Highlights of the 2021 Brano Heart Failure Forum

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The forum was postponed in 2020 due to the COVID-19 pandemic and then resumed in September of 2021 in Graz, Austria. It was attended by over 75 faculty from 13 countries. Due to the ongoing pandemic, 13 presentations were given virtually. Throughout the forum, 17 separate sessions focused on challenges and solutions related to mechanical circulatory support and heart transplantation. In this special issue of The VAD Journal, a summary of conference highlights from available presentations is presented

Highlights of the 2022 Brano Heart Failure Forum: Part One

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2022 BHHF forum was held on the 6th thru 8th of September 2022 in Trieste, Italy. It was attended by over 94 faculty from 14 countries. In addition, participation through online streaming was available. Throughout the forum, 17 sessions focused on challenges and solutions related to mechanical circulatory support and heart transplantation. This special issue of The VAD Journal presents a summary of conference highlights from available presentations

Highlights of the 2023 Brano Heart Failure Forum

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2023 BHHF forum was held on the 13th thru 15th of September 2023 in Budapest, Hungary. It was attended by over 100 faculty from 16 countries. In addition, participation through online streaming was available. Throughout the forum, 16 sessions focused on challenges and solutions related to mechanical circulatory support and heart transplantation. This special issue of The VAD Journal presents a summary of conference highlights from available presentations

Highlights of the 2022 Brano Heart Failure Forum: Part Two

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2022 BHFF forum was held on the 6th thru 8th of September 2022 in Trieste, Italy. It was attended by over 94 faculty from 14 countries. In addition, participation through online streaming was available. Throughout the forum, 17 sessions focused on challenges and solutions related to mechanical circulatory support (MCS) and heart transplantation. The second portion of conference highlights from available presentations is presented herein

Houston SHOCK: A Practical Scoring System Incorporating Cardiogenic Shock Dynamic Changes

Cardiogenic shock has an unacceptably high mortality rate and additional tools are needed to improve outcomes. The Society of Cardiovascular Angiography and Interventions (SCAI) shock severity classification has provided a unified definition of shock severity that has proven to be reproducible and predictive of survival. However, cardiogenic shock assessment goes beyond standardizing its severity, and a uniform and practical approach to comprehensive assessment that may guide therapy in a dynamic state is currently lacking. Since cardiogenic shock is a rapidly evolving pathophysiological catastrophe, we propose a new assessment tool – the Houston SHOCK Score – which incorporates dynamic changes. The acronym SHOCK can be used to emphasize five key aspects of patients in cardiogenic shock: Severity, Hemodynamics, Onset, Causes, and Kinetics. We believe this tool provides physicians with vital information that will facilitate appropriate care by incorporating dynamic changes in the patient’s profile

Risk stratification and prediction of severity of COVID-19 infection in patients with preexisting cardiovascular disease

Introduction: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is a highly contagious viral disease. Cardiovascular diseases and heart failure elevate the risk of mechanical ventilation and fatal outcomes among COVID-19 patients, while COVID-19 itself increases the likelihood of adverse cardiovascular outcomes. Methods: We collected blood samples and clinical data from hospitalized cardiovascular patients with and without proven COVID-19 infection in the time period before the vaccine became available. Statistical correlation analysis and machine learning were used to evaluate and identify individual parameters that could predict the risk of needing mechanical ventilation and patient survival. Results: Our results confirmed that COVID-19 is associated with a severe outcome and identified increased levels of ferritin, fibrinogen, and platelets, as well as decreased levels of albumin, as having a negative impact on patient survival. Additionally, patients on ACE/ARB had a lower chance of dying or needing mechanical ventilation. The machine learning models revealed that ferritin, PCO2, and CRP were the most efficient combination of parameters for predicting survival, while the combination of albumin, fibrinogen, platelets, ALP, AB titer, and D-dimer was the most efficient for predicting the likelihood of requiring mechanical ventilation. Conclusion: We believe that creating an AI-based model that uses these patient parameters to predict the cardiovascular patient’s risk of mortality, severe complications, and the need for mechanical ventilation would help healthcare providers with rapid triage and redistribution of medical services, with the goal of improving overall survival. The use of the most effective combination of parameters in our models could advance risk assessment and treatment planning among the general population of cardiovascular patients

A Case of Inferior Myocardial Infarction Complicated by Ventricular Septal Rupture Leading to Cardiogenic Shock: Tandem Heart to the Rescue!

Ventricular septal rupture (VSR) is a rare but life-threatening complication of acute myocardial infarction. We present a case of VSR-related refractory cardiogenic shock that was successfully managed with TandemHeart® followed by surgical repair

Long-Term Results of Aortic Banding for Complex Infrarenal Neck Anatomy and Type I Endoleak After Endovascular Abdominal Aortic Aneurysm Repair

For many patients with abdominal aortic aneurysm, unsuitable anatomy of the infrarenal aortic neck precludes endovascular aortic aneurysm repair or causes type I endoleak after the procedure. In an attempt to overcome these challenges, we retrospectively examined the usefulness of aortic banding as an adjunctive procedure to endovascular repair in 8 patients who had an abdominal aortic aneurysm with a complex infrarenal aortic neck. The procedures were performed with the patients under general anesthesia and involved making an 8-cm upper-midline laparotomy incision to expose the aneurysmal aorta. Three patients underwent aortic banding before endovascular repair; the other 5 underwent banding after the repair because of persistent type I endoleak. After banding, the abdominal aortic aneurysm was successfully excluded in all 8 patients. Long-term follow-up (mean, 38±20 mo) revealed no type I endoleak and no procedure-related complications. In patients who have an abdominal aortic aneurysm with complex infrarenal neck anatomy or a refractory type I endoleak, performing aortic banding as an adjunctive procedure to endovascular aortic repair appears to be a safe strategy with good long-term results

Analysis of the Correlation between In-hospital Adverse Events and Transcatheter Aortic Valve Replacement Outcomes

Transcatheter aortic valve replacement (TAVR) has been recommended as the standard treatment for elderly patients with severe aortic stenosis (AS) and those at increased risk for conventional surgical procedures. Recently, TAVR has been recognized as the treatment of choice for intermediate-risk patients or even low-risk populations with AS. Our study aimed to identify factors influencing adverse events after TAVR procedures. This single-center, retrospective cohort study involved patients with severe AS treated with TAVR from 2016 to 2019. The patient’s electronic medical record was reviewed, and those with valve-in-valve replacements and missing demographical data were excluded. We analyzed risk factors related to in-hospital adverse outcomes after the TAVR procedure. Among 953 screened patients, 889 were included in the study. The complication rates were relatively low. Factors that significantly influenced the outcome included age, chronic kidney disease (CKD), dialysis, mitral stenosis, Katz test for frailty, surgical risk score, and calculated operability. Multivariate logistic regression analysis showed that only CKD predicts the likelihood of the composite adverse outcome in TAVR patients during hospitalization. Our study showed that TAVR is an effective and safe option for aortic valve replacement. Perioperative complications depend on different risk factors, particularly CKD, and the results of the Katz test. Identification of risk factors influencing the TAVR outcome is crucial to prevent perioperative complications and mortality

Off-pump HeartMate II Exchange in a Patient with Severe Lower Extremity Peripheral Artery Disease: A Case Report

Thrombosis of left ventricular assist device (LVAD) pumps is a serious complication that often requires exchange of the device. A 66-year-old man with severe peripheral vascular disease presented with pump thrombosis of the HeartMate II (HMII) LVAD 1.5 years after implantation. The HMII was exchanged to another HMII through a subcostal incision and without the use of cardiopulmonary bypass. For safety, the patient was prepared for cardiopulmonary bypass by exposing the right subclavian artery and insertion of a 5 FR cannula in the left common femoral vein. The pump was exchanged through a subcostal incision made over the LVAD pump pocket perpendicular to the costal margin. After deairing the pump and graft, LVAD support was resumed, postoperative course was uneventful, and the patient was discharged from the hospital four days later. Re-thrombosis, stroke, and right heart failure are frequent complications after LVAD exchange. Exchange through a subcostal incision with cardiopulmonary bypass backup appears to be safe