More informationFrom Lawrence Weed to Apex and ICD-10. Paul Brakeman MD PhD Physician Lead for Provider Practice Change and Education
From Lawrence Weed to Apex and ICD-10 Paul Brakeman MD PhD Physician Lead for Provider Practice Change and Education The Question: Why is optimizing Problem List use important for patient care and the
More informationMagnetic Resonance Quantitative Analysis. MRV MR Flow. Reliable analysis of heart and peripheral arteries in the clinical workflow
Magnetic Resonance Quantitative Analysis MRV MR Flow Reliable analysis of heart and peripheral arteries in the clinical workflow CAAS MRV Functional Workflow Designed for imaging specialists, CAAS MRV
More informationIsabella Sudano & Franco Muggli
Swiss Hypertension Guidelines Isabella Sudano & Franco Muggli CoLaus, Swisshype ESC 2005 Dokumentenname Datum Seite 1 European Journal of Cardiovascular Prevention and Rehabilitation 2009 Guideline...
More informationUnderstanding your child s heart Atrial septal defect
Understanding your child s heart Atrial septal defect About this factsheet This factsheet is for the parents of babies and children who have an atrial septal defect (ASD). It explains, what an atrial septal
More informationGeriatric Cardiology: Challenges and Strategies
Geriatric Cardiology: Challenges and Strategies No financial disclosures Geriatrics -- No Specific Age 'you know it when you see it' Functional Status Polypharmacy Impaired Renal Function Diagnostic Testing:
More informationTranscatheter Mitral Valve-in-Valve and Valve-in-Ring Implantations. Danny Dvir, MD On behalf of VIVID registry investigators
Transcatheter Mitral Valve-in-Valve and Valve-in-Ring Implantations Danny Dvir, MD On behalf of VIVID registry investigators Introduction Bioprosthetic valves are increasingly implanted in open-heart surgeries.
More informationCardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology
Cardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89) The diabetes mellitus codes are combination codes
More informationResuscitation in congenital heart disease. Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto
Resuscitation in congenital heart disease Peter C. Laussen MBBS FCICM Department Critical Care Medicine Hospital for Sick Children Toronto Evolution of Congenital Heart Disease Extraordinary success: Overall
More informationAuscultation of the Heart
Review of Clinical Signs uscultation of the Heart Series Editor: Bernard Karnath, MD Bernard Karnath, MD William Thornton, MD uscultation of the heart can provide clues to the diagnosis of many cardiac
More informationon behalf of the AUGMENT-HF Investigators
One Year Follow-Up Results from AUGMENT-HF: A Multicenter Randomized Controlled Clinical Trial of the Efficacy of Left Ventricular Augmentation with Algisyl-LVR in the Treatment of Heart Failure* Douglas
More informationPre-Operative Cardiac Evaluation Kalpana Jain, MD
Pre-Operative Cardiac Evaluation Kalpana Jain, MD Cardiac evaluation is an integral part of pre-op evaluation. Perioperative cardiac events are common causes of mortality. Major cardiac complications associated
More informationMICROGRAVITY EFFECTS ON HUMAN PHYSIOLOGY: CIRCULATORY SYSTEM
National Aeronautics and Space Administration MICROGRAVITY EFFECTS ON HUMAN PHYSIOLOGY: CIRCULATORY SYSTEM Instructional Objectives Students will: analyze the effects of external stimuli on the physiological
More informationMay 1 6, 2016 Loews Atlanta Hotel Atlanta, GA PRELIMINARY PROGRAM AT A GLANCE
Sunday, May 1 7:00-8:30 pm Image Optimization Workshop: 2D Echocardiography Moderators: Fabio De Vasconelos Papa, MD; Mark A. Taylor, MD : Annemarie Thompson, MD Speakers: Gregg S. Hartman, MD Lori B.
More information