Journal: JHLT Open

Article Title: Pulmonary wave intensity analysis to assess ventriculo-arterial interactions in cardiogenic shock

doi: 10.1016/j.jhlto.2026.100528

Figure Lengend Snippet: Study flow diagram. Figure caption: Study flowchart outlining patient screening and enrollment for pulmonary WIA. Over a 12-month period, patients undergoing diagnostic RHC were screened. Ten control subjects were recruited from the post-heart transplant population and were required to be >6 months post-transplant, >18 years of age, and have normal pulmonary artery hemodynamics. Nineteen patients with CS were enrolled based on low cardiac index (CI <2.2 L/min/m²) and additional markers of hypoperfusion or organ dysfunction, with exclusion of those mechanically ventilated or recently resuscitated. CS subjects underwent implantation of either an IABP or Impella 5.5 device. All patients underwent simultaneous RHC and transthoracic Doppler TTE for WIA. Control subjects had a single recording, while CS patients were assessed pre- and post-MCS device implantation. A total of 29 subjects had complete paired pressure-flow datasets available for analysis. Abbreviations: ALT , Alanine Aminotransferase; CI , Cardiac Index; CS, Cardiogenic Shock; IABP , Intra-Aortic Balloon Pump; Impella 5.5, Percutaneous Left Ventricular Assist Device (Abiomed Impella 5.5); MCS , Mechanical Circulatory Support ; PA, Pulmonary Artery; RHC, Right Heart Catheterization; SBP, Systolic Blood Pressure; TTE , Transthoracic Echocardiography.

Article Snippet: Abbreviations: BCW, backward compression wave; BDW , backward decompression wave; CS , cardiogenic shock; FCW , forward compression wave; FDW , forward decompression wave; IABP , Intra-Aortic Balloon Pump; Impella , Percutaneous Left Ventricular Assist Device (Abiomed Impella 5.5); MCS, mechanical circulatory support; NWI, net wave intensity; WIA , wave intensity analysis.

Techniques: Diagnostic Assay, Control

Journal: JHLT Open

Article Title: Pulmonary wave intensity analysis to assess ventriculo-arterial interactions in cardiogenic shock

doi: 10.1016/j.jhlto.2026.100528

Figure Lengend Snippet: Representative pulmonary wave intensity analyses. Figure caption: Each panel displays wave intensity profiles derived from pressure-flow data over a single cardiac cycle, showing forward compression waves (FCW, blue), forward decompression waves (FDW, green), backward compression waves (BCW, red), and backward decompression waves (BDW, purple). The timing of peak BCW (red dotted line) and end of the cardiac cycle (black dotted line) are marked. All plots are normalized to the same x - (time) and y -(wave intensity) axes for comparison. 1a: pulmonary WIA during dobutamine infusion at 7.5 µg/kg/min in a patient with CS. This high-dose inotropic support is associated with increased forward wave intensity, a moderate increase in backward wave intensity, but no increase in reflected wave speed. 1b: pulmonary WIA during milrinone infusion at 0.375 µg/kg/min in a patient with CS. There is a minimal increase in forward-traveling wave intensity with salutatory effects on the backward-traveling wave intensity. There is a relative reduction in reflected wave speed, likely due to peripheral vasodilation. 1c: pulmonary WIA during sodium nitroprusside infusion at 1.25 µg/kg/min. There is minimal effect on forward or backward-traveling wave intensities. Reflected wave speed is increased consistent, likely due to the systemic vasodilatory action of sodium nitroprusside without direct inotropic effect. 1d: pulmonary WIA from a patient in CS prior to any treatment initiation. There are markedly reduced forward and backward wave intensities, with late return of the reflected wave, suggesting blunted wave generation and delayed reflection timing, likely due to CS with relative vasoplegia. 1e: pulmonary WIA from a patient in CS with IABP support-off and IABP support-on. IABP-on support is associated with increased forward-traveling wave intensities, as well as a delay to peak backward compression wave. 1f: pulmonary WIA from a patient in CS with Impella support off and Impella support on (performance level 8, flow 4.8 L/min). Impella-on support is also associated with increased forward-traveling wave intensities, with no significant effect on backward-traveling wave magnitudes or timing. Abbreviations: BCW, backward compression wave; BDW , backward decompression wave; CS , cardiogenic shock; FCW , forward compression wave; FDW , forward decompression wave; IABP , intra-aortic balloon pump; Impella, percutaneous left ventricular assist device (Abiomed Impella 5.5); MCS, mechanical circulatory support; WIA , wave intensity analysis.

Article Snippet: Abbreviations: BCW, backward compression wave; BDW , backward decompression wave; CS , cardiogenic shock; FCW , forward compression wave; FDW , forward decompression wave; IABP , Intra-Aortic Balloon Pump; Impella , Percutaneous Left Ventricular Assist Device (Abiomed Impella 5.5); MCS, mechanical circulatory support; NWI, net wave intensity; WIA , wave intensity analysis.

Techniques: Derivative Assay, Comparison

Journal: JHLT Open

Article Title: Pulmonary wave intensity analysis to assess ventriculo-arterial interactions in cardiogenic shock

doi: 10.1016/j.jhlto.2026.100528

Figure Lengend Snippet: Box-and-Whisker plots. Figure caption: Box-and-whisker plots demonstrate forward compression wave (FCW), forward decompression wave (FDW), backward compression wave (BCW), backward decompression wave (BDW), time-to-peak BCW, reflection index (RI), net wave intensity (NWI), and wave speed in 3 groups: healthy controls (0), patients with cardiogenic shock (CS; 1), and those supported with mechanical circulatory support (MCS; 2) using either intra-aortic balloon pump (IABP) or Impella 5.5. Significant pairwise differences were observed between controls and CS for BDW ( p < 0.01) and wave speed ( p < 0.01), and between CS and MCS for time-to-peak BCW ( p = 0.048). Significant pairwise differences between controls and MCS subjects in FCW ( p = 0.02), FDW ( p < 0.01), BDW ( p < 0.01), and wave speed ( p = 0.03) were observed. Abbreviations: BCW, backward compression wave; BDW , backward decompression wave; CS , cardiogenic shock; FCW , forward compression wave; FDW , forward decompression wave; IABP , Intra-Aortic Balloon Pump; Impella , Percutaneous Left Ventricular Assist Device (Abiomed Impella 5.5); MCS, mechanical circulatory support; NWI, net wave intensity; WIA , wave intensity analysis.

Article Snippet: Abbreviations: BCW, backward compression wave; BDW , backward decompression wave; CS , cardiogenic shock; FCW , forward compression wave; FDW , forward decompression wave; IABP , Intra-Aortic Balloon Pump; Impella , Percutaneous Left Ventricular Assist Device (Abiomed Impella 5.5); MCS, mechanical circulatory support; NWI, net wave intensity; WIA , wave intensity analysis.

Techniques: Whisker Assay

Journal: JHLT Open

Article Title: Pulmonary wave intensity analysis to assess ventriculo-arterial interactions in cardiogenic shock

doi: 10.1016/j.jhlto.2026.100528

Figure Lengend Snippet: Spaghetti plots pre- and post- MCS intervention. 4 (top): Pre- and post-IABP support changes in wave intensity parameters among patients with CS. Forward wave magnitudes (FCW, FDW) increased in most patients, while backward wave magnitudes (BCW, BDW) remained largely unchanged, resulting in a consistent reduction in reflection index (RI). There was no significant change in time-to-peak BCW or wave speed, suggesting preserved timing and stiffness characteristics. A general upward shift in net wave intensity (NWI) was observed, indicating improved overall wave energy balance and potentially more favorable ventriculo-arterial coupling with IABP support. 4 (bottom): Pre- and post-Impella 5.5support changes in wave intensity parameters among patients with CS. Following Impella 5.5 insertion, FCW and FDW magnitudes increased in several patients, though a subset showed either no change or a decrease. BCW timing was consistently delayed post-support, indicating later arrival of reflected waves. Backward wave magnitudes (BDW and BCW) generally became less negative, reflecting a reduction in wave reflection severity, although exceptions were noted. These changes were associated with a notable increase in RI in most individuals. Net wave intensity shifted upward in some cases, but responses were heterogeneous. Wave speed showed no consistent pattern, with both increases and decreases observed across the cohort. Abbreviations: BCW, backward compression wave; BDW , backward decompression wave; CS , cardiogenic shock; FCW , forward compression wave; FDW , forward decompression wave; IABP , Intra-Aortic Balloon Pump; Impella , Percutaneous Left Ventricular Assist Device (Abiomed Impella 5.5); MCS, mechanical circulatory support; WIA , wave intensity analysis.

Article Snippet: Abbreviations: BCW, backward compression wave; BDW , backward decompression wave; CS , cardiogenic shock; FCW , forward compression wave; FDW , forward decompression wave; IABP , Intra-Aortic Balloon Pump; Impella , Percutaneous Left Ventricular Assist Device (Abiomed Impella 5.5); MCS, mechanical circulatory support; NWI, net wave intensity; WIA , wave intensity analysis.

Techniques:

Journal: ACG Case Reports Journal

Article Title: Recurrent Anastomotic Leak After Hartmann Reversal: Successful Management With Vacuum-Assisted Endoscopic Drainage and Diversion

doi: 10.14309/crj.0000000000001976

Figure Lengend Snippet: Components of the Endo-sponge kit: (1) Two sizes of overtubes used to deploy the Endo-sponge into the leakage cavity. (2) The Endo-sponge, designed to be placed within the cavity to absorb pus and leakage fluid while promoting approximation of the cavity edges. (3) The pusher, used to advance the Endo-sponge through the overtube to the leak site. (4) The catheter attached to the Endo-sponge, which allows for irrigation of the device. (5–6) Irrigation system, consisting of a syringe and a plastic connector, which can be attached to the catheter.

Article Snippet: Second, an endoscopic vacuum-assisted drainage (Endo-sponge) device (B. Braun Surgical, S.A., Barcelona, Spain) was placed directly into the leak cavity under direct vision (Figure ).

Techniques:

Journal: ACG Case Reports Journal

Article Title: Recurrent Anastomotic Leak After Hartmann Reversal: Successful Management With Vacuum-Assisted Endoscopic Drainage and Diversion

doi: 10.14309/crj.0000000000001976

Figure Lengend Snippet: Endoscopic and device images during management of recurrent anastomotic leak. (A) Endoscopic view of the anastomotic site showing mucosal edema and inflammatory changes, with a defect through which the scope was advanced into the cavity. (B) Identification of the recurrent defect with purulent discharge. (C) Placement of the Endo-sponge into the leak cavity under direct endoscopic guidance. (D) Vacuum drainage bottle (REDYROB TRANS PLUS, Barcelona, Spain) connected to the Endo-sponge system, providing continuous negative pressure therapy.

Article Snippet: Second, an endoscopic vacuum-assisted drainage (Endo-sponge) device (B. Braun Surgical, S.A., Barcelona, Spain) was placed directly into the leak cavity under direct vision (Figure ).

Techniques:

Journal: NPJ Regenerative Medicine

Article Title: Optimized biomechanical design of a tissue engineered pulsatile Fontan conduit

doi: 10.1038/s41536-025-00450-x

Figure Lengend Snippet: A Schema of a canonical pressure–volume (P–V) loop biomimicking the right ventricle, as well as associated states, that a cylindrical pulsatile conduit will need to assume to replace ventricular function. B Illustrative multiaxial loops generated by a pulsatile conduit, comprising P–V, axial force–length, and torque–twist. The P–V loop reflects hemodynamic performance, while the force–length and torque–twist loops reflect additional work done. The overall shape of a P–V loop is defined by prescribed values of pressures ( P 1 , P 2 , P 3 , and P 4 ) and volumes (EDV and ESV) that are defined by physiological requirements (SV and EF). By contrast, shapes of force–length and torque–twist loops can be controlled by design parameters to optimize the overall function of the conduit.

Article Snippet: The maximal available space in the thoracic cavity is assumed to be up to ~2.5 cm in diameter based on the Abbott HeartMate 3 Left Ventricular Assist Device and up to ~6.0 cm in length (if tubular), based on the distance between the intrapericardial part of the IVC and the undersurface of the right pulmonary artery for 3-year-old children .

Techniques: Generated

Journal: NPJ Regenerative Medicine

Article Title: Optimized biomechanical design of a tissue engineered pulsatile Fontan conduit

doi: 10.1038/s41536-025-00450-x

Figure Lengend Snippet: Basic conduit parameters for spherical ( A ) and cylindrical ( B ) geometries are deemed admissible if within the gray regions of interest (ROI) for an illustrative value of stroke volume SV = 17 ml and a range of ejection fractions EF \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\in$$\end{document} ∈ [0.5,0.8]. The maximal available space in the thoracic cavity is assumed to be up to ~2.5 cm in diameter based on the Abbott HeartMate 3 Left Ventricular Assist Device and up to ~6.0 cm in length (if tubular), based on the distance between the intrapericardial part of the IVC and the undersurface of the right pulmonary artery for 3-year-old children . These representative dimensions are also consistent with current GoreTex Fontan conduits.

Article Snippet: The maximal available space in the thoracic cavity is assumed to be up to ~2.5 cm in diameter based on the Abbott HeartMate 3 Left Ventricular Assist Device and up to ~6.0 cm in length (if tubular), based on the distance between the intrapericardial part of the IVC and the undersurface of the right pulmonary artery for 3-year-old children .

Techniques:

Journal: JACC Case Reports

Article Title: Microaxial Flow Pump–Protected Percutaneous Pulmonary Valve Replacement in High-Risk Patients With Severe Left Ventricular Dysfunction

doi: 10.1016/j.jaccas.2025.106147

Figure Lengend Snippet: Procedural Details Procedural steps in patient 1. Pulmonary artery angiogram (A) depicts right ventricular outflow tract dilatation and severe pulmonary valve regurgitation. Balloon sizing of the right ventricular outflow tract with a 34-mm Amplatzer sizing balloon (B) showing a minimal landing zone diameter (anterior-posterior plane) of 28.5 mm at the pulmonary valve annulus, considered adequate for the self-expandable Venus P-Valve. Stop flow is ascertained by a simultaneously performed right ventricular angiogram. Adequate positioning of the Impella CP assist device in fluoroscopy (C) and transesophageal echocardiography (D) with the blood inlet within the left ventricular cavity approximately 3.5 cm below the aortic valve and the outlet above the aortic valve. Slow and controlled deployment of the Venus P-Valve (E) with gradual release of and gentle pullback of the delivery system toward the designated landing zone. Final pulmonary artery angiogram (F) showing adequate position and function of the implanted valve. (G) Invasive hemodynamics from patient 3. Left ventricular pressure recordings show an immediate increase of the left ventricular end-diastolic pressure from 25 mm Hg to >40 mm Hg after percutaneous pulmonary valve implantation.

Article Snippet: Impella CP assist device with SmartAssist system , Abiomed Inc/Johnson&Johnson Medtech, USA.

Techniques: Gentle