Titan™ sensor a potential hemodynamic monitor or not

Heart failure is a common problem and long term monitoring of heart function accurately in patients has gained increased interest. A study was carried out in 40 patients to test the safety and feasibility of Titan™ pressure sensor. Titan™ sensor is small, resembling the CardioMEMS® device . Titan™ is implanted principally in any heart chambers, recently for the first time modified device of Titan™ was implemented viacatheter in animals and good results were observed. The first study in man on a new implanted wireless hemodynamic monitor showed favourable results.

Heart failure is a huge health problem. The disease often follows a similar course; stable in the initial stages but progressive deterioration develops with exacerbations that eventually lead to recurrent hospitalization. To begin with, patients usually respond to standard medical treatment, but the course is unpredictable and in the final stages inotropic support is often required to preserve life.The possibility of monitoring heart function more accurately in these patients has gained increasing interest. The ability to detect a sudden increase in filling pressure would provide early warning of an imminent exacerbation and enable medical intervention before the development of clinical symptoms .

There are a few implantable cardiac hemodynamic monitors on the market, some already in use while others have gone through clinical studies with successful safety records. These devices can be divided into two categories; those monitoring pressure of the left side of the heart, and those on the right.A catheter-based technology with a device introduced into the pulmonary artery allowing wireless recordings of pulmonary artery pressure and indirectly pulmonary artery wedge pressure is currently approved by the Food and Drug Administration. Read more.............

Wireless Monitoring of Cardiac Function

Heart failure is a huge bloom problem. The achievability of abiding ecology affection action added accurately in these patients has acquired accretion interest. The primary aim of this abstraction was to see if a wireless burden sensor can be cautiously built-in to accord authentic and reproducible abiding intracardiac burden recordings. Another aim was to see if there are any adverse furnishings affiliated with the implant. A ascendancy accumulation was included for allegory of analytic data.Forty patients with heart failure, 31 appointed for accessible affection anaplasty and 9 for transcatheter aortic valve backup (TAVR) were included to analysis the assurance and achievability of the Titan burden sensor.

Data were prospectively registered on a analytic address form, and transferred to and adored in an Excel database for approaching analysis. The abstraction architecture and sample admeasurement were called with basal action and assurance of the implant as primary endpoints. Linear corruption was acclimated to abstraction the accord amid intraoperative sensor and advertence catheter burden values. Non-parametric tests were acclimated to analysis differences amid connected variables, as the belief for course application the Shapiro-Wilks analysis was not fulfilled.

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Early Aortic Root and Left Main Coronary Artery Thrombosis after Left Ventricular Assist Device Implantation

Introduction:

In the modern era, the use of surgically implanted left ventricular assist devices (LVADs) as a bridge therapy to either recovery or cardiac transplantation has given a hope at the end of the HF course of disease. More recently, the use of LVADs as “DT” has further illuminated a future for patients with end-stage HF.

Today, LVADs have evolved from large, bulky pulsatile systems to smaller, compact, fully implantable continuous flow (CF) pumps. These CF-LVADs use rotodynamic pumps to transfer kinetic energy from a circulating impeller to the bloodstream, thereby generating forward flow .

Starling et al. summarized the rate of device thrombosis among 837 patients across three implantation centers in USA, and Kirklin et al. described data reported to the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) on the rate of device thrombosis among 6910 patients from 2011 till April 2014. But all these big studies were done on Heart Mate2 devices (Thoratec) and very few were done on (HeartWare) HVAD devices.

Left main coronary artery thrombosis and aortic root thrombosis are rarely described, but in our case; thrombus had occurred earlywith the newer generation (HeartWare) HVAD device despite full anticoagulation and antithrombotic coverage.

Case Report:

39 years old man was diagnosed with severe dilated cardiomyopathy since 2003 with recurrent admissions due to decompensated congestive heart failure. Dual Chamber ICD was inserted in 2012, but removed after few months due to infection and thrombosis. He is a known diabetic on insulin therapy, heavy smoker with liver cardiac cirrhosis and has severe chronic kidney disease with baseline creatinine around 200 mmol/L. Echocardiography showed severe LV dysfunction with EF less than 20% and RV moderate to severe dysfunction with systolic PAP pressure 55-65 mmHg.