Andrew Civitello, MD

Dr. Andrew Civitello supports THI’s mission through his leadership as the Program Director of The Advanced Heart Failure and Transplant Cardiology Fellowship.

Show full bio

Dr. Andrew Civitello is board-certified in Cardiology, Interventional Cardiology and Advanced Heart Failure and Transplant Cardiology and serves as the Medical Director of the Heart Transplant Program at The Texas Heart Institute as a member of the THI Professional Staff. He received his medical degree from The University of Texas Health Science Center in Houston. His extensive training includes internship, residency and a year as Chief Medical Resident at The University of Texas Health Science Center in Houston, followed by fellowships in Cardiology and Interventional Cardiology at Baylor College of Medicine and The Texas Heart Institute. Dr. Civitello specializes in interventional cardiology and peripheral vascular procedures, with advanced training in heart failure management and heart transplantation, general and interventional cardiology, including cardiac catheterization, CT angiography, nuclear cardiology, and advanced training in peripheral artery interventions. The major focus of Dr. Civitello’s clinical and research interests include advanced heart failure management, mechanical circulatory support, and heart transplantation. He has authored and co-authored numerous articles for major scientific journals and spoken professionally in both national and international forums.

See Publications

Texas Heart Institute Positions

  • Medical Director Heart Transplant Program, THI Leadership
  • Teaching Staff, Cardiovascular Disease Fellowship
  • Program Director, Advanced Heart Failure and Transplant Cardiology Fellowship
  • Teaching Staff, Interventional Cardiology Fellowship

Interests

  • Interventional Cardiology
  • Advanced Heart Failure
  • Mechanical Circulatory Support
  • Novel Treatments for Heart Failure

Education

  • Medical School:

    University of Texas Health Science Center Houston

  • Residency:

    University of Texas Health Science Center - Houston

  • Fellowships:

    Baylor College of Medicine

Academic & Clinical Affiliations

Certifications

  • American Board of Internal Medicine

Publications

4862227 9FBUJBMU 1 alternatives-to-animal-experimentation 10 date desc Civitello 1072 https://www.texasheart.org/wp-content/plugins/zotpress/
%7B%22status%22%3A%22success%22%2C%22updateneeded%22%3Afalse%2C%22instance%22%3Afalse%2C%22meta%22%3A%7B%22request_last%22%3A0%2C%22request_next%22%3A0%2C%22used_cache%22%3Atrue%7D%2C%22data%22%3A%5B%7B%22key%22%3A%22LY937V3N%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Civitello%20and%20Nair%22%2C%22parsedDate%22%3A%222023-02-28%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3B%26lt%3Bstrong%26gt%3BCivitello%26lt%3B%5C%2Fstrong%26gt%3B%2C%20A.%20and%20Nair%2C%20A.%20%282023%29.%20Simultaneous%20heart-kidney%20transplantation%3A%20balancing%20competing%20outcomes%20for%20transplant%20wait-listed%26%23xA0%3Bpatients.%20%26lt%3Bi%26gt%3BJ%20Am%20Coll%20Cardiol%26lt%3B%5C%2Fi%26gt%3B%20%26lt%3Bi%26gt%3B81%26lt%3B%5C%2Fi%26gt%3B%2C%20741%26%23x2013%3B742.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.jacc.2022.12.010%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.jacc.2022.12.010%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Simultaneous%20heart-kidney%20transplantation%3A%20balancing%20competing%20outcomes%20for%20transplant%20wait-listed%5Cu00a0patients%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%22%2C%22lastName%22%3A%22Civitello%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Ajith%22%2C%22lastName%22%3A%22Nair%22%7D%5D%2C%22abstractNote%22%3A%22%22%2C%22date%22%3A%222023-02-28%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1016%5C%2Fj.jacc.2022.12.010%22%2C%22ISSN%22%3A%221558-3597%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%22S7WF6DG3%22%2C%22JD5ZU4IS%22%5D%2C%22dateModified%22%3A%222023-03-13T20%3A12%3A57Z%22%7D%7D%2C%7B%22key%22%3A%22ZANSTJ68%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Maitra%20et%20al.%22%2C%22parsedDate%22%3A%222023-02-16%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BMaitra%2C%20N.%20S.%2C%20Dugger%2C%20S.%20J.%2C%20Balachandran%2C%20I.%20C.%20et%20al.%20%282023%29.%20Impact%20of%20the%202018%20UNOS%20heart%20transplant%20policy%20changes%20on%20patient%26%23xA0%3Boutcomes.%20%26lt%3Bi%26gt%3BJACC%20Heart%20Fail%26lt%3B%5C%2Fi%26gt%3B%2C%20S2213-1779%2823%2900038%26%23x2013%3B0.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.jchf.2023.01.009%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.jchf.2023.01.009%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Impact%20of%20the%202018%20UNOS%20heart%20transplant%20policy%20changes%20on%20patient%5Cu00a0outcomes%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Neil%20S.%22%2C%22lastName%22%3A%22Maitra%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Samuel%20J.%22%2C%22lastName%22%3A%22Dugger%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Isabel%20C.%22%2C%22lastName%22%3A%22Balachandran%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%20B.%22%2C%22lastName%22%3A%22Civitello%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Prateeti%22%2C%22lastName%22%3A%22Khazanie%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Joseph%20G.%22%2C%22lastName%22%3A%22Rogers%22%7D%5D%2C%22abstractNote%22%3A%22In%202018%2C%20the%20United%20Network%20for%20Organ%20Sharing%20implemented%20a%206-tier%20allocation%20policy%20to%20replace%20the%20prior%203-tier%20system.%20Given%20increasing%20listings%20of%20critically%20ill%20candidates%20for%20heart%20transplantation%20and%20lengthening%20waitlist%20times%2C%20the%20new%20policy%20aimed%20to%20better%20stratify%20candidates%20by%20waitlist%20mortality%2C%20shorten%20waiting%20times%20for%20high%20priority%20candidates%2C%20add%20objective%20criteria%20for%20common%20cardiac%20conditions%2C%20and%20further%20broaden%20sharing%20of%20donor%20hearts.%20There%20have%20been%20significant%20shifts%20in%20cardiac%20transplantation%20practices%20and%20patient%20outcomes%20following%20the%20implementation%20of%20the%20new%5Cu00a0policy%2C%20including%20changes%20in%20listing%20practices%2C%20waitlist%20time%20and%20mortality%2C%20transplant%20donor%20characteristics%2C%20post-transplantation%20outcomes%2C%20and%20mechanical%20circulatory%20support%20use.%20This%20review%20aims%20to%20highlight%20emerging%20trends%20in%20United%20States%20heart%20transplantation%20practice%20and%20outcomes%20following%20the%20implementation%20of%20the%202018%20United%20Network%20for%20Organ%20Sharing%20heart%20allocation%20policy%20and%20to%20address%20areas%20for%20future%20modification.%22%2C%22date%22%3A%22Feb%2016%2C%202023%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1016%5C%2Fj.jchf.2023.01.009%22%2C%22ISSN%22%3A%222213-1787%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%224XZV96J9%22%2C%227DBQSZ99%22%2C%22JD5ZU4IS%22%5D%2C%22dateModified%22%3A%222023-03-14T14%3A35%3A06Z%22%7D%7D%2C%7B%22key%22%3A%22UEPATAH5%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Civitello%20and%20Rogers%22%2C%22parsedDate%22%3A%222023-01-01%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3B%26lt%3Bstrong%26gt%3BCivitello%26lt%3B%5C%2Fstrong%26gt%3B%2C%20A.%20B.%20and%20Rogers%2C%20J.%20G.%20%282023%29.%20Toward%20a%20self-actuating%20continuous%20flow%20ventricular%20assist%20device%3A%20the%20pudding%20is%20in%20the%20proof.%20%26lt%3Bi%26gt%3BASAIO%20J%26lt%3B%5C%2Fi%26gt%3B%20%26lt%3Bi%26gt%3B69%26lt%3B%5C%2Fi%26gt%3B%2C%2059%26%23x2013%3B60.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1097%5C%2FMAT.0000000000001881%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1097%5C%2FMAT.0000000000001881%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Toward%20a%20self-actuating%20continuous%20flow%20ventricular%20assist%20device%3A%20the%20pudding%20is%20in%20the%20proof%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%20B.%22%2C%22lastName%22%3A%22Civitello%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Joseph%20G.%22%2C%22lastName%22%3A%22Rogers%22%7D%5D%2C%22abstractNote%22%3A%22%22%2C%22date%22%3A%22Jan%2001%2C%202023%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1097%5C%2FMAT.0000000000001881%22%2C%22ISSN%22%3A%221538-943X%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%227DBQSZ99%22%2C%228PULYTSK%22%2C%22TXW6RMW4%22%5D%2C%22dateModified%22%3A%222023-01-06T17%3A15%3A59Z%22%7D%7D%2C%7B%22key%22%3A%229SC85ZEF%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Inchaustegui%20et%20al.%22%2C%22parsedDate%22%3A%222022-10-08%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BInchaustegui%2C%20C.%20A.%2C%20Patel%2C%20A.%2C%20Lamba%2C%20H.%20K.%20et%20al.%20%282022%29.%20Impact%20of%20time%20off%20anticoagulation%20in%20patients%20with%20continuous-flow%20left%20ventricular%20assist%20devices.%20%26lt%3Bi%26gt%3BJ%20Artif%20Organs%26lt%3B%5C%2Fi%26gt%3B.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1007%5C%2Fs10047-022-01367-8%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1007%5C%2Fs10047-022-01367-8%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Impact%20of%20time%20off%20anticoagulation%20in%20patients%20with%20continuous-flow%20left%20ventricular%20assist%20devices%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Christian%20A.%22%2C%22lastName%22%3A%22Inchaustegui%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Ashley%22%2C%22lastName%22%3A%22Patel%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Harveen%20K.%22%2C%22lastName%22%3A%22Lamba%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%22%2C%22lastName%22%3A%22Brown%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Justin%22%2C%22lastName%22%3A%22Arunthamakun%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kevin%22%2C%22lastName%22%3A%22Ting%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Subhasis%22%2C%22lastName%22%3A%22Chatterjee%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Ajith%20P.%22%2C%22lastName%22%3A%22Nair%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Joggy%20K.%22%2C%22lastName%22%3A%22George%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Alexis%20E.%22%2C%22lastName%22%3A%22Shafii%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kenneth%20K.%22%2C%22lastName%22%3A%22Liao%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%20B.%22%2C%22lastName%22%3A%22Civitello%22%7D%5D%2C%22abstractNote%22%3A%22Patients%20with%20left%20ventricular%20assist%20devices%20%28LVADs%29%20receive%20anticoagulation%20to%20decrease%20the%20risk%20of%20thrombosis.%20Various%20circumstances%20require%20discontinuing%20anticoagulation%20in%20LVAD%20patients%2C%20but%20the%20risks%20entailed%20are%20not%20well%20defined.%20In%20a%20retrospective%20review%20of%20LVAD%20implantation%20procedures%2C%20we%20examined%20the%20effect%20of%20time%20off%20anticoagulation%20on%20thrombosis%20and%20mortality%20rates%20after%20implantation.%20An%20international%20normalized%20ratio%5Cu2009%5Cu2264%5Cu20091.5%20was%20used%20to%20screen%20for%20patients%20taken%20off%20anticoagulation.%20Patients%20were%20divided%20into%20three%20groups%20by%20the%20cumulative%20number%20of%20days%20off%20anticoagulation%3A%20no%20discontinuation%2C%20short-term%20discontinuation%20%28%26lt%3B%5Cu200930%5Cu00a0days%29%2C%20and%20long-term%20discontinuation%20%28%5Cu2265%5Cu200930%5Cu00a0days%29.%20Rates%20of%20ischemic%20stroke%2C%20pump%20thrombosis%2C%20and%20mortality%20were%20compared%20among%20groups.%20Of%20245%20patients%20who%20underwent%20LVAD%20implantation%20during%20the%20study%2C%2070%20%2828.6%25%29%20were%20off%20anticoagulation%20during%20follow-up%3A%2037%20%2815.1%25%29%20had%20short-term%20discontinuation%20%28median%2C%2011%5Cu00a0days%29%2C%20and%2033%20%2813.5%25%29%20had%20long-term%20discontinuation%20%28median%2C%20124%5Cu00a0days%29.%20Patients%20with%20long-term%20discontinuation%20had%20a%20higher%20rate%20of%20ischemic%20stroke%20%28adjusted%20hazard%20ratio%208.5%2C%20p%5Cu2009%3D%5Cu20090.001%29%20and%20death%20%28adjusted%20hazard%20ratio%203.9%2C%20p%5Cu2009%3D%5Cu20090.001%29.%20The%20three%20groups%20did%20not%20differ%20in%20pump%20thrombosis%20rate.%20We%20conclude%20that%20after%20LVAD%20implantation%2C%20discontinuing%20anticoagulation%20for%5Cu2009%5Cu2265%5Cu200930%5Cu00a0days%20is%20independently%20associated%20with%20an%20increased%20risk%20of%20ischemic%20stroke%20and%20death.%22%2C%22date%22%3A%22Oct%2008%2C%202022%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1007%5C%2Fs10047-022-01367-8%22%2C%22ISSN%22%3A%221619-0904%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%22S7WF6DG3%22%2C%22WS63FIXU%22%2C%22ZMAN8MMI%22%2C%22VCK5HVUS%22%2C%22C2VFJYPK%22%2C%22MDTREPAF%22%5D%2C%22dateModified%22%3A%222022-11-04T15%3A28%3A42Z%22%7D%7D%2C%7B%22key%22%3A%22RR6UI8W6%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Walther%20et%20al.%22%2C%22parsedDate%22%3A%222022-09-08%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BWalther%2C%20C.%20P.%2C%20Benoit%2C%20J.%20S.%2C%20Lamba%2C%20H.%20K.%20et%20al.%20%282022%29.%20Distinctive%20kidney%20function%20trajectories%20following%20left%20ventricular%20assist%20device%20implantation.%20%26lt%3Bi%26gt%3BJ%20Heart%20Lung%20Transplant%26lt%3B%5C%2Fi%26gt%3B%2C%20S1053-2498%2822%2902110%26%23x2013%3B6.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.healun.2022.08.024%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.healun.2022.08.024%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Distinctive%20kidney%20function%20trajectories%20following%20left%20ventricular%20assist%20device%20implantation%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Carl%20P.%22%2C%22lastName%22%3A%22Walther%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Julia%20S.%22%2C%22lastName%22%3A%22Benoit%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Harveen%20K.%22%2C%22lastName%22%3A%22Lamba%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%20B.%22%2C%22lastName%22%3A%22Civitello%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kevin%20F.%22%2C%22lastName%22%3A%22Erickson%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Nandan%20K.%22%2C%22lastName%22%3A%22Mondal%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kenneth%20K.%22%2C%22lastName%22%3A%22Liao%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sankar%20D.%22%2C%22lastName%22%3A%22Navaneethan%22%7D%5D%2C%22abstractNote%22%3A%22BACKGROUND%3A%20The%20aim%20of%20this%20study%20was%20to%20assess%20for%20distinct%20kidney%20function%20trajectories%20following%20left%20ventricular%20assist%20device%20%28LVAD%29%20placement.%20Cohort%20studies%20of%20LVAD%20recipients%20demonstrate%20that%20kidney%20function%20tends%20to%20increase%20early%20after%20LVAD%20placement%2C%20followed%20by%20decline%20and%20limited%20sustained%20improvement.%20Inter-individual%20differences%20in%20kidney%20function%20response%20may%20be%20obscured.%5CnMETHODS%3A%20We%20identified%20continuous%20flow%20LVAD%20implantations%20in%20US%20adults%20%282016-2017%29%20from%20INTERMACS%20%28Interagency%20Registry%20for%20Mechanically%20Assisted%20Circulatory%20Support%29.%20Primary%20outcomes%20were%20estimated%20glomerular%20filtration%20rate%20%28eGFR%29%20trajectories%20pre-implantation%20to%20%5Cu223c12%20months.%20Latent%20class%20mixed%20models%20were%20applied%20to%20primary%20and%20validation%20samples.%20Clinical%20differences%20among%20trajectory%20groups%20were%20investigated.%5CnRESULTS%3A%20Among%204%2C615%20LVAD%20implantations%2C%205%20eGFR%20trajectory%20groups%20were%20identified.%20The%202%20largest%20groups%20%28Groups%201%20and%202%29%20made%20up%20%26gt%3B80%25%20of%20the%20cohort%2C%20and%20were%20similar%20to%20group%20average%20trajectories%20previously%20reported%2C%20with%20early%20eGFR%20rise%20followed%20by%20decline%20and%20stabilization.%20Three%20novel%20trajectory%20groups%20were%20found%3A%20worsening%20followed%20by%20sustained%20low%20kidney%20function%20%28Group%203%2C%2010.1%25%29%2C%20sustained%20improvement%20%28Group%204%2C%203.3%25%29%2C%20and%20worsening%20followed%20by%20variation%20%28Group%205%2C%201.7%25%29.%20These%20groups%20differed%20in%20baseline%20characteristics%20and%20outcomes.%20Group%204%20was%20younger%20and%20had%20more%20cardiogenic%20shock%20and%20pre-implantation%20dialysis%3B%20Group%203%20had%20higher%20rates%20of%20pre-existing%20chronic%20kidney%20disease%2C%20along%20with%20older%20age.%5CnCONCLUSIONS%3A%20Novel%20eGFR%20trajectories%20were%20identified%20in%20a%20national%20cohort%2C%20possibly%20representing%20distinct%20cardiorenal%20processes.%20Type%201%20cardiorenal%20syndrome%20may%20have%20been%20predominant%20in%20Group%204%2C%20and%20parenchymal%20kidney%20disease%20may%20have%20been%20predominant%20in%20Group%203.%22%2C%22date%22%3A%22Sept%2008%2C%202022%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1016%5C%2Fj.healun.2022.08.024%22%2C%22ISSN%22%3A%221557-3117%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%22C2VFJYPK%22%2C%22MDTREPAF%22%5D%2C%22dateModified%22%3A%222022-11-04T15%3A28%3A19Z%22%7D%7D%2C%7B%22key%22%3A%22SNYY8ZJW%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Krittanawong%20et%20al.%22%2C%22parsedDate%22%3A%222022-07-01%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BKrittanawong%2C%20C.%2C%20Rivera%2C%20M.%20R.%2C%20Shaikh%2C%20P.%20et%20al.%20%282022%29.%20Key%20concepts%20surrounding%20cardiogenic%20shock.%20%26lt%3Bi%26gt%3BCurr%20Probl%20Cardiol%26lt%3B%5C%2Fi%26gt%3B%2C%20101303.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.cpcardiol.2022.101303%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2Fj.cpcardiol.2022.101303%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Key%20concepts%20surrounding%20cardiogenic%20shock%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Chayakrit%22%2C%22lastName%22%3A%22Krittanawong%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mario%20Rodriguez%22%2C%22lastName%22%3A%22Rivera%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Preet%22%2C%22lastName%22%3A%22Shaikh%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Anirudh%22%2C%22lastName%22%3A%22Kumar%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Adam%22%2C%22lastName%22%3A%22May%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Dhruv%22%2C%22lastName%22%3A%22Mahtta%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Jacob%22%2C%22lastName%22%3A%22Jentzer%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%22%2C%22lastName%22%3A%22Civitello%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Jason%22%2C%22lastName%22%3A%22Katz%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Srihari%20S.%22%2C%22lastName%22%3A%22Naidu%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mauricio%20G.%22%2C%22lastName%22%3A%22Cohen%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Venu%22%2C%22lastName%22%3A%22Menon%22%7D%5D%2C%22abstractNote%22%3A%22Cardiogenic%20shock%20%28CS%29%20is%20the%20final%20common%20pathway%20of%20impaired%20cardiovascular%20performance%20that%20results%20in%20ineffective%20forward%20cardiac%20output%20producing%20clinical%20and%20biochemical%20signs%20of%20organ%20hypoperfusion.%20CS%20represents%20the%20most%20common%20cause%20of%20shock%20in%20the%20cardiac%20intensive%20care%20unit%20%28CICU%29%20and%20accounts%20for%20a%20substantial%20proportion%20of%20CICU%20patient%20deaths.%20Despite%20significant%20advances%20in%20revascularization%20techniques%2C%20pharmacologic%20therapeutics%20and%20mechanical%20support%20devices%2C%20CS%20remains%20associated%20with%20a%20high%20mortality%20rate.%20Indeed%2C%20the%20prevalence%20of%20CS%20within%20the%20CICU%20appears%20to%20be%20increasing.%20CS%20can%20be%20differentiated%20as%20phenotypes%20reflecting%20different%20metabolic%2C%20inflammatory%2C%20and%20hemodynamic%20profiles%2C%20depending%20also%20on%20anatomic%20substrate%20and%20congestion%20profile.%20Future%20prospective%20studies%20and%20clinical%20trials%20may%20further%20characterize%20these%20phenotypes%20and%20apply%20targeted%20intervention%20for%20each%20phenotype%20and%20SCAI%20SHOCK%20stage%20rather%20than%20a%20one-size-fits-all%20approach.%20Overall%2C%20there%20are%208%20key%20concepts%20of%20CS%3B%201%29%20the%20mortality%20associated%20with%20CS%3B%202%29%20Shock%20attributed%20to%20AMI%20may%20be%20declining%20in%20both%20incidence%20and%20associated%20mortality%3B%203%29%20providers%20should%20think%20about%20hemodynamic%2C%20metabolic%2C%20inflammation%20and%20cardiac%20function%20in%20totality%20to%20assess%20CS%3B%204%29%20CS%20is%20a%20dynamic%20process%3B%205%29%20no%20randomized%20trials%20evaluating%20use%20of%20the%20PAC%20in%20patients%20with%20CS%3B%206%29%20most%20data%20supporting%20neosynephrine%20as%20first%20line%20agent%20in%20CS%3B%207%29%20most%20registries%20suggest%20that%20almost%20half%20of%20CS%20patients%20do%20not%20have%20any%20mechanical%20support%2C%20and%20the%20vast%20majority%20of%20the%20remainder%20utilize%20the%20IABP%3B%20and%208%29%20patients%20with%20AMI%20CS%20should%20receive%20emergent%20PCI%20of%20the%20culprit%20vessel.%22%2C%22date%22%3A%22Jul%2001%202022%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1016%5C%2Fj.cpcardiol.2022.101303%22%2C%22ISSN%22%3A%221535-6280%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%22VTWWYEIB%22%5D%2C%22dateModified%22%3A%222022-09-02T20%3A13%3A10Z%22%7D%7D%2C%7B%22key%22%3A%22HMFLMJH8%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Walther%20et%20al.%22%2C%22parsedDate%22%3A%222022-05-31%22%2C%22numChildren%22%3A2%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BWalther%2C%20C.%20P.%2C%20%26lt%3Bstrong%26gt%3BCivitello%26lt%3B%5C%2Fstrong%26gt%3B%2C%20A.%20B.%2C%20Liao%2C%20K.%20K.%20et%20al.%20%282022%29.%20Nephrology%20considerations%20in%20the%20management%20of%20durable%20and%20temporary%20mechanical%20circulatory%20support.%20%26lt%3Bi%26gt%3BKidney360%26lt%3B%5C%2Fi%26gt%3B%20%26lt%3Bi%26gt%3B3%26lt%3B%5C%2Fi%26gt%3B%2C%20569%26%23x2013%3B579.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.34067%5C%2FKID.0003382021%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.34067%5C%2FKID.0003382021%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Nephrology%20considerations%20in%20the%20management%20of%20durable%20and%20temporary%20mechanical%20circulatory%20support%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Carl%20P.%22%2C%22lastName%22%3A%22Walther%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%20B.%22%2C%22lastName%22%3A%22Civitello%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kenneth%20K.%22%2C%22lastName%22%3A%22Liao%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sankar%20D.%22%2C%22lastName%22%3A%22Navaneethan%22%7D%5D%2C%22abstractNote%22%3A%22Durable%20and%20temporary%20mechanical%20circulatory%20support%20%28MCS%29%20use%20is%20growing%20for%20a%20range%20of%20cardiovascular%20indications.%20Kidney%20dysfunction%20is%20common%20in%20people%20evaluated%20for%20or%20receiving%20durable%20or%20temporary%20MCS%20and%20portends%20worse%20outcomes.%20This%20kidney%20dysfunction%20can%20be%20due%20to%20preexisting%20kidney%20chronic%20kidney%20disease%20%28CKD%29%2C%20acute%20kidney%20injury%20%28AKI%29%20related%20to%20acute%20cardiovascular%20disease%20necessitating%20MCS%2C%20AKI%20due%20to%20cardiac%20procedures%2C%20and%20acute%20and%20chronic%20MCS%20effects%20and%20complications.%20Durable%20MCS%2C%20with%20implantable%20continuous%20flow%20pumps%2C%20is%20used%20for%20long-term%20support%20in%20advanced%20heart%20failure%20refractory%20to%20guideline-directed%20medical%20and%20device%20therapy%2C%20either%20permanently%20or%20as%20a%20bridge%20to%20heart%20transplantation.%20Temporary%20MCS-encompassing%20in%20this%20review%20intra-aortic%20balloon%20pumps%20%28IABP%29%2C%20axial%20flow%20pumps%2C%20centrifugal%20flow%20pumps%2C%20and%20venoarterial%20ECMO-is%20used%20for%20diverse%20situations%3A%20high-risk%20percutaneous%20coronary%20interventions%20%28PCI%29%2C%20acute%20decompensated%20heart%20failure%2C%20cardiogenic%20shock%2C%20and%20resuscitation%20after%20cardiac%20arrest.%20The%20wide%20adoption%20of%20MCS%20makes%20it%20imperative%20to%20improve%20understanding%20of%20the%20effects%20of%20MCS%20on%20kidney%20health%5C%2Ffunction%20and%20of%20kidney%20health%5C%2Ffunction%20on%20MCS%20outcomes.%20The%20complex%20structure%20and%20functions%20of%20the%20kidney%2C%20and%20the%20complex%20health%20states%20of%20individuals%20receiving%20MCS%2C%20makes%20investigations%20in%20this%20area%20challenging%2C%20and%20current%20knowledge%20is%20limited.%20Fortunately%2C%20the%20increasing%20nephrology%20toolbox%20of%20noninvasive%20kidney%20health%5C%2Ffunction%20assessments%20may%20enable%20development%20and%20testing%20of%20individualized%20management%20strategies%20and%20therapeutics%20in%20the%20future.%20We%20review%20technology%2C%20epidemiology%2C%20pathophysiology%2C%20clinical%20considerations%2C%20and%20future%20directions%20in%20MCS%20and%20nephrology.%22%2C%22date%22%3A%22May%2031%202022%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.34067%5C%2FKID.0003382021%22%2C%22ISSN%22%3A%222641-7650%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%22C2VFJYPK%22%2C%22V4E2TPM3%22%5D%2C%22dateModified%22%3A%222022-05-27T19%3A06%3A15Z%22%7D%7D%2C%7B%22key%22%3A%22VUJA6IFM%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Lamba%20et%20al.%22%2C%22parsedDate%22%3A%222022-05-07%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BLamba%2C%20H.%20K.%2C%20Parikh%2C%20U.%20M.%2C%20Vincent%2C%20J.%20et%20al.%20%282022%29.%20Preoperative%20hyponatremia%20and%20survival%20after%20left%20ventricular%20assist%20device%20implantation.%20%26lt%3Bi%26gt%3BArtif%20Organs%26lt%3B%5C%2Fi%26gt%3B.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1111%5C%2Faor.14280%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1111%5C%2Faor.14280%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Preoperative%20hyponatremia%20and%20survival%20after%20left%20ventricular%20assist%20device%20implantation%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Harveen%20K.%22%2C%22lastName%22%3A%22Lamba%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Umang%20M.%22%2C%22lastName%22%3A%22Parikh%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Justin%22%2C%22lastName%22%3A%22Vincent%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%20B.%22%2C%22lastName%22%3A%22Civitello%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Ajith%22%2C%22lastName%22%3A%22Nair%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Anju%22%2C%22lastName%22%3A%22Bhardwaj%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mourad%20H.%22%2C%22lastName%22%3A%22Senussi%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Gabriel%22%2C%22lastName%22%3A%22Loor%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Alexis%20E.%22%2C%22lastName%22%3A%22Shafii%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Kenneth%20K.%22%2C%22lastName%22%3A%22Liao%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Subhasis%22%2C%22lastName%22%3A%22Chatterjee%22%7D%5D%2C%22abstractNote%22%3A%22BACKGROUND%3A%20Hyponatremia%20is%20associated%20with%20adverse%20outcomes%20in%20heart%20failure%20and%20after%20cardiac%20surgery.%20We%20hypothesized%20that%20hyponatremia%20is%20associated%20with%20poorer%20short-term%20and%20longer%20term%20survival%20in%20patients%20after%20continuous-flow%20left%20ventricular%20assist%20device%20%28CF-LVAD%29%20placement.%5CnMETHODS%3A%20We%20reviewed%20a%20single-center%20database%20of%20patients%20who%20received%20a%20CF-LVAD%20during%202012-2017.%20Sodium%20%28Na%29%20values%20obtained%20within%2014%5Cu2009days%20before%20CF-LVAD%20insertion%20were%20averaged%3B%20patients%20%28n%5Cu00a0%3D%5Cu00a0332%29%20were%20divided%20into%20hyponatremia%20%28mean%20Na%20%26lt%3B135%5Cu2009mEq%5C%2FL%3B%20n%5Cu00a0%3D%5Cu00a0160%3B%2048.2%25%29%20and%20normonatremia%20groups%20%28mean%20Na%20135-145%5Cu2009mEq%5C%2FL%3B%20n%5Cu00a0%3D%5Cu00a0172%3B%2051.8%25%29.%20Patients%20requiring%20preoperative%20dialysis%20or%20pump%20exchange%20were%20excluded.%20We%20compared%20outcomes%20between%20preoperative%20hyponatremia%20and%20normonatremia%20groups.%5CnRESULTS%3A%20The%20two%20groups%26%23039%3B%20baseline%20characteristics%20were%20similar%2C%20although%20hyponatremia%20patients%20more%20often%20had%20preoperative%20mechanical%20circulatory%20support%20%2844.4%25%20vs.%2031.4%25%2C%20p%5Cu00a0%3D%5Cu00a00.002%29.%20Although%20hyponatremic%20and%20normonatremic%20patients%20did%20not%20differ%20in%2030-day%20mortality%20%287.5%25%20vs.%206.5%25%2C%20p%5Cu00a0%3D%5Cu00a00.7%29%2C%20preoperative%20hyponatremia%20was%20associated%20with%20greater%205-year%20mortality%20%2861%25%20vs.%2044%25%2C%20p%5Cu00a0%3D%5Cu00a00.03%29.%20On%20binary%20logistic%20regression%20analysis%2C%20the%20strongest%20independent%20predictors%20of%20late%20mortality%20were%20hyponatremia%20%28odds%20ratio%20%5BOR%5D%201.88%2C%2095%25%20CI%20%5B1.07-3.31%5D%2C%20p%5Cu00a0%3D%5Cu00a00.02%29%2C%20older%20age%20%28OR%201.03%2C%2095%25%20CI%20%5B1.01-1.05%5D%2C%20p%5Cu00a0%3D%5Cu00a00.01%29%2C%20and%20elevated%20mean%20right%20atrial%20pressure%5C%2Fpulmonary%20capillary%20wedge%20pressure%20ratio%20%28OR%204.69%2C%2095%25%20CI%20%5B1.76-12.47%5D%2C%20p%5Cu00a0%3D%5Cu00a00.002%29.%5CnCONCLUSIONS%3A%20Hyponatremia%20was%20not%20associated%20with%20greater%20early%20mortality%20but%20was%20associated%20with%20poorer%20late%20survival.%20The%20optimal%20timing%20of%20LVAD%20implantation%20in%20relation%20to%20hyponatremia%2C%20and%20whether%20correcting%20hyponatremia%20perioperatively%20improves%20long-term%20survival%2C%20should%20be%20investigated.%22%2C%22date%22%3A%22May%2007%202022%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1111%5C%2Faor.14280%22%2C%22ISSN%22%3A%221525-1594%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%22GNSKWJNU%22%2C%22S7WF6DG3%22%2C%22ZMAN8MMI%22%2C%22VCK5HVUS%22%2C%22C2VFJYPK%22%2C%22V4E2TPM3%22%5D%2C%22dateModified%22%3A%222022-05-27T18%3A58%3A39Z%22%7D%7D%2C%7B%22key%22%3A%22TQTFA93M%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Shah%20et%20al.%22%2C%22parsedDate%22%3A%222022-01-31%22%2C%22numChildren%22%3A1%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BShah%2C%20S.%20J.%2C%20Borlaug%2C%20B.%20A.%2C%20Chung%2C%20E.%20S.%20et%20al.%20%282022%29.%20Atrial%20shunt%20device%20for%20heart%20failure%20with%20preserved%20and%20mildly%20reduced%20ejection%20fraction%20%28REDUCE%20LAP-HF%20II%29%3A%20a%20randomised%2C%20multicentre%2C%20blinded%2C%20sham-controlled%20trial.%20%26lt%3Bi%26gt%3BLancet%26lt%3B%5C%2Fi%26gt%3B%2C%20S0140-6736%2822%2900016%26%23x2013%3B2.%20%26lt%3Ba%20class%3D%26%23039%3Bzp-DOIURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2FS0140-6736%2822%2900016-2%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1016%5C%2FS0140-6736%2822%2900016-2%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Atrial%20shunt%20device%20for%20heart%20failure%20with%20preserved%20and%20mildly%20reduced%20ejection%20fraction%20%28REDUCE%20LAP-HF%20II%29%3A%20a%20randomised%2C%20multicentre%2C%20blinded%2C%20sham-controlled%20trial%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sanjiv%20J.%22%2C%22lastName%22%3A%22Shah%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Barry%20A.%22%2C%22lastName%22%3A%22Borlaug%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Eugene%20S.%22%2C%22lastName%22%3A%22Chung%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Donald%20E.%22%2C%22lastName%22%3A%22Cutlip%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Philippe%22%2C%22lastName%22%3A%22Debonnaire%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Peter%20S.%22%2C%22lastName%22%3A%22Fail%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Qi%22%2C%22lastName%22%3A%22Gao%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Gerd%22%2C%22lastName%22%3A%22Hasenfu%5Cu00df%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Rami%22%2C%22lastName%22%3A%22Kahwash%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22David%20M.%22%2C%22lastName%22%3A%22Kaye%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sheldon%20E.%22%2C%22lastName%22%3A%22Litwin%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Philipp%22%2C%22lastName%22%3A%22Lurz%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Joseph%20M.%22%2C%22lastName%22%3A%22Massaro%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Rajeev%20C.%22%2C%22lastName%22%3A%22Mohan%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Mark%20J.%22%2C%22lastName%22%3A%22Ricciardi%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Scott%20D.%22%2C%22lastName%22%3A%22Solomon%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Aaron%20L.%22%2C%22lastName%22%3A%22Sverdlov%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Vijendra%22%2C%22lastName%22%3A%22Swarup%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Dirk%20J.%22%2C%22lastName%22%3A%22van%20Veldhuisen%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sebastian%22%2C%22lastName%22%3A%22Winkler%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Martin%20B.%22%2C%22lastName%22%3A%22Leon%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22name%22%3A%22REDUCE%20LAP-HF%20II%20investigators%22%7D%5D%2C%22abstractNote%22%3A%22BACKGROUND%3A%20Placement%20of%20an%20interatrial%20shunt%20device%20reduces%20pulmonary%20capillary%20wedge%20pressure%20during%20exercise%20in%20patients%20with%20heart%20failure%20and%20preserved%20or%20mildly%20reduced%20ejection%20fraction.%20We%20aimed%20to%20investigate%20whether%20an%20interatrial%20shunt%20can%20reduce%20heart%20failure%20events%20or%20improve%20health%20status%20in%20these%20patients.%5CnMETHODS%3A%20In%20this%20randomised%2C%20international%2C%20blinded%2C%20sham-controlled%20trial%20performed%20at%2089%20health-care%20centres%2C%20we%20included%20patients%20%28aged%20%5Cu226540%20years%29%20with%20symptomatic%20heart%20failure%2C%20an%20ejection%20fraction%20of%20at%20least%2040%25%2C%20and%20pulmonary%20capillary%20wedge%20pressure%20during%20exercise%20of%20at%20least%2025%20mm%20Hg%20while%20exceeding%20right%20atrial%20pressure%20by%20at%20least%205%20mm%20Hg.%20Patients%20were%20randomly%20assigned%20%281%3A1%29%20to%20receive%20either%20a%20shunt%20device%20or%20sham%20procedure.%20Patients%20and%20outcome%20assessors%20were%20masked%20to%20randomisation.%20The%20primary%20endpoint%20was%20a%20hierarchical%20composite%20of%20cardiovascular%20death%20or%20non-fatal%20ischemic%20stroke%20at%2012%20months%2C%20rate%20of%20total%20heart%20failure%20events%20up%20to%2024%20months%2C%20and%20change%20in%20Kansas%20City%20Cardiomyopathy%20Questionnaire%20overall%20summary%20score%20at%2012%20months.%20Pre-specified%20subgroup%20analyses%20were%20conducted%20for%20the%20heart%20failure%20event%20endpoint.%20Analysis%20of%20the%20primary%20endpoint%2C%20all%20other%20efficacy%20endpoints%2C%20and%20safety%20endpoints%20was%20conducted%20in%20the%20modified%20intention-to-treat%20population%2C%20defined%20as%20all%20patients%20randomly%20allocated%20to%20receive%20treatment%2C%20excluding%20those%20found%20to%20be%20ineligible%20after%20randomisation%20and%20therefore%20not%20treated.%20This%20study%20is%20registered%20with%20ClinicalTrials.gov%2C%20NCT03088033.%5CnFINDINGS%3A%20Between%20May%2025%2C%202017%2C%20and%20July%2024%2C%202020%2C%201072%20participants%20were%20enrolled%2C%20of%20whom%20626%20were%20randomly%20assigned%20to%20either%20the%20atrial%20shunt%20device%20%28n%3D314%29%20or%20sham%20procedure%20%28n%3D312%29.%20There%20were%20no%20differences%20between%20groups%20in%20the%20primary%20composite%20endpoint%20%28win%20ratio%201%5Cu00b70%20%5B95%25%20CI%200%5Cu00b78-1%5Cu00b72%5D%3B%20p%3D0%5Cu00b785%29%20or%20in%20the%20individual%20components%20of%20the%20primary%20endpoint.%20The%20prespecified%20subgroups%20demonstrating%20a%20differential%20effect%20of%20atrial%20shunt%20device%20treatment%20on%20heart%20failure%20events%20were%20pulmonary%20artery%20systolic%20pressure%20at%2020W%20of%20exercise%20%28pinteraction%3D0%5Cu00b7002%20%5B%26gt%3B70%20mm%20Hg%20associated%20with%20worse%20outcomes%5D%29%2C%20right%20atrial%20volume%20index%20%28pinteraction%3D0%5Cu00b7012%20%5B%5Cu226529%5Cu00b77%20mL%5C%2Fm2%2C%20worse%20outcomes%5D%29%2C%20and%20sex%20%28pinteraction%3D0%5Cu00b702%20%5Bmen%2C%20worse%20outcomes%5D%29.%20There%20were%20no%20differences%20in%20the%20composite%20safety%20endpoint%20between%20the%20two%20groups%20%28n%3D116%20%5B38%25%5D%20for%20shunt%20device%20vs%20n%3D97%20%5B31%25%5D%20for%20sham%20procedure%3B%20p%3D0%5Cu00b711%29.%5CnINTERPRETATION%3A%20Placement%20of%20an%20atrial%20shunt%20device%20did%20not%20reduce%20the%20total%20rate%20of%20heart%20failure%20events%20or%20improve%20health%20status%20in%20the%20overall%20population%20of%20patients%20with%20heart%20failure%20and%20ejection%20fraction%20of%20greater%20than%20or%20equal%20to%2040%25.%5CnFUNDING%3A%20Corvia%20Medical.%22%2C%22date%22%3A%22Jan%2031%202022%22%2C%22language%22%3A%22eng%22%2C%22DOI%22%3A%2210.1016%5C%2FS0140-6736%2822%2900016-2%22%2C%22ISSN%22%3A%221474-547X%22%2C%22url%22%3A%22%22%2C%22collections%22%3A%5B%229FBUJBMU%22%2C%22AAQ89W3S%22%2C%222K4N54U2%22%2C%22S7WF6DG3%22%2C%22WC4XX237%22%5D%2C%22dateModified%22%3A%222022-02-25T20%3A26%3A12Z%22%7D%7D%2C%7B%22key%22%3A%22X9LRAGJ4%22%2C%22library%22%3A%7B%22id%22%3A4862227%7D%2C%22meta%22%3A%7B%22creatorSummary%22%3A%22Broda%20et%20al.%22%2C%22parsedDate%22%3A%222022%22%2C%22numChildren%22%3A0%7D%2C%22bib%22%3A%22%26lt%3Bdiv%20class%3D%26quot%3Bcsl-bib-body%26quot%3B%20style%3D%26quot%3Bline-height%3A%201.35%3B%20padding-left%3A%201em%3B%20text-indent%3A-1em%3B%26quot%3B%26gt%3B%5Cn%20%20%26lt%3Bdiv%20class%3D%26quot%3Bcsl-entry%26quot%3B%26gt%3BBroda%2C%20C.%20R.%2C%20Frankel%2C%20W.%20C.%2C%20Nair%2C%20A.%20P.%20et%20al.%20%282022%29.%20Continuous-flow%20ventricular%20assist%20device%20support%20in%20adult%20congenital%20heart%20disease%3A%20A%2015-year%2C%20multicenter%20experience%20of%20temporary%20and%20durable%20support.%20%26lt%3Bi%26gt%3BASAIO%20J%26lt%3B%5C%2Fi%26gt%3B.%20Available%20at%3A%20%26lt%3Ba%20class%3D%26%23039%3Bzp-ItemURL%26%23039%3B%20href%3D%26%23039%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1097%5C%2FMAT.0000000000001853%26%23039%3B%26gt%3Bhttps%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1097%5C%2FMAT.0000000000001853%26lt%3B%5C%2Fa%26gt%3B.%26lt%3B%5C%2Fdiv%26gt%3B%5Cn%26lt%3B%5C%2Fdiv%26gt%3B%22%2C%22data%22%3A%7B%22itemType%22%3A%22journalArticle%22%2C%22title%22%3A%22Continuous-flow%20ventricular%20assist%20device%20support%20in%20adult%20congenital%20heart%20disease%3A%20A%2015-year%2C%20multicenter%20experience%20of%20temporary%20and%20durable%20support%22%2C%22creators%22%3A%5B%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Christopher%20R.%22%2C%22lastName%22%3A%22Broda%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22William%20C.%22%2C%22lastName%22%3A%22Frankel%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Ajith%20P.%22%2C%22lastName%22%3A%22Nair%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22W.%20Jeffrey%22%2C%22lastName%22%3A%22Dreyer%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Hari%20P.%22%2C%22lastName%22%3A%22Tunuguntla%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22O.%20Howard%22%2C%22lastName%22%3A%22Frazier%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Stephen%20J.%22%2C%22lastName%22%3A%22Dolgner%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Marc%20M.%22%2C%22lastName%22%3A%22Anders%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Sebastian%20C.%22%2C%22lastName%22%3A%22Tume%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Athar%20M.%22%2C%22lastName%22%3A%22Qureshi%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Dhaval%20R.%22%2C%22lastName%22%3A%22Parekh%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Edward%20J.%22%2C%22lastName%22%3A%22Hickey%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Iki%22%2C%22lastName%22%3A%22Adachi%22%7D%2C%7B%22creatorType%22%3A%22author%22%2C%22firstName%22%3A%22Andrew%20B.%22%2C%22lastName%22%3A%22Civitello%22%7D%5D%2C%22abstractNote%22%3A%22Heart%20failure%20%28HF%29%20is%20common%20in%20adult%20congenital%20heart%20disease%20%28ACHD%29%20patients%3B%20however%2C%20use%20of%20continuous-flow%20ventricular%20assist%20devices%20%28CF-VADs%29%20remains%20rare.%20We%20reviewed%20outcomes%20of%20patients%20with%20congenital%20heart%20disease%20greater%20than%20or%20equal%20to%2018%20years%20of%20age%20at%20the%20time%20of%20CF-VAD%20implant%20at%20the%20affiliated%20pediatric%20and%20adult%20institutions%20between%202006%20and%202020.%20In%20total%2C%2018%20ACHD%20patients%20%2815%20with%20great%20anatomical%20complexity%29%20received%2021%20CF-VADs.%20Six%20patients%20%28median%20age%2034%20years%29%20received%20seven%20percutaneous%20CF-VADs%20with%20a%20median%20duration%20of%20support%20of%2020%20days%20%283%5Cu201344%20days%29%20with%20all%20patients%20survived%20to%20hospital%20discharge%20and%20two%20patients%20were%20bridged%20to%20durable%20CF-VADs.%20Fourteen%20patients%20%28median%20age%2038%20years%29%20received%20durable%20CF-VADs.%20Thirteen%20patients%20%2893%25%29%20survived%20to%20hospital%20discharge%20and%20the%20median%20duration%20of%20support%20was%2025.8%20months%20%286.4%5Cu201352.1%20months%29.%20Estimated%20survival%20on%20durable%20CF-VAD%20at%201%2C%203%2C%20and%205%20years%20was%2084%25%2C%2072%25%2C%20and%2036%25%2C%20respectively.%20Three%20patients%20were%20successfully%20bridged%20to%20transplantation.%20Device-related%20complications%20include%20cerebrovascular%20accident%20%28n%20%3D%205%29%2C%20driveline%20infection%20%28n%20%3D%203%29%2C%20device%20infection%20requiring%20chronic%20antibiotic%20therapy%20%28n%20%3D%204%29%2C%20gastrointestinal%20bleeding%20%28n%20%3D%206%29%2C%20and%20presumed%20pump%20thrombosis%20%28n%20%3D%205%29.%20These%20results%20show%20percutaneous%20and%20durable%20CF-VADs%20can%20support%20ACHD%20patients%20with%20advanced%20HF.%22%2C%22date%22%3A%222022%22%2C%22language%22%3A%22%22%2C%22DOI%22%3A%22%22%2C%22ISSN%22%3A%221058-2916%22%2C%22url%22%3A%22https%3A%5C%2F%5C%2Fdoi.org%5C%2F10.1097%5C%2FMAT.0000000000001853%22%2C%22collections%22%3A%5B%22SE7HDD49%22%2C%229FBUJBMU%22%2C%22S7WF6DG3%22%2C%22QF52JASW%22%5D%2C%22dateModified%22%3A%222023-03-07T22%3A39%3A43Z%22%7D%7D%5D%7D
Civitello, A. and Nair, A. (2023). Simultaneous heart-kidney transplantation: balancing competing outcomes for transplant wait-listed patients. J Am Coll Cardiol 81, 741–742. https://doi.org/10.1016/j.jacc.2022.12.010.
Maitra, N. S., Dugger, S. J., Balachandran, I. C. et al. (2023). Impact of the 2018 UNOS heart transplant policy changes on patient outcomes. JACC Heart Fail, S2213-1779(23)00038–0. https://doi.org/10.1016/j.jchf.2023.01.009.
Civitello, A. B. and Rogers, J. G. (2023). Toward a self-actuating continuous flow ventricular assist device: the pudding is in the proof. ASAIO J 69, 59–60. https://doi.org/10.1097/MAT.0000000000001881.
Inchaustegui, C. A., Patel, A., Lamba, H. K. et al. (2022). Impact of time off anticoagulation in patients with continuous-flow left ventricular assist devices. J Artif Organs. https://doi.org/10.1007/s10047-022-01367-8.
Walther, C. P., Benoit, J. S., Lamba, H. K. et al. (2022). Distinctive kidney function trajectories following left ventricular assist device implantation. J Heart Lung Transplant, S1053-2498(22)02110–6. https://doi.org/10.1016/j.healun.2022.08.024.
Krittanawong, C., Rivera, M. R., Shaikh, P. et al. (2022). Key concepts surrounding cardiogenic shock. Curr Probl Cardiol, 101303. https://doi.org/10.1016/j.cpcardiol.2022.101303.
Walther, C. P., Civitello, A. B., Liao, K. K. et al. (2022). Nephrology considerations in the management of durable and temporary mechanical circulatory support. Kidney360 3, 569–579. https://doi.org/10.34067/KID.0003382021.
Lamba, H. K., Parikh, U. M., Vincent, J. et al. (2022). Preoperative hyponatremia and survival after left ventricular assist device implantation. Artif Organs. https://doi.org/10.1111/aor.14280.
Shah, S. J., Borlaug, B. A., Chung, E. S. et al. (2022). Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial. Lancet, S0140-6736(22)00016–2. https://doi.org/10.1016/S0140-6736(22)00016-2.
Broda, C. R., Frankel, W. C., Nair, A. P. et al. (2022). Continuous-flow ventricular assist device support in adult congenital heart disease: A 15-year, multicenter experience of temporary and durable support. ASAIO J. Available at: https://doi.org/10.1097/MAT.0000000000001853.