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Haidari Z, Thielmann M, Lüdike P, Gabry ME, Pizanis N, Biewer M, Kamler M, Rassaf T, Ruhparwar A, Schmack B. Clinical Effects of Hemoadsorption in Patients Undergoing Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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2
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Osswald A, Gabry ME, Shehada S, Zubarevich A, Thielmann M, Weymann A, Ruhparwar A, Schmack B. Short-Term Mechanical Support with the Impella 5.x for Mitral Valve Surgery in Advanced Heart Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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3
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Shehada S, Jasarevic M, Jarkas S, Haddad A, Al-Rashid F, Thielmann M, Koch A, Pizanis N, Kamler M, Ruhparwar A, Schmack B. Mechanical Circulatory Support Using Impella 5.5 for Patients Presented with Ischemic Heart Disease and Severely Impaired Left Ventricular Function Undergoing Coronary Artery Bypass Surgery: A Three-Year Single Centre Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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4
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Haidari Z, Thielmann M, Lüdike P, Gabry ME, Pizanis N, Biewer M, Kamler M, Rassaf T, Ruhparwar A, Schmack B. Incidence, Predictors and Outcome of Vasoplegia after Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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5
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Zubarevich A, Szczechowicz M, Lind A, Janosi A, Kamler M, Thielmann M, Schmack B, Ruhparwar A, Weymann A, Wendt D. Transapical Transcatheter Mitral Valve Implantation in Patients with a History of Surgical Mitral Valve Procedures. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A. Zubarevich
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | | | - A. Lind
- Essen University Hospital, Essen, Deutschland
| | - A. Janosi
- Universitätsklinikum Essen Klinik für Thorax- und Kardiovaskuläre, Essen, Deutschland
| | - M. Kamler
- Essen University Hospital, Essen, Deutschland
| | | | - B. Schmack
- Heidelberg University Hospital, Heidelberg, Deutschland
| | - A. Ruhparwar
- Im Neuenheimer Feld 110, Heidelberg, Deutschland
| | - A. Weymann
- Essen University Hospital, Essen, Deutschland
| | - D. Wendt
- Hufelandstraße 55, Essen, Deutschland
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6
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Jakstaite A, Papathanasiou M, Tonscheidt W, Mincu R, Wernhart S, Pizanis N, Schmack B, Kamler M, Weymann A, Ruhparwar A, Rassaf T, Luedike P. Impact of phosphodiesterase-5 inhibitors on right ventricular function and exercise capacity after left ventricular assist-device implantation: the PIVAD study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Long-term therapy with oral phosphodiesterase-5 inhibitors (PDE5I) is frequently implemented after left ventricular assist-device (LVAD) implantation to improve hemodynamics and prevent late-onset right ventricular (RV) failure or to facilitate listing for heart transplantation in individuals with persistent pulmonary hypertension. The safety and efficacy of this appoach has not been prospectively studied. Recent analyses of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) demonstrated improved survival for patients under long-term PDE5I after 48 months but higher incidence of early postoperative RV failure as well as a higher risk for gastrointestinal bleeding.
Purpose
To evaluate the impact of discontinuation of PDE5I in patients on LVAD support.
Methods
In this prospective, single-arm, interventional study we enrolled LVAD recipients on oral PDE5I (sildenafil or tadalafil) after at least 1 month post-implant who were clinically stable on optimal medical therapy. The patients underwent physical examination, ECG, 6-minute walking test, cardiopulmonary exercise testing, transthoracic echocardiography, LVAD interrogation, questionnaire based evaluation of quality of life and testing of serum biomarkers at baseline and 4 weeks after discontinuation of oral PDE5I therapy.
Results
From 10/2019 to 02/2021 thirty patiens were included in the study and completed the follow-up. Mean age was 54 years, 90% were male. Destination therapy was the primary treatment goal in 13% of this cohort while 87% received LVAD as a bridge to transplant. Mean dosis of tadalafil was 24.6 mg, of sildenafil 42.5 mg. At follow-up no significant changes were elicited in echocardiographic markers of RV function, peak oxygen consumption, VE/VCO2 slope, eGFR, N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration, quality of life and average flow and power readings of the device but mild increase in walking distance (Table 1). Two patients were hospitalized for non-cardiac reasons (subtherapeutic INR, driveline infection). No patient was hospitalized for cardiac decompensation.
Conclusion
Discontinuation of PDE5I was not associated with deterioration of RV function, exercise capacity and quality of life after 4 weeks. The risk/benefit profile of PDE5I in LVAD patients needs to be further investigated in context of randomized controlled trials.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- A Jakstaite
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - M Papathanasiou
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - W Tonscheidt
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - R Mincu
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - S Wernhart
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - N Pizanis
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - B Schmack
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - M Kamler
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - A Weymann
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - A Ruhparwar
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - T Rassaf
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
| | - P Luedike
- University of Duisburg-Essen - West-German Heart and Vascular Center, Essen, Germany
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7
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Kremer J, Mueller F, Farag M, Ruhparwar A, Karck M, Schmack B. Follow-Up after Cold Atmospheric Argon Plasma for Wound Management of Driveline Infections - A Promising Strategy. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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8
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Pizanis N, Dimitriou A, Koch A, Ayoub G, Luedike P, Papathanasiou M, Ruhparwar A, Schmack B, Weymann A, Kamler M. Introduction of Machine Perfusion in Donor Hearts. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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9
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Jakstaite A, Luedike P, Schmack B, Pizanis N, Riebisch M, Weymann A, Kamler M, Ruhparwar A, Rassaf T, Papathanasiou M. Increased Bleeding Risk with Phosphodiesterase-5 Inhibitors after Left Ventricular Assist-Device Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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Koch A, Pizanis N, Ayoub G, Slama A, Weymann A, Bessa V, Taube C, Aigner C, Ruhparwar A, Kamler M. Use of Ex Vivo Lung Perfusion for Lung Transplantation: Midterm Results. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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11
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Oßwald A, Zubarevich A, Schlosser T, Janosi A, Jasarevic M, Weymann A, Ruhparwar A, Tsagakis K. Residual Stent Graft Expansion Capacity in Frozen Elephant Trunk in Aortic Dissection: A Parameter to Evaluate the Counteracting between SG and the True Lumen. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Mathy RM, Kuhn TC, Kappes J, Wielpütz MO, Ruhparwar A, Frankenstein L, Tanner M, Geis N, Fischer C, Kasperk C, Heussel CP, Kreuter M, Wilkens FM. Intracardial PMMA bone cement embolism after kyphoplasty-an unusual cause for sudden chest pain, hemothorax and hemopericardium. Med Klin Intensivmed Notfmed 2020; 116:61-64. [PMID: 32607594 DOI: 10.1007/s00063-020-00698-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 07/08/2019] [Accepted: 08/10/2019] [Indexed: 10/24/2022]
Affiliation(s)
- R M Mathy
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
| | - T C Kuhn
- Department of Internal Medicine III, Division of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - J Kappes
- Department of Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| | - M O Wielpütz
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany
| | - A Ruhparwar
- Cardiac Surgery Clinic, University of Heidelberg, Heidelberg, Germany
| | - L Frankenstein
- Department of Internal Medicine III, Division of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - M Tanner
- Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, University of Heidelberg, Heidelberg, Germany
| | - N Geis
- Department of Internal Medicine III, Division of Cardiology, University of Heidelberg, Heidelberg, Germany
| | - C Fischer
- Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, University of Heidelberg, Heidelberg, Germany
| | - C Kasperk
- Department of Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - C P Heussel
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany.,Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| | - M Kreuter
- Department of Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany
| | - F M Wilkens
- Department of Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
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13
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Kremer J, Müller F, Heininger A, Soethoff J, Farag M, Karck M, Ruhparwar A, Schmack B. Wound Management of Driveline Infections with Cold Atmospheric Argon Plasma - Proof of Concept. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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14
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Farag M, Soethoff J, Arif R, Kreusser M, Kremer J, Brcic A, Ruhparwar A, Karck M, Schmack B. In Search for the “Right Partner”. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Koch A, Pizanis N, Olberz C, Bäumker H, Rauen U, Ruhparwar A, Aigner C, Falk C, Kamler M. Inflammatory Response after Immediate versus Delayed Ex-Vivo Lung Perfusion in a Porcine Cardiac Arrest Donation Model. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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16
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Rischpler C, Ruhparwar A, Luedike P. Collateral damage: Imaging of long-term changes in perfusion and innervation following arterial switch-operation after transposition of the greater arteries. Int J Cardiol 2020; 300:299-300. [PMID: 31706625 DOI: 10.1016/j.ijcard.2019.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Affiliation(s)
- C Rischpler
- Department of Nuclear Medicine, University Hospital Essen, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
| | - A Ruhparwar
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, Medical Faculty, University of Duisburg-Essen, Germany
| | - P Luedike
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, Medical Faculty, University of Duisburg-Essen, Germany
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17
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Tsagakis K, Shehada SE, Dimitriou AM, Mourad F, Osswald A, Wendt D, Thielmann M, El Gabry M, Ruhparwar A. Fate of Extra-anatomic Aortoaxillary Bypass for Facilitation of Frozen Elephant Trunk Surgery in Zone 2: Midterm Results. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Thielmann M, Vaghiri S, Dirkmann D, Neuhäuser M, Peters J, Heusch G, Jakob H, Ruhparwar A, Kamler M, Kleinbongard P. Remote Ischemic Preconditioning in Elective Cardiac Surgery: Long-Term Overall Survival Benefit in a Single-Center Randomized Double-Blinded Controlled Trial. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Kalka K, Keldenich Z, Pizanis N, Carstens H, Reiner G, Ruhparwar A, Kamler M, Koch A. The Isolated Pig Lung from the Slaughtering Process as a Model for Ex Vivo Lung Perfusion: A Comparison in a Model for uDCDD. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Ilias C, Pizanis N, Koch A, Papathanasiou M, Luedike P, Ruhparwar A, Kamler M. Vascular Complications after Peripheral (V-A) ECLS Cannulation in Cardiogenic Shock. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Ruhparwar A, Zubarevich A, Osswald A, Raake P, Kreusser MM, Grossekettler L, Karck M, Schmack B. ECPELLA 2.0—Minimally Invasive Biventricular Groin-Free Full Mechanical Circulatory Support with Impella 5.0/5.5 Pump and ProtekDuo Canula as a Bridge to Bridge Concept: A First-in-Man Method Description. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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Shehada SE, Mourad F, Balaj I, Reichardt EM, Spangel GM, Wendt D, Thielmann M, El Gabry M, Ruhparwar A, Jakob H. Outcomes of Patients Undergoing Coronary Endarterectomy within Coronary Artery Bypass Grafting: A 20-Year Single-Center Study. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Daniel W, Kieser T, Giammarco G, Trachiotis G, Puskas J, Kappetein P, Ruhparwar A, Jakob H, Head S, Taggart D. Intraoperative Transit-Time Flow Measurement in CABG: Insights from the Registry for Quality Assessment (RE-QUEST) Study. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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24
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Thielmann M, Wendt D, Slottosch I, Welp H, Martens S, Schiller W, Neuhäuser M, Wahlers T, Ruhparwar A, Liakopoulos O. Emergency Coronary Artery Bypass Grafting in Patients with Acute Coronary Syndromes following Primary PCI: A Current Report of the North–Rhine–Westphalia Surgical Myocardial Infarction Registry. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Tsagakis K, Janosi A, Dimitriou AM, Osswald A, Shehada SE, Mourad F, Wendt D, Thielmann M, El Gabry M, Ruhparwar A. True Lumen Stabilization of the Entire Thoracoabdominal Aorta in Acute Type I Aortic Dissection: A New Technique toward Complete Aortic Repair in One Stage. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Thielmann M, Wendt D, Slottosch I, Welp H, Martens S, Schiller W, Jakob H, Wahlers T, Ruhparwar A, Liakopoulos O. Impact of Preoperative Antiplatelet Therapy and Major Bleeding Complications after Emergency Coronary Artery Bypass Grafting in Patients with Acute Coronary Syndromes: A Current Report of the North-Rhine-Westphalia Surgical Myocardial Infarction Registry. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Schmack B, Kremer J, Brcic A, Grossekettler L, Goldwasser R, Arif R, Farag M, Schmidt H, Kreusser M, Raake P, Karck M, Ruhparwar A. Results of Concomitant Percutaneous Temporary RVAD Support Using the Cardiac Assist TandemHeart With ProtekDuo Cannula in LVAD Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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28
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Hochstuhl J, Kassi M, Elias S, Ruhparwar A, Karmonik C, Chang S. Computational Fluid Dynamics (CFD) - A Reliable Basis for Therapy and Surgical VAD Strategy? J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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29
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Kreusser M, Kristen A, Blum P, Schönland S, Ruhparwar A, Hegenbart U, Katus H, Raake P. Herztransplantation bei kardialer Amyloidose - Erfahrung aus 48 Patienten am Universitätsklinikum Heidelberg. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Kreusser
- University of Heidelberg, Heidelberg, Germany
| | - A. Kristen
- University of Heidelberg, Heidelberg, Germany
| | - P. Blum
- University of Heidelberg, Heidelberg, Germany
| | | | | | | | - H. Katus
- University of Heidelberg, Heidelberg, Germany
| | - P. Raake
- University of Heidelberg, Heidelberg, Germany
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30
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Dib B, Seppelt P, Mkalaluh S, Ruhparwar A, Veres G, Weymann A, Beller C, Kallenbach K, Karck M. Aortic Root Surgery in Acute Aortic Dissection Type A: Comparison of Aortic Valve-sparing Repair versus Composite Grafting. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- B. Dib
- Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - P. Seppelt
- Department of Cardiology, University Hospital Frankfurt, Frankfurt, Germany
| | - S. Mkalaluh
- Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - A. Ruhparwar
- Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - G. Veres
- Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - A. Weymann
- Department of Cardiac Surgery, Hospital Oldenburg, Oldenburg, Germany
| | - C. Beller
- Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - K. Kallenbach
- Department of Cardiac Surgery, INCCI HaerzZenter, Luxembourg, Germany
| | - M. Karck
- Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
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31
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Ghodsizad A, Koerner M, El-Banayosy A, Zeriouh M, Ruhparwar A, Loebe M. Extracorporeal Membrane Oxygenation (ECMO): An Option for Cardiac Reccovery from Advanced Cardiogenic Shock. Heart Surg Forum 2017; 20:E274-E277. [DOI: 10.1532/hsf.1635] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/10/2016] [Indexed: 11/20/2022]
Abstract
Mechanical circulatory support can prevent multi-organ failure and death in patients with advanced cardiogenic shock. Here we describe our experience using extracorporeal membrane oxygenation (ECMO) for treatment of advanced cardiogenic shock which has been used by our team for daily routine care in more than 200 patients during the last five years at the Penn State Medical Center.Venoarterial (VA) ECMO has been used as a viable therapeutic option for advanced cardiogenic shock as a bridge to recovery (BTR) or bridge to next decision (BTD). Our group performed a retrospective review of data from 155 patients from our single center cohort treated with VA ECMO for advanced cardiogenic shock. After successful ECMO treatment, the one year survival rate of patients with ischemic heart disease was 73.7 %, and the one year survival for patients with non-ischemic heart disease was 75%.
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Schmack B, Weymann A, Zych B, Sabashnikov A, Grossekettler L, Ruhparwar A, Karck M, Simon AR, Popov AF. Extrakorporale Unterstützungsverfahren bei Lungentransplantation. Z Herz- Thorax- Gefäßchir 2017. [DOI: 10.1007/s00398-016-0090-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Trojan M, Müller-Eschner M, Kotelis D, MD Partovi S, Karmonik C, Fink C, Tengg-Koblink H, Ruhparwar A, Böckler D, Kauczor H, Rengier F. Dynamische 3D-MR-Angiografie bei Patienten mit Aortendissektion als Risikofaktor für eine chronische Expansion. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Trojan
- Universitätsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg
| | - M Müller-Eschner
- Universitätsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg
| | - D Kotelis
- Universitätsklinikum Heidelberg, Gefäßchirurgie, Heidelberg
| | - S MD Partovi
- University Hospitals Case Medical Center Cleveland, Radiology, Cleveland, Ohio USA
| | - C Karmonik
- Houston Methodist, Neurosurgery, Houston, Texas USA
| | - C Fink
- AKH Celle, Radiologie, Celle
| | - H Tengg-Koblink
- Universitätsspital Bern, Inselspital, Diagnostische, Interventionelle und pädiatrische Radiologie, Bern, Schweiz
| | - A Ruhparwar
- Universitätsklinikum Heidelberg, Herzchirurgie, Heidelberg
| | - D Böckler
- Universitätsklinikum Heidelberg, Gefäßchirurgie, Heidelberg
| | - H Kauczor
- Universitätsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg
| | - F Rengier
- Universitätsklinikum Heidelberg, Diagnostische und Interventionelle Radiologie, Heidelberg
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Michels G, Ruhparwar A, Pfister R, Welte T, Gottlieb J, Andriopoulos N, Teschner S, Burst V, Mertens J, Stippel D, Herter-Sprie G, Shimabukuro-Vornhagen A, Böll B, von Bergwelt-Baildon M, Theurich S, Vehreschild J, Scheid C, Chemnitz J, Kochanek M. Transplantationsmedizin in der Intensivmedizin. Repetitorium Internistische Intensivmedizin 2017. [PMCID: PMC7193715 DOI: 10.1007/978-3-662-53182-2_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Die Betreuung von Patienten vor und nach einer Organtransplantation gehört zum Gebiet der „speziellen Intensivmedizin“ des jeweiligen Fachbereichs. Die transplantationsspezifische Intensivmedizin setzt daher ein interdisziplinäres Management voraus. Neben der Organprotektion bzw. dem Monitoring von speziellen transplantationsrelevanten Problemen steht die Immunsuppression. Auf das Management mit Immunsuppressiva und von transplantationsassoziierten, intensivmedizinisch relevanten Problemen wird in diesem Kapitel eingegangen. Speziell werden Herz-, Lungen-, Leber-, Nieren- und Stammzelltransplantationen dargestellt.
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Borde JP, Sitaru G, Kopp WH, Ruhparwar A, Ehlermann P, Lasitschka F, Dalpke A, Heininger A. Heart transplantation as salvage therapy for progressive prosthetic valve endocarditis due to methicillin-resistant Staphylococcus epidermidis (MRSE). J Cardiothorac Surg 2016; 11:100. [PMID: 27400724 PMCID: PMC4939521 DOI: 10.1186/s13019-016-0505-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 07/06/2016] [Indexed: 11/10/2022] Open
Abstract
Background Prosthetic valve endocarditis (PVE) has the highest in-hospital mortality among all cases of infective endocarditis (IE), it is estimated at about 40 %. Orthotopic heart transplantation (OHT) as a measure of last resort, may be considered in selected cases where repeated surgical procedures and conservative efforts have failed to eradicate persistent or recurrent IE. Only few clinical data are available regarding this rare indication for OHT, since active IE has traditionally been considered as a contraindication for OHT. Case presentation We report on a 55 year old male patient who underwent prosthetic valve replacement with a mechanical valved conduit ten years ago and developed now persistent PVE with severe complications due to methicillin-resistant Staphylococcus epidermidis (MRSE). Repeated surgical procedures and conservative efforts have failed to eradicate the pathogen. Regarding the lack of curative options, salvage OHT was discussed as a measure of last resort. 28 months after the first diagnosis of PVE, the patient was successfully transplanted and is now doing well under close follow-up (6 months post-OHT). Conclusions PVE remains a challenging condition regarding diagnosis and treatment. The presented case underscores the urgent need for an integrated and multidisciplinary approach to patients with suspected and definitive IE - especially in PVE. OHT might be a feasible measure of last resort in selected patients with IE. Our case report adds published clinical experience to this rarely performed procedure and consolidates previous findings. Electronic supplementary material The online version of this article (doi:10.1186/s13019-016-0505-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J P Borde
- Department of Internal Medicine, Ortenauklinikum Achern-Oberkirch, Division of Infectious Diseases, Josef-Wurzler-Straße 7, 77855, Achern, Germany. .,Department of Medicine, Division of Infectious Disease and Travel Medicine, Freiburg University Medical Center, Hugstetter Str. 55, 79106, Freiburg i.Br, Germany.
| | - G Sitaru
- MVZ Clotten, Labor Dr. Haas, Dr. Raif & Kollegen, Merzhausener Straße 112a, 79100, Freiburg i.Br, Germany
| | - W H Kopp
- Eurotransplant International Foundation, P.O. Box 2304, 2301 CH, Leiden, The Netherlands
| | - A Ruhparwar
- Department of Cardiac Surgery, Heidelberg University Hospital Center, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - P Ehlermann
- Department of Cardiology, Heidelberg University Hospital Center, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - F Lasitschka
- Institute of Pathology, Heidelberg University Hospital Center, Im Neuenheimer Feld 220/221, 69120, Heidelberg, Germany
| | - A Dalpke
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital Center, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - A Heininger
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital Center, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
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Engelke J, Popov A, Simon A, Partovi S, Karck M, Rengier F, Weymann A, Raake P, Doesch A, Lotz J, Karmonik C, Ruhparwar A. Competing Flow Between Partial Circulatory Support and Native Cardiac Output: A Computational Fluid Dynamics-Study. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Arif R, Zaradzki M, Seppelt P, Franz M, Reissfelder C, Ruhparwar A, Beller C, Karck M, Kallenbach K. Colectomy due to Ischemic Colitis after Heart Surgery: A Matched-pairs Analysis. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dib B, Seppelt P, Arif R, Weymann A, Beller C, Ruhparwar A, Karck M, Kallenbach K. Technical Improvements and Individualized Operations Result in Favorable Outcome in Patients with Acute Aortic Dissection Type A. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Engelke J, Popov AF, Partovi S, Karck M, Simon A, Rengier F, Weymann A, Raake P, Doesch A, Lotz J, Karmonik C, Ruhparwar A. Competing Flow between Partial Circulatory Support and Native Cardiac Output: a computational Fluid Dynamics-Study. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Weymann A, Farag M, Sabashnikov A, Fatullayev J, Schmack B, Arif R, Müller F, Möbius A, Raake P, Dösch A, Popov AF, Simon A, Beller C, Kallenbach K, Karck M, Ruhparwar A. Central ECLS with Left Ventricular Decompression to Berlin Heart Excor: a Reliable “Bridge to Bridge” Strategy in Crash and Burn Patients. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Weymann A, Patil N, Sabashnikov A, Zych B, Mohite P, Garcia S, Wahlers T, Karck M, Kallenbach K, Ruhparwar A, Amrani M, De Robertis F, Lehmkuhl H, Popov AF, Simon A. Continuous Flow Left Ventricular Assist Device Therapy in Patients with Preoperative Hepatic Failure: A Single Center Experience. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Arif R, Seppelt P, Farag M, Zaradzki M, Ruhparwar A, Karck M, Kallenbach K. 062 * PATIENTS WITH LUPUS ERYTHEMATODES AND ANTIPHOSPHOLIPID SYNDROME UNDERGOING CARDIAC VALVE SURGERY. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Takahashi H, Arif R, Almashhoor A, Ruhparwar A, Karck M, Kallenbach K. Long-term results after surgical treatment of postinfarction ventricular septal rupture. Eur J Cardiothorac Surg 2014; 47:720-4. [DOI: 10.1093/ejcts/ezu248] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Arif R, Seppelt P, Zaradzki M, Farag M, Ruhparwar A, Karck M, Kallenbach K. Long-term outcome of patients with lupus erythematodes and Antiphospholipid Syndrome after cardiac valve surgery. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Reiss N, Karck M, Ruhparwar A. Herztransplantation vs. „Destination“-Therapie. Z Herz- Thorax- Gefäßchir 2013. [DOI: 10.1007/s00398-013-1016-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Arif R, Ruhparwar A, Dienemann H, Kallenbach K, Karck M. 205 * RESECTION OF MEDIASTINAL MALIGNOMA WITH THE USE OF CARDIOPULMONARY BYPASS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Takahashi H, Arif R, Kallenbach K, Tochtermann U, Karck M, Ruhparwar A. Surgical treatment of aortic valve endocarditis with left ventricular – aortic discontinuity. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Takahashi H, Al A, Ruhparwar A, Karck M, Kallenbach K. Surgical repair of postinfarction ventricular septal rupture: 27 years of single institution experience. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Arif R, Zaradzki M, Reissfelder C, Seppelt P, Verch M, Schwill S, Ruhparwar A, Karck M, Kallenbach K. Colectomy after heart surgery with use of extracorporeal circulation. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Reiss N, Fritz M, Karck M, Ruhparwar A. Mitral valve surgery after orthotopic heart transplantation – an effective and safe treatment option. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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