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Dewaswala N, Bhopalwala H, Minhas AMK, Amanullah K, Abramov D, Arshad S, Dani S, Vaidya G, Banerjee D, Birks E, Michos E. Sex differences in heart transplantation - analysis of the national inpatient sample 2012-2019. Curr Probl Cardiol 2024; 49:102515. [PMID: 38499082 DOI: 10.1016/j.cpcardiol.2024.102515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 03/13/2024] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Advanced heart failure therapies and heart transplantation (HT) have been underutilized in women. Therefore, we aimed to explore the clinical characteristics and outcomes of HT by sex. METHODS We conducted a retrospective analysis of adult discharges from the National Inpatient Sample (NIS) between 2012 and 2019. International Classification of Disease (ICD) procedure codes were used to identify those who underwent HT. RESULTS A total of 20,180 HT hospitalizations were identified from 2012-2019. Among them, 28 % were female. Women undergoing HT were younger (mean age 51 vs. 54.5 years, p<0.001). HT hospitalizations among men were more likely to have atrial fibrillation, diabetes, hypertension, renal failure, dyslipidemia, smoking, and ischemic heart disease. HT hospitalizations among women were more likely to have hypothyroidism and valvular heart disease. HT hospitalizations in women were associated with no significant difference in risk of in-hospital mortality (adjusted odds ratio [OR] 0.82; 95 % confidence interval [CI] 0.58-1.16, p=0.271), no significant difference in length of stay or inflation-adjusted cost. Men were more likely to develop acute kidney injury during HT hospitalization (69.2 % vs. 59.7 %, adjusted OR 0.71, 95 % CI 0.61-0.83, p<0.001). CONCLUSIONS HT utilization is lower in women. However, most major in-hospital outcomes for HT are similar between the sexes. Further studies are need to explore the causes of lower rates of HT in women.
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Sowder A, Ather A, Birks E, Kolodziej A, Malyala R, Sieg A, Schadler A, Unger R, Guglin M, Kuan W. Evaluation of adjusted international normalized ratio goal in patients with HeartMate 3 left ventricular assist devices. Artif Organs 2023; 47:1613-1621. [PMID: 37184287 DOI: 10.1111/aor.14565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/08/2023] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND The HeartMate3 left ventricular assist device (HM3 LVAD) has shown a low incidence of thrombosis, but bleeding risk is as high as 43%. We aim to describe the impact of lower international normalization ratio (INR) goal on clinical outcomes. METHODS In February 2019, our tertiary care institution lowered INR goal in HM3 patients from manufacturer recommendations to 1.8-2.2 and retrospectively analyzed the data. Two cohorts were compared: patients with lower INR goal upon implant (De novo) and those with subsequently lowered INR goal (Adjusted). The Adjusted group also served as its own historical control. Both groups continued aspirin 81 milligrams daily per manufacturer recommendations. The primary outcomes were incidences of bleed and thrombosis events within 12 months. Secondary outcomes included survival free of disabling stroke or reoperation to remove or replace the device and Rosendaal time in therapeutic range (TTR) over 12 months. RESULTS Thirty-one patients were evaluated for inclusion with 26 meeting criteria. Within 12 months, incidence of bleeding events was 25% and 28.6% in the De novo and Adjusted groups, respectively. Incidence of thrombotic events within 12 months was 0% in the De novo group and 7.1% in the Adjusted group. Twelve-month survival free of disabling stroke or reoperation to remove or replace the device was higher over 12 months for patients in the De novo group (91.7% vs. 78.6%). Median 12-month TTR was 36%, which was primarily attributable to subtherapeutic deviations. CONCLUSIONS A lower INR goal may be safe when initiated De novo following implantation of the HM3. This study informs the need for larger prospective studies.
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Affiliation(s)
- Amanda Sowder
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
| | - Ayesha Ather
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Emma Birks
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
- Department of Cardiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Andrew Kolodziej
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
- Department of Cardiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Rajasekhar Malyala
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
- Department of Cardiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Adam Sieg
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Aric Schadler
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
| | - Rachel Unger
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
| | - Maya Guglin
- Department of Cardiology, Indiana University Health, Indianapolis, Indiana, USA
| | - William Kuan
- Department of Cardiology, University of Kentucky Healthcare, Lexington, Kentucky, USA
- Department of Pharmaceutical Sciences, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA
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Vaidya GN, Kolodziej A, Stoner B, Galaviz JV, Cao X, Heier K, Thompson M, Birks E, Campbell K. Bedside ultrasound of the internal jugular vein to assess fluid status and right ventricular function: The POCUS-JVD study. Am J Emerg Med 2023; 70:151-156. [PMID: 37307660 DOI: 10.1016/j.ajem.2023.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/08/2023] [Accepted: 05/28/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Accurate estimation of fluid status is important in the management of heart failure patients, however, the current methods for bedside assessment can be unreliable or impractical for daily use. METHODS Non-ventilated patients were enrolled immediately prior to scheduled right heart catheterization (RHC). Using M-mode, IJV maximum (Dmax) and minimum (Dmin) anteroposterior diameters were measured during normal breathing, while supine. Respiratory variation in diameter (RVD) was calculated as [(Dmax - Dmin)/Dmax] in percentage. Collapsibility with sniff maneuver (COS) was assessed. Lastly, inferior vena cava (IVC) was assessed. Pulmonary artery pulsatility index (PAPi) was calculated. Data was obtained by five investigators. RESULTS Total 176 patients were enrolled. Mean BMI was 30.5 kg/m2, LVEF 14-69% (range), 38% with LVEF ≤35%. The POCUS of IJV could be performed in all patients in <5 min. Increasing RAP demonstrated progressive increase in IJV and IVC diameters. For high filling pressure (RAP ≥10 mmHg), an IJV Dmax ≥1.2 cm or IJV-RVD < 30% had specificity >70%. Combining the POCUS of IJV to physical examination improved the combined specificity to 97% for RAP ≥10 mmHg. Conversely, a finding of IJV-COS was 88% specific for normal RAP (<10 mmHg). An IJV-RVD <15% is suggested as a cutoff for RAP ≥15 mmHg. The performance of IJV POCUS was comparable to IVC. For RV function assessment, IJV-RVD < 30% had 76% sensitivity and 73% specificity for PAPi <3, while IJV-COS was 80% specific for PAPi ≥3. CONCLUSION POCUS of IJV is an easy to perform, specific and reliable method for volume status estimation in daily practice. An IJV-RVD < 30% is suggested for estimation of RAP ≥10 mmHg and PAPi <3.
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Affiliation(s)
- Gaurang Nandkishor Vaidya
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America; Cardiac Amyloidosis Program, University of Kentucky, Lexington, KY, United States of America.
| | - Andrew Kolodziej
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Benjamin Stoner
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Josue Villegas Galaviz
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Xiangkun Cao
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Kory Heier
- Department of Biostatistics, University of Kentucky, Lexington, KY, United States of America
| | - Mindy Thompson
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Emma Birks
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Kenneth Campbell
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
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Vaidya GN, Anaya P, Ignaszewski M, Kolodziej A, Malyala R, Rajagopalan N, Sekela M, Birks E. Covid-19 positive donor utilization for heart transplantation: The new frontier for donor pool expansion. Clin Transplant 2023; 37:e15046. [PMID: 37306941 DOI: 10.1111/ctr.15046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Hearts from COVID-19 positive donors (CPD) are being utilized for heart transplantation by some centers; however, this is in the setting of the lack of guidelines or robust evidence. The paucity of evidence is reflected in the recent Organ Procurement and Transplantation Network (OPTN) communication describing CPD utilization as an "unknown risk." METHODS AND RESULTS We analyzed the UNOS database for adult heart transplants performed between January 2021 to December 2022, and CPD comprised of a significant percentage of donors, being used in >10% of recipients in some UNOS regions. Between July 2022 and December 2022, 7.9% of heart transplants were with CPD, and in the same period Hepatitis C positive donors accounted for 7.1% and donation after circulatory death (DCD) accounted for 10.3%. CONCLUSION If the transplant community comes up with a standardized approach and guidance in using CPD hearts, this could provide an effective donor pool expansion strategy.
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Affiliation(s)
| | - Paul Anaya
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Maya Ignaszewski
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Andrew Kolodziej
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Rajasekhar Malyala
- Department of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Navin Rajagopalan
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Michael Sekela
- Department of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Emma Birks
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
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Saeed D, Feldman D, Banayosy AE, Birks E, Blume E, Cowger J, Hayward C, Jorde U, Kremer J, MacGowan G, Maltais S, Maybaum S, Mehra M, Shah KB, Mohacsi P, Schweiger M, Schroeder SE, Shah P, Slepian M, Tops LF, Alvarez P, Arabia F, Aslam S, Benson-Louis L, Birati E, Buchholz HW, Cedars A, Christensen D, Ciarka A, Coglianese E, Cogswell R, Cook J, Copeland J, Costello JG, Drakos SG, Eghtesady P, Elliot T, Estep JD, Eulert-Grehn JJ, Fabrizio DR, Garbade J, Gelow J, Guglin M, Hernandez-Montfort J, Horstmanshof D, John R, Kanwar M, Khaliel F, Kim G, Kumar S, Lavee J, Leache M, Leprince P, Lim S, Loforte A, Maly J, Najjar S, Netuka I, Pamboukian SV, Patel SR, Pinney S, Pluym CV, Potapov E, Robson D, Rochlani Y, Russell S, Sandau K, Sandoval E, Sayer G, Schettle S, Schibilsky D, Schlöglhofer T, Schmitto J, Siddique A, Silvestry S, Slaughter MS, Sun B, Takayama H, Tedford R, Teuteberg JJ, Ton VK, Uriel N, Vierecke J, Zimpfer D, D'Alessandro D. The 2023 International Society for Heart and Lung Transplantation Guidelines for Mechanical Circulatory Support: A 10- Year Update. J Heart Lung Transplant 2023; 42:e1-e222. [PMID: 37245143 DOI: 10.1016/j.healun.2022.12.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/05/2022] [Indexed: 05/29/2023] Open
Affiliation(s)
- Diyar Saeed
- University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany..
| | - David Feldman
- University of Cincinnati & Cincinnati Childrens Hosptial, Cincinnati, Ohio, USA.
| | - Aly El Banayosy
- Integris Nazih Zuhdi Transplant Institute, Oklahoma City, OK, USA
| | - Emma Birks
- University of Louisville, Louisville, KY, USA
| | | | - Jennifer Cowger
- Department of Cardiology, Henry Ford Hospital, Detroit, MI, USA
| | - Christopher Hayward
- Faculty of Medicine, St Vincent's Hospital, University of New South Wales, Sydney, Australia
| | | | - Jamila Kremer
- Department of Cardiothoracic Surgery, Heidelberg University, Heidelberg, Germany
| | - Guy MacGowan
- Newcastle Upon Tyne Hospitals, and Newcastle University, Newcastle upon Tyne, UK
| | - Simon Maltais
- Department of cardiac Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Keyur B Shah
- Department of Cardiology, Virginia Commonwealth University, Virginia
| | - Paul Mohacsi
- CardioVascular Center Im Park, Seestrasse 247, CH-8038 Zürich
| | | | | | - Palak Shah
- Inova Heart and Vascular Institute, Falls Church VA, USA
| | | | - Laurens F Tops
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Paulino Alvarez
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Francisco Arabia
- Advanced Heart Program, Banner University Medical Group, Phoenix, AZ, USA
| | - Saima Aslam
- University of California, San Diego, San Diego, CA, USA
| | | | - Edo Birati
- Cardiovascular Division, Padeh-Poriya Medical Center, Bar Ilan University, Israel
| | | | - Ari Cedars
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Erin Coglianese
- Department of Medicine/Cardiology, Mass General Hospital, Harvard School of Medicine, Boston Massachusetts USA
| | | | - Jennifer Cook
- University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Jack Copeland
- Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona, Tucson, AZ, USA
| | | | - Stavros G Drakos
- University of Utah Health and School of Medicine and Salt Lake VA Medical Center, Salt Lake City, Utah, USA
| | - Pirooz Eghtesady
- Department of Pediatrics, Washington University in St. Louis, USA
| | | | - Jerry D Estep
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | | | - De Rita Fabrizio
- Consultant in Congenital Heart Surgery, Adult and Paediatric Congenital Heart Unit Freeman Hospital, Newcastle Upon Tyne, UK
| | - Jens Garbade
- University Department for Cardiac Surgery, Leipzig Heart Center, Leipzg, Germany
| | - Jill Gelow
- Department of Pediatrics, Providence Heart Institute, Portland, Oregon, USA
| | | | | | | | - Ranjit John
- University of Minnesota, Minneapolis, MN, USA
| | | | - Feras Khaliel
- King Faisal Specialist Hospital & Research Center, Riyadh
| | - Gene Kim
- Department of Cardiology, University of Chicago, Illinois, USA
| | - Sachin Kumar
- Division of Cardiovascular Surgery, Advanced Heart Failure Program, University of Texas Medical Center, Houston, Texas, USA
| | - Jacob Lavee
- Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, Israel
| | - Marzia Leache
- Department of Cardiac Surgery, New Yok University Medical Center, New York, NY, USA
| | - Pascal Leprince
- Department of Thoracic and Cardiovascular Surgery, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Sern Lim
- University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Antonio Loforte
- Bologna University, Cardiothorac, Transplant and Vasc Surg Dept, Bologna, Italy
| | - Jiri Maly
- Department of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czeck Republic
| | - Samer Najjar
- Department of Medicine, MedStar Washington Hospital Center, Georgetown University, Wahington DC USA
| | - Ivan Netuka
- Dept. of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - Snehal R Patel
- Cardiology Division, Montefiore Medical Center, Bronx, NY, USA
| | - Sean Pinney
- Mount Sinai Medical Center, New York, NY, USA
| | - Christina Vander Pluym
- Division of Cardiology, Boston Children's Hospital/Harvard School of Medicine, Boston, Massachusetts, USA
| | | | - Desiree Robson
- Department of Cardiology, Montefiore Medical Center, Bronx, NY, USA
| | | | | | | | | | - Gabriel Sayer
- University of Chicago Medical Center, Chicago, IL, USA
| | | | - David Schibilsky
- Department of Surgery, Universitats- Herzzentrum, Freiburg Germany
| | | | - Jan Schmitto
- Dept. of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Aleem Siddique
- Department of Surgery, University of Nebraska Medical Center, Omha, Nebraska, USA
| | - Scott Silvestry
- Department of Cardiac Surgery, Florida Hospital, Orlando, FL, USA
| | - Mark S Slaughter
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Kentucky, USA
| | - Benjamin Sun
- Cardiac Surgery department, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Hiroo Takayama
- Department of Cardiac Surgery, Columbia University Medical Center, New York, NY, USA
| | - Ryan Tedford
- Department of Medicine/Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Van-Khue Ton
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nir Uriel
- Department of Cardiology, Columbia University, New York, NY, USA
| | - Juliane Vierecke
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Daniel Zimpfer
- Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria
| | - David D'Alessandro
- Massachusetts General Hospital, Boston, Harvard School of Medicine, Boston, MA, USA.
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Kyriakopoulos C, Taleb I, Wever-Pinzon O, Selzman C, Bonios M, Dranow E, Wever-Pinzon J, Yin M, Tseliou E, Stehlik J, Alharethi R, Kfoury A, Hanff T, Fang J, Koliopoulou A, Sideris K, Krauspe E, Nelson M, Elmer A, Singh R, Psotka M, Birks E, Slaughter M, Koenig S, Kyvernitakis A, Hoffman K, Guglin M, Kotter J, Campbell K, Silvestry S, Vidic A, Raval N, Mehra M, Cowger J, Kanwar M, Shah P, Drakos S. Multicenter Development and Validation of a Machine Learning Model to Predict Myocardial Recovery During LVAD Support: The UCAR Score. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1519] [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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Njoroge L, Malyala R, Meece L, Jeng E, Ahmed M, Birks E. Dual VADs to Dual Organs: Successful Bridge to Heart and Kidney Transplantation with 2 HeartMate 3 LVADs in Biventricular Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.839] [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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Vaidya GN, Anaya P, Ignaszewski M, Kolodziej A, Malyala R, Sekela M, Birks E. Patterns and outcomes of COVID-19 donor utilization for heart transplant. Clin Transplant 2023; 37:e14917. [PMID: 36681878 DOI: 10.1111/ctr.14917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/28/2022] [Accepted: 01/18/2023] [Indexed: 01/23/2023]
Abstract
BACKGROUND The outcomes following COVID-19 positive donor (CPD) utilization for heart transplant are unknown. METHODS UNOS database was analyzed for heart transplants performed from the declaration of COVID-19 pandemic until September 30, 2022. RESULT Since the onset of pandemic, there were 9876 heart transplants reported. COVID-19 antigen or NAT results were available in 7698 adult donors within 14 days of donation, of which 177 (2.3%) were positive. There was no difference in recipient demographics, including age (COVID positive donor vs. negative: 55 vs. 56 years, p = .2) and BMI. Listing status 1 and 2 were similar in both groups (7% vs. 10% and 48% vs. 49% respectively, p = .4). Durable and temporary mechanical support were similar in both groups pre-transplant (both groups 33%, p = .9). There was no difference in days on the waitlist (median 31 days, p = .9). Simultaneous renal transplant rates were similar (11% vs. 10%, p = .9). CPD utilization has increased since the onset of the pandemic, and the adoption is present across most UNOS regions. Post-transplant, there was no difference in length of stay (median 16 vs. 17 days, p = .9) and acute rejection episodes prior to discharge (3% vs. 8%, p = .1). In survival analysis of 90-day follow up, number of deaths reported were comparable (5% in both groups, p = .9) Follow-up LVEF was comparable (62% vs. 60%, p = .4). CONCLUSION Active COVID-19 infection in donors did not affect survival or rejection rates in the short-term post-heart transplant.
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Affiliation(s)
| | - Paul Anaya
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Maya Ignaszewski
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Andrew Kolodziej
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Rajasekhar Malyala
- Department of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Michael Sekela
- Department of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Emma Birks
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
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Stoner B, Cao X, Kolodziej A, Villegas-Galaviz J, Campbell K, Thompson M, Birks E, Vaidya G. Bedside Ultrasound of Internal Jugular Vein for Right Ventricular Function Assessment. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1119] [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: 12/01/2022] Open
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10
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Kyriakopoulos C, Taleb I, Wever-Pinzon O, Selzman C, Kfoury A, Tseliou E, Stehlik J, Alharethi R, Fang J, Catino A, Koliopoulou A, Goodwin M, Kagawa H, Dranow E, Singh R, Psotka M, Birks E, Slaughter M, Koenig S, Kyvernitakis A, Hoffman K, Guglin M, Kotter J, Vidic A, Silvestry S, Raval N, Kanwar M, Shah P, Drakos S. Multicenter-Derived Clinical Score Predicts Structural and Functional Cardiac Improvement in Chronic Heart Failure Patients Undergoing Mechanical Circulatory Support. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.147] [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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Ballout J, Harris A, Su L, Birks E, Kolodziej A. ANGIOTENSIN II AND NEPRILYSIN INHIBITION IS ASSOCIATED WITH REDUCED RISK OF GASTROINTESTINAL BLEEDING IN PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICES: A TIME DEPENDENT EFFECT. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01482-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Samsky MD, Milano CA, Pamboukian S, Slaughter MS, Birks E, Boyce S, Najjar SS, Itoh A, Reid B, Mokadam N, Aaronson KD, Pagani FD, Rogers JG. The Impact of Adverse Events on Functional Capacity and Quality of Life After HeartWare Ventricular Assist Device Implantation. ASAIO J 2021; 67:1159-1162. [PMID: 33927085 PMCID: PMC8478694 DOI: 10.1097/mat.0000000000001378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Left ventricular assist devices (LVADs) improve quality of life (QoL) and functional capacity (FC) for patients with advanced heart failure. The association between adverse events (AEs) and changes in QoL and FC are unknown. Patients treated with the HeartWare ventricular assist device (HVAD) with paired 6-minute walk distance (6MWD, n = 263) and Kansas City Cardiomyopathy Questionnaires (KCCQ, n = 272) at baseline and 24 months in the ENDURANCE and ENDURANCE Supplemental Trial databases were included. Patients were stratified based upon occurrence of clinically significant AEs during the first 24 months of support and analyzed for the mean change in 6MWD and KCCQ. The impact of AE frequency on change in 6MWD and KCCQ from baseline to 24 months was evaluated. Of the AEs examined, only sepsis was associated with an improvement in 6MWD (109 m vs. 16 m, p = 0.002). Patients without improvement in 6MWD test from baseline to 24 months had significantly more AEs than those with FC improvement (p = 0.0002). Adverse events did not affect the KCCQ overall summary score. In this analysis, patients with fewer AEs had greater improvement in FC during the 24-month follow up. The frequency of AEs did not have a significant impact on QoL after LVAD implantation.
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Affiliation(s)
- Marc D Samsky
- From the Duke University Medical Center, Durham, North Carolina
| | | | | | | | - Emma Birks
- University of Louisville, Louisville, Kentucky
| | | | | | | | - Bruce Reid
- Intermountain Medical Center, Murray, Utah
| | | | | | | | - Joseph G Rogers
- From the Duke University Medical Center, Durham, North Carolina
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Arshad S, Unger RE, Birks E. NOSOCOMIAL COVID-19 INFECTION IN AN LVAD PATIENT. J Am Coll Cardiol 2021. [PMID: 34140103 PMCID: PMC8091372 DOI: 10.1016/s0735-1097(21)04360-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Birks E, Yin M, Rame J, Patel S, Lowes B, Selzman C, Starling R, Trivedi J, Slaughter M, Atluri P, Goldstein D, Maybaum S, Um J, Margulies K, Stehlik J, Cunnigham C, Farrar D, Drakos S. Predictors of Myocardial Recovery Following LVAD-Mediated Reverse Remodeling and Device Removal: Insights from RESTAGE-HF. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1939] [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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15
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Vaidya G, Kolodziej A, Malyala R, Reddy N, O'Connor W, Birks E. Successful Heart Transplantation in a Pan-Inflammatory Patient with Interstitial Lung Disease. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1297] [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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16
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Birks E, Rame J, Yin M, Patel S, Lowes B, Selzman C, Trivedi J, Laughter M, Atluri P, Goldstein D, Maybaum S, Um J, Margulies K, Stehlik J, Cunnigham C, Starling R, Farrar D, Drakos S. Long Term Post Explant Outcomes from RESTAGE-HF: A Prospective Multi-Center Study of Myocardial Recovery Using LVADs. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1938] [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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17
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Taleb I, Wever-Pinzon O, Yin M, Kfoury A, Caine W, Stehlik J, Catino A, Wever-Pinzon J, Bonios M, McKellar S, Alharethi R, Koliopoulou A, Fang J, Selzman C, Dranow E, Shah P, Singh R, Psotka M, Zhu W, Slaughter M, Birks E, Koenig S, Kanwar M, Kyvernitakis A, Hoffman K, Guglin M, Kotter J, Campbell K, Drakos S. Predicting Cardiac Structural and Functional Improvement Induced by Mechanical Unloading in Chronic Heart Failure: A Derivation-Validation Multicenter Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1052] [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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Abstract
There are only 2 treatments for the thousands of patients who progress to the most advanced form of heart failure despite the application of guideline-based medical therapy, use of ventricular assist devices and heart transplantation. There has been a great deal of progress in both of these therapies that have led to improved outcomes including significant improvement in survival and functional capacity. Heart transplantation offers the best short- and long-term survival for patients with end-stage heart failure, and the majority of these recipients achieve relatively limitless functional capacity for their age. However, the chronic shortage of available donors limits the number of recipients in the United States to an only 2500 patients/y or only a fraction of potential candidates. The significant improvement in outcomes now possible with durable ventricular assist devices has led to a significant increase in their use, which now exceeds the volume of heart transplants in the United States, with the greatest growth in use for those not considered to be candidates for heart transplantation, previously referred to as destination therapy. This article will review the substantial progress that has taken place for both of these life-saving treatment options, as well as the future directions.
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Affiliation(s)
- Leslie Miller
- From the Division of Cardiovascular Medicine, Texas Heart Institute, Houston (L.M., H.L., O.H.F.)
| | - Emma Birks
- Division of Cardiology, University of Louisville, KY (E.B.)
| | - Maya Guglin
- Division of Cardiology, University of Kentucky, Lexington (M.G.)
| | - Harveen Lamba
- From the Division of Cardiovascular Medicine, Texas Heart Institute, Houston (L.M., H.L., O.H.F.)
| | - O H Frazier
- From the Division of Cardiovascular Medicine, Texas Heart Institute, Houston (L.M., H.L., O.H.F.)
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Taleb I, Wever-Pinzon O, Kfoury A, Caine W, Stehlik J, McKellar S, Alharethi R, Koliopoulou A, Fang JC, Selzman C, Shah P, Singh R, Psotka M, Zhu W, Slaughter MS, Birks E, Koenig S, Kanwar M, Guglin M, Kotter J, Campbell K, Vidic A, Raval N, Silvestry S, Drakos S. PREDICTING CARDIAC STRUCTURAL AND FUNCTIONAL IMPROVEMENT INDUCED BY MECHANICAL UNLOADING IN CHRONIC HEART FAILURE: A DERIVATION-VALIDATION MULTICENTER STUDY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31653-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Vaidya GN, Amankwa K, Dulnuan K, Birks E, Rajakrishnan V. Effect of Ischemic Time on Immediate Post-Transplant Heart Rate and Chronotropic Agent Use. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.533] [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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21
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Pillarella J, Albers L, Katrapati P, Abramov D, Birks E, Vijayakrishnan R. Safety and Efficacy of Home Inotropes as Bridge to LVAD and Transplant. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.978] [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: 11/30/2022] Open
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22
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Rice J, Slaughter M, Birks E, Trivedi J. Impact of Center Volume on Post Heart Transplant Survival. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1005] [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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23
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Ferket BS, Ailawadi G, Gelijns AC, Acker MA, Hohmann SF, Chang HL, Bouchard D, Meltzer DO, Michler RE, Moquete EG, Voisine P, Mullen JC, Lala A, Mack MJ, Gillinov AM, Thourani VH, Miller MA, Gammie JS, Parides MK, Bagiella E, Smith RL, Smith PK, Hung JW, Gupta LN, Rose EA, O’Gara PT, Moskowitz AJ, Taddei-Peters WC, Buxton D, Geller NL, Gordon D, Jeffries NO, Lee A, Moy CS, Gombos IK, Ralph J, Weisel RD, Gardner TJ, Ascheim DD, Moquete E, Chang H, Chase M, Foo J, Gupta L, Kirkwood K, Dobrev E, Levitan R, O’Sullivan K, Overbey J, Santos M, Williams D, Williams P, Ye X, Mack M, Adame T, Settele N, Adams J, Ryan W, Grayburn P, Chen FY, Nohria A, Cohn L, Shekar P, Aranki S, Couper G, Davidson M, Bolman RM, Lawrence R, Blackstone EH, Geither C, Berroteran L, Dolney D, Doud K, Fleming S, Palumbo R, Whitman C, Sankovic K, Sweeney DK, Pattakos G, Clarke PA, Argenziano M, Williams M, Goldsmith L, Smith CR, Naka Y, Stewart A, Schwartz A, Bell D, Van Patten D, Sreekanth S, Alexander JH, Milano CA, Glower DD, Mathew JP, Harrison JK, Welsh S, Berry MF, Parsa CJ, Tong BC, Williams JB, Ferguson TB, Kypson AP, Rodriguez E, Harris M, Akers B, O’Neal A, Puskas JD, Guyton R, Baer J, Baio K, Neill AA, Senechal M, Dagenais F, O’Connor K, Dussault G, Ballivian T, Keilani S, Speir AM, Magee P, Ad N, Keyte S, Dang M, Slaughter M, Headlee M, Moody H, Solankhi N, Birks E, Groh MA, Shell LE, Shepard SA, Trichon BH, Nanney T, Hampton LC, Mangusan R, D’Alessandro DA, DeRose JJ, Goldstein DJ, Bello R, Jakobleff W, Garcia M, Taub C, Spevak D, Swayze R, Sookraj N, Perrault LP, Basmadjian AJ, Bouchard D, Carrier M, Cartier R, Pellerin M, Tanguay JF, El-Hamamsy I, Denault A, Lacharité J, Robichaud S, Horvath KA, Corcoran PC, Siegenthaler MP, Murphy M, Iraola M, Greenberg A, Sai-Sudhakar C, Hasan A, McDavid A, Kinn B, Pagé P, Sirois C, Young CA, Beach D, Villanueva R, Woo YJ, Mayer ML, Bowdish M, Starnes VA, Shavalle D, Matthews R, Javadifar S, Romar L, Kron IL, Johnston K, Dent JM, Kern J, Keim J, Burks S, Gahring K, Bull DA, Desvigne-Nickens P, Dixon DO, Haigney M, Holubkov R, Jacobs A, Miller F, Murkin JM, Spertus J, Wechsler AS, Sellke F, McDonald CL, Byington R, Dickert N, Dixon DO, Ikonomidis JS, Williams DO, Yancy CW, Fang JC, Giannetti N, Richenbacher W, Rao V, Furie KL, Miller R, Pinney S, Roberts WC, Walsh MN, Hung J, Zeng X, Kilcullen N, Hung D, Keteyian S, Aldred H, Brawner C, Mathew J, Browndyke J, Toulgoat-Dubois Y. Cost-Effectiveness of Mitral Valve Repair Versus Replacement for Severe Ischemic Mitral Regurgitation. Circ Cardiovasc Qual Outcomes 2018. [DOI: 10.1161/circoutcomes.117.004466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Bart S. Ferket
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
| | - Gorav Ailawadi
- Division of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville (G.A.)
| | - Annetine C. Gelijns
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
| | - Michael A. Acker
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia (M.A.A.)
| | | | - Helena L. Chang
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
| | - Denis Bouchard
- Montréal Heart Institute, University of Montréal, QC, Canada (D.B.)
| | | | - Robert E. Michler
- Department of Cardiovascular and Thoracic Surgery, Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY (R.E.M.)
| | - Ellen G. Moquete
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
| | - Pierre Voisine
- Institut Universitaire de Cardiologie de Québec, Hôpital Laval, Canada (P.V.)
| | - John C. Mullen
- Division of Cardiac Surgery, University of Alberta, Edmonton, Canada (J.C.M.)
| | - Anuradha Lala
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
| | - Michael J. Mack
- Department of Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott & White Health, Plano, TX (M.J.M., R.L.S.)
| | - A. Marc Gillinov
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, OH (A.M.G.)
| | - Vinod H. Thourani
- Clinical Research Unit, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA and Department of Cardiac Surgery, Med-Star Heart & Vascular Institute, Washington, DC (V.H.T.)
| | - Marissa A. Miller
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (M.A.M.)
| | - James S. Gammie
- Division of Cardiac Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore (J.S.G.)
| | - Michael K. Parides
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
| | - Emilia Bagiella
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
| | - Robert L. Smith
- Department of Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott & White Health, Plano, TX (M.J.M., R.L.S.)
| | - Peter K. Smith
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC (P.K.S.)
| | - Judy W. Hung
- Division of Cardiology, Massachusetts General Hospital, Boston (J.W.H.)
| | | | - Eric A. Rose
- Department of Cardiac Surgery, Mount Sinai Health System, New York, NY (E.A.R.)
| | - Patrick T. O’Gara
- Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA (P.T.O.)
| | - Alan J. Moskowitz
- International Center for Health Outcomes and Innovation Research, the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (B.S.F., A.C.G., H.L.C., E.G.M., A.L., M.K.P., E.B., A.J.M.)
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Abstract
Left ventricular assist device (LVAD) treatment may lead to reverse remodeling in heart failure patients. Selected patients can recover heart function and be eligible for LVAD explantation. Surgical methods for explanting an LVAD have been reported using various surgical accesses and different degrees of retained device material. We report a surgical technique for achieving a complete pump removal, with an emphasis on the technical details of inflow and outflow pump cannula management.
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Affiliation(s)
| | | | | | | | - Mark Slaughter
- Department of Thoracic and Cardiovascular Surgery University of Louisville 201 Abraham Flexner Way, Suite 1200 Louisville, KY 40202
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Bitar A, Vijayakrishnan R, Lenneman A, Birks E, Massey T, Slaughter M, Abramov D. The Use of Eptifibatide Alone or in Combination With Heparin or Argatroban for Suspected Thrombosis in Patients With Left Ventricular Assist Devices. Artif Organs 2017. [DOI: 10.1111/aor.12910] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Abbas Bitar
- University of Louisville Hospital-Advanced Heart Failure; Louisville KY USA
| | | | - Andrew Lenneman
- University of Louisville Hospital-Advanced Heart Failure; Louisville KY USA
| | - Emma Birks
- University of Louisville Hospital-Advanced Heart Failure; Louisville KY USA
| | - Todd Massey
- University of Louisville Hospital-Advanced Heart Failure; Louisville KY USA
| | - Mark Slaughter
- University of Louisville Hospital-Advanced Heart Failure; Louisville KY USA
| | - Dmitry Abramov
- University of Louisville Hospital-Advanced Heart Failure; Louisville KY USA
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Kapoor A, Birks E, Lenneman A, McCants K. Posterior Reversible Encephalopathy Syndrome after Heart Transplantation: Diagnosis and Immunosuppressive Therapy. Tex Heart Inst J 2017; 44:205-208. [PMID: 28761402 DOI: 10.14503/thij-15-5007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Posterior reversible encephalopathy syndrome, an infrequent neurotoxicity associated with the use of tacrolimus, was first described in 1996, as a reversible syndrome manifested by headache, altered mental function, seizures, and visual disturbances. We describe the case of a 37-year-old woman who developed neurologic symptoms consistent with encephalopathy after treatment with tacrolimus, which was prescribed to maintain immunosuppression after orthotopic heart transplantation. This report also discusses the imaging methods used in the diagnosis of posterior reversible encephalopathy and highlights the difficulty of maintaining immunosuppression and managing medication-related adverse effects, while taking into account the risk of acute rejection after transplantation.
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Jakovljevic DG, Yacoub MH, Schueler S, MacGowan GA, Velicki L, Seferovic PM, Hothi S, Tzeng BH, Brodie DA, Birks E, Tan LB. Left Ventricular Assist Device as a Bridge to Recovery for Patients With Advanced Heart Failure. J Am Coll Cardiol 2017; 69:1924-1933. [PMID: 28408022 PMCID: PMC5388890 DOI: 10.1016/j.jacc.2017.02.018] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/04/2017] [Accepted: 02/06/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation, as destination therapy, or in some patients, as a bridge to recovery. OBJECTIVES This study evaluated whether patients undergoing an LVAD bridge-to-recovery protocol can achieve cardiac and physical functional capacities equivalent to those of healthy controls. METHODS Fifty-eight male patients-18 implanted with a continuous-flow LVAD, 16 patients with LVAD explanted (recovered patients), and 24 heart transplant candidates (HTx)-and 97 healthy controls performed a maximal graded cardiopulmonary exercise test with continuous measurements of respiratory gas exchange and noninvasive (rebreathing) hemodynamic data. Cardiac function was represented by peak exercise cardiac power output (mean arterial blood pressure × cardiac output) and functional capacity by peak exercise O2 consumption. RESULTS All patients demonstrated a significant exertional effort as demonstrated with the mean peak exercise respiratory exchange ratio >1.10. Peak exercise cardiac power output was significantly higher in healthy controls and explanted LVAD patients compared with other patients (healthy 5.35 ± 0.95 W; explanted 3.45 ± 0.72 W; LVAD implanted 2.37 ± 0.68 W; and HTx 1.31 ± 0.31 W; p < 0.05), as was peak O2 consumption (healthy 36.4 ± 10.3 ml/kg/min; explanted 29.8 ± 5.9 ml/kg/min; implanted 20.5 ± 4.3 ml/kg/min; and HTx 12.0 ± 2.2 ml/kg/min; p < 0.05). In the LVAD explanted group, 38% of the patients achieved peak cardiac power output and 69% achieved peak O2 consumption within the ranges of healthy controls. CONCLUSIONS The authors have shown that a substantial number of patients who recovered sufficiently to allow explantation of their LVAD can even achieve cardiac and physical functional capacities nearly equivalent to those of healthy controls.
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Affiliation(s)
- Djordje G Jakovljevic
- Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, and Clinical Research Facility, Newcastle Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
| | | | - Stephan Schueler
- Cardiothoracic Centre, Freeman Hospital, and Institute of Genetic Medicine Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Guy A MacGowan
- Cardiothoracic Centre, Freeman Hospital, and Institute of Genetic Medicine Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lazar Velicki
- Faculty of Medicine, University of Novi Sad, and Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases Vojvodina, Novi Sad, Serbia
| | - Petar M Seferovic
- Cardiology Department, Clinical Centre Serbia, Medical School, Belgrade, Serbia
| | - Sandeep Hothi
- Physiological Laboratory and Murray Edwards College, University of Cambridge, Cambridge, and Department of Cardiology, Glenfield Hospital, Leicester, United Kingdom
| | - Bing-Hsiean Tzeng
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital and Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - David A Brodie
- Cardiovascular Research Centre, Buckinghamshire New University, Bucks, London, United Kingdom
| | - Emma Birks
- Department of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky
| | - Lip-Bun Tan
- Leeds General Infirmary, Cardiology and Institute of Medical Sciences, Leeds University, Leeds, United Kingdom
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Pillarella J, Vaidya G, Salgado B, Dunbar Matos C, Vijayakrishnan R, Lenneman A, Slaughter M, Birks E, Abramov D. RA Pressure and RV Enlargement Are Predictive of Heart Failure Hospitalizations in Patients with LVAD. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1224] [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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Teuteberg JJ, Slaughter MS, Rogers JG, McGee EC, Pagani FD, Gordon R, Rame E, Acker M, Kormos RL, Salerno C, Schleeter TP, Goldstein DJ, Shin J, Starling RC, Wozniak T, Malik AS, Silvestry S, Ewald GA, Jorde UP, Naka Y, Birks E, Najarian KB, Hathaway DR, Aaronson KD. The HVAD Left Ventricular Assist Device: Risk Factors for Neurological Events and Risk Mitigation Strategies. JACC Heart Fail 2016; 3:818-28. [PMID: 26450000 DOI: 10.1016/j.jchf.2015.05.011] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 05/20/2015] [Accepted: 05/26/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the risk factors for ischemic in hemorrhage cerebrovascular events in patients supported by the HeartWare ventricular assist device (HVAD). BACKGROUND Patients supported with left ventricular assist devices are at risk for both ischemic and hemorrhagic cerebrovascular events. METHODS Patients undergoing implantation with a HVAD as part of the bridge-to-transplant trial and subsequent continued access protocol were included. Neurological events (ischemic cerebrovascular accidents [ICVAs] and hemorrhagic cerebrovascular accidents [HCVAs]) were assessed, and the risk factors for these events were evaluated in a multivariable model. RESULTS A total of 382 patients were included: 140 bridge-to-transplant patients from the ADVANCE (Evaluation of the HeartWare Left Ventricular Assist Device for the Treatment of Advanced Heart Failure) clinical trial and 242 patients from the continued access protocol. Patients had a mean age of 53.2 years; 71.2% were male, and 68.1% were white. Thirty-eight percent had ischemic heart disease, and the mean duration of support was 422.7 days. The overall prevalence of ICVA was 6.8% (26 of 382); for HCVA, it was 8.4% (32 of 382). Pump design modifications and a protocol-driven change in the antiplatelet therapy reduced the prevalence of ICVA from 6.3% (17 of 272) to 2.7% (3 of 110; p = 0.21) but had a negligible effect on the prevalence of HVCA (8.8% [24 of 272] vs. 6.4% [7 of 110]; p = 0.69). Multivariable predictors of ICVA were aspirin ≤81 mg and atrial fibrillation; predictors of HCVA were mean arterial pressure >90 mm Hg, aspirin ≤81 mg, and an international normalized ratio >3.0. Eight of the 30 participating sites had established improved blood pressure management (IBPM) protocols. Although the prevalence of ICVA for those with and without IBPM protocols was similar (5.3% [6 of 114] vs. 5.2% [14 of 268]; p = 0.99), those with IBPM protocols had a significantly lower prevalence of HCVA (1.8% [2 of 114] vs. 10.8% [29 of 268]; p = 0.0078). CONCLUSIONS Anticoagulation, antiplatelet therapy, and blood pressure management affected the prevalence of cerebrovascular events after implantation of the HVAD. Attention to these clinical parameters can have a substantial impact on the occurrence of serious neurological events. (Evaluation of the HeartWare Left Ventricular Assist Device for the Treatment of Advanced Heart Failure [ADVANCE]; NCT00751972).
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Affiliation(s)
| | | | | | | | | | | | - Eduardo Rame
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael Acker
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert L Kormos
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | | | | | | | | | | | | | | | | | | | | | - Emma Birks
- University of Louisville, Louisville, Kentucky
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Kiernan MS, Najjar S, Birks E, Uriel N, Ewald G, Leadley K, Patel C. BODY MASS INDEX AND OUTCOMES OF PATIENTS SUPPORTED BY THE HEARTWARE VENTRICULAR ASSIST SYSTEM. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31271-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hawkins L, Birks E, Clark E, Drummond A, Lagogianni C, Lincoln NB, Milligan H, Mistri A, Sprigg N, Tyrrell P, Ward N, Worthington A, Worthington E. An Investigation of post-stroke fatigue: The Nottingham Fatigue After Stroke (NotFAST) study. International Journal of Therapy and Rehabilitation 2015. [DOI: 10.12968/ijtr.2015.22.sup8.s7] [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: 11/11/2022]
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Cheng A, Trivedi J, Lenneman A, Birks E, Slaughter M. Use of Extra-Corporeal Membrane Oxygenation in Patients Listed for Heart Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.493] [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: 11/30/2022] Open
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Bolli R, Birks E, Flaherty MP, Keith M, Ghafghazi S. Response to letter regarding article, "Cell therapy for heart failure: a comprehensive overview of experimental and clinical studies, current challenges, and future directions". Circ Res 2014; 115:e33-4. [PMID: 25378533 DOI: 10.1161/circresaha.114.305263] [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] [Indexed: 11/16/2022]
Affiliation(s)
- Roberto Bolli
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY
| | - Emma Birks
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY
| | - Michael P Flaherty
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY
| | - Matthew Keith
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY
| | - Shahab Ghafghazi
- Division of Cardiovascular Medicine, University of Louisville, Louisville, KY
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Bhatia N, Voelkel A, Sharma U, Birks E, McCants K. SAFETY AND OUTCOMES OF INDUCTION IMMUNOSUPPRESSION FOR CARDIAC TRANSPLANTATION IN PATIENTS WITH ACTIVE DRIVELINE INFECTION. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60857-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mohammad Alahmad M, Alkhalil B, Sayfo S, Spayd S, Slaughter M, Birks E, Lenneman A, Mccants K. Diagnostic Utility of Capsule Endoscopy in Evaluating GI Bleeding in LVAD Patients. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.636] [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: 11/26/2022] Open
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Taimeh Z, Vakil K, Rawasia W, Cavallazzi R, Nunley D, Birks E, Lenneman C. Thoracic Organ Transplantation for Autoimmune-Mediated Disease Is Not Associated With Detrimental Clinical Outcomes. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.461] [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] Open
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Espinosa Ginic MA, Alnabki Z, Keith MC, Vongooru H, Underwood B, Wiemken T, Wagner S, McCants KC, Birks E, Prabhu SD. Myocardial Recovery with Optimization of Medical Management in Patients with Advanced Systolic Heart Failure. J Card Fail 2013. [DOI: 10.1016/j.cardfail.2013.06.155] [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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McCants K, McCants J, Combs P, Raheja P, Slaughter M, Birks E. Predisposition to Infection and Bleeding in Mechanical Assist Devices (LVADs) Recepients after Dental Procedures: A Single Center Experience. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Feldman D, Pamboukian SV, Teuteberg JJ, Birks E, Lietz K, Moore SA, Morgan JA, Arabia F, Bauman ME, Buchholz HW, Deng M, Dickstein ML, El-Banayosy A, Elliot T, Goldstein DJ, Grady KL, Jones K, Hryniewicz K, John R, Kaan A, Kusne S, Loebe M, Massicotte MP, Moazami N, Mohacsi P, Mooney M, Nelson T, Pagani F, Perry W, Potapov EV, Eduardo Rame J, Russell SD, Sorensen EN, Sun B, Strueber M, Mangi AA, Petty MG, Rogers J. The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: Executive summary. J Heart Lung Transplant 2013; 32:157-87. [DOI: 10.1016/j.healun.2012.09.013] [Citation(s) in RCA: 850] [Impact Index Per Article: 77.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 09/14/2012] [Indexed: 02/08/2023] Open
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Nanka O, Krejci E, Pesevski Z, Sedmera D, Smart N, Rossdeutsch A, Dube KN, Riegler J, Price AN, Taylor A, Muthurangu V, Turner M, Lythgoe MF, Riley PR, Kryvorot S, Vladimirskaya T, Shved I, Schwarzl M, Seiler S, Huber S, Steendijk P, Maechler H, Truschnig-Wilders M, Pieske B, Post H, Caprio C, Baldini A, Chiavacci E, Dolfi L, Verduci L, Meghini F, Cremisi F, Pitto L, Kuan TC, Chen MC, Yang TH, Wu WT, Lin CS, Rai H, Kumar S, Sharma AK, Mastana S, Kapoor A, Pandey CM, Agrawal S, Sinha N, Orlowska-Baranowska EH, Placha G, Gora J, Baranowski R, Abramczuk E, Hryniewiecki T, Gaciong Z, Verschuren JJW, Wessels JAM, Trompet S, Stott DJ, Sattar N, Buckley B, Guchelaar HJ, Jukema JW, Gharanei M, Hussain A, Mee CJ, Maddock HL, Wijnen WJ, Van Den Oever S, Van Der Made I, Hiller M, Tijsen AJ, Pinto YM, Creemers EE, Nikulina SUY, Chernova A, Petry A, Rzymski T, Kracun D, Riess F, Pike L, Harris AL, Gorlach A, Katare R, Oikawa A, Riu F, Beltrami AP, Cesseli D, Emanueli C, Madeddu P, Zaglia T, Milan G, Franzoso M, Pesce P, Sarais C, Sandri M, Mongillo M, Butler TJ, Seymour AML, Ashford D, Jaffre F, Bussen M, Ferrara N, Koch WJ, Leosco D, Akhmedov A, Klingenberg R, Brokopp C, Hof D, Zoller S, Corti R, Gay S, Flohrschutz I, Von Eckardstein A, Hoerstrup SP, Luescher TF, Heijman J, Zaza A, Johnson DM, Rudy Y, Peeters RLM, Volders PGA, Westra RL, Martin GR, Morais CAS, Oliveira SHV, Brandao FC, Gomes IF, Lima LM, Fujita S, Okamoto R, Taniguchi M, Konishi K, Goto I, Engelhardt S, Sugimoto K, Nakamura M, Shiraki K, Buechler C, Ito M, Kararigas G, Nguyen BT, Jarry H, Regitz-Zagrosek V, Van Bilsen M, Daniels A, Munts C, Janssen BJA, Van Der Vusse GJ, Van Nieuwenhoven FA, Montalvo C, Villar AV, Merino D, Garcia R, Llano M, Ares M, Hurle MA, Nistal JF, Dembinska-Kiec A, Beata Kiec-Wilk BKW, Anna Polus AP, Urszula Czech UC, Tatiana Konovaleva TK, Gerd Schmitz GS, Bertrand L, Balteau M, Timmermans A, Viollet B, Sakamoto K, Feron O, Horman S, Vanoverschelde JL, Beauloye C, De Meester C, Martinez E, Martin R, Miana M, Jurado R, Gomez-Hurtado N, Bartolome MV, San Roman JA, Lahera V, Nieto ML, Cachofeiro V, Rochais F, Sturny R, Mesbah K, Miquerol L, Kelly RG, Messaoudi S, Gravez B, Tarjus A, Pelloux V, Samuel JL, Delcayre C, Launay JM, Clement K, Farman N, Jaisser F, Hadyanto L, Castellani C, Vescovo G, Ravara B, Tavano R, Pozzobon M, De Coppi P, Papini E, Vettor R, Thiene G, Angelini A, Meloni M, Caporali A, Cesselli D, Fortunato O, Avolio E, Madeddu P, Beltrami AP, Emanueli C, Schindler R, Simrick S, Brand T, Dube KN, Riley PR, Smart NS, Oikawa A, Katare R, Herman A, Emanueli C, Madeddu P, Roura Ferrer S, Rodriguez Bago J, Soler-Botija C, Pujal JM, Galvez-Monton C, Prat-Vidal C, Llucia-Valldeperas A, Blanco J, Bayes-Genis A, Foldes G, Maxime M, Ali NN, Schneider MD, Harding SE, Reni C, Mangialardi G, Caporali A, Meloni M, Emanueli C, Madeddu P, De Pauw A, Sekkali B, Friart A, Ding H, Graffeuil A, Catalucci D, Balligand JL, Azibani F, Tournoux F, Schlossarek S, Polidano E, Fazal L, Merval R, Carrier L, Chatziantoniou C, Samuel JL, Delcayre C, Buyandelger B, Linke W, Zou P, Kostin S, Ku C, Felkin L, Birks E, Barton P, Sattler M, Knoell R, Schroder K, Benkhoff S, Shimokawa H, Grisk O, Brandes RP, Parepa IR, Mazilu L, Suceveanu AI, Suceveanu A, Rusali L, Cojocaru L, Matei L, Toringhibel M, Craiu E, Pires AL, Pinho M, Pinho S, Sena C, Seica R, Leite-Moreira A, Zaglia T, Milan G, Franzoso M, Dabroi F, Pesce P, Schiaffino S, Sandri M, Mongillo M, Kiseleva E, Krukov N, Nikitin O, Ardatova L, Mourouzis I, Pantos C, Kokkinos AD, Cokkinos DV, Scoditti E, Massaro M, Carluccio MA, Pellegrino M, Calabriso N, Gastaldelli A, Storelli C, De Caterina R, Lindner D, Zietsch C, Schultheiss HP, Tschope C, Westermann D, Everaert BR, Nijenhuis VJ, Reith FCM, Hoymans VY, Timmermans JP, Vrints CJ, Simova I, Mateev H, Katova T, Haralanov L, Dimitrov N, Mironov N, Golitsyn SP, Sokolov SF, Yuricheva YUA, Maikov EB, Shlevkov NB, Rosenstraukh LV, Chazov EI, Radosinska J, Knezl V, Benova T, Slezak J, Urban L, Tribulova N, Virag L, Kristof A, Kohajda ZS, Szel T, Husti Z, Baczko I, Jost N, Varro A, Sarusi A, Farkas AS, Orosz SZ, Forster T, Varro A, Farkas A, Zakhrabova-Zwiauer OM, Hardziyenka M, Nieuwland R, Tan HL, Raaijmakers AJA, Bourgonje VJA, Kok GJM, Van Veen AAB, Anderson ME, Vos MA, Bierhuizen MFA, Benes J, Sebestova B, Sedmera D, Ghouri IA, Kemi OJ, Kelly A, Burton FL, Smith GL, Bourgonje VJA, Vos MA, Ozdemir S, Acsai K, Doisne N, Van Der Nagel R, Beekman HDM, Van Veen TAB, Sipido KR, Antoons G, Harmer SC, Mohal JS, Kemp D, Tinker A, Beech D, Burley DS, Cox CD, Wann KT, Baxter GF, Wilders R, Verkerk A, Fragkiadaki P, Germanakis G, Tsarouchas K, Tsitsimpikou C, Tsardi M, George D, Tsatsakis A, Rodrigues P, Barros C, Najmi AK, Khan V, Akhtar M, Pillai KK, Mujeeb M, Aqil M, Bayliss CR, Messer AE, Leung MC, Ward D, Van Der Velden J, Poggesi C, Redwood CS, Marston S, Vite A, Gandjbakhch E, Gary F, Fressart V, Leprince P, Fontaine G, Komajda M, Charron P, Villard E, Falcao-Pires I, Gavina C, Hamdani N, Van Der Velden J, Stienen GJM, Niessens HWM, Leite-Moreira AF, Paulus WJ, Messer AE, Marston S, Memo M, Leung MC, Bayliss CR, Memo M, Messer AE, Marston SB, Vafiadaki E, Qian J, Arvanitis DA, Sanoudou D, Kranias EG, Elmstedt N, Lind B, Ferm-Widlund K, Westgren M, Brodin LA, Mansfield C, West T, Ferenczi M, Wijnker PJM, Foster DB, Coulter A, Frazier A, Murphy AM, Stienen GJM, Van Der Velden J, Shah M, Sikkel MB, Desplantez T, Collins TP, O' Gara P, Harding SE, Lyon AR, Macleod KT, Ottesen AH, Louch WE, Carlson C, Landsverk OJB, Stridsberg M, Sjaastad I, Oie E, Omland T, Christensen G, Rosjo H, Cartledge J, Clark LA, Ibrahim M, Siedlecka U, Navaratnarajah M, Yacoub MH, Camelliti P, Terracciano CM, Chester A, Gonzalez-Tendero A, Torre I, Garcia-Garcia F, Dopazo J, Gratacos E, Taylor D, Bhandari S, Seymour AM, Fliegner D, Jost J, Bugger H, Ventura-Clapier R, Regitz-Zagrosek V, Carpi A, Campesan M, Canton M, Menabo R, Pelicci PG, Giorgio M, Di Lisa F, Hancock M, Venturini A, Al-Shanti N, Stewart C, Ascione R, Angelini G, Suleiman MS, Kravchuk E, Grineva E, Galagudza M, Kostareva A, Bairamov A, Krychtiuk KA, Watzke L, Kaun C, Demyanets S, Pisoni J, Kastl SP, Huber K, Maurer G, Wojta J, Speidl WS, Varga ZV, Farago N, Zvara A, Kocsis GF, Pipicz M, Csonka C, Csont T, Puskas GL, Ferdinandy P, Klevstigova M, Silhavy J, Manakov D, Papousek F, Novotny J, Pravenec M, Kolar F, Novakova O, Novak F, Neckar J, Barallobre-Barreiro J, Didangelos A, Yin X, Fernandez-Caggiano M, Drozdov I, Willeit P, Domenech N, Mayr M, Lemoine S, Allouche S, Coulbault L, Galera P, Gerard JL, Hanouz JL, Suveren E, Whiteman M, Baxter GF, Studneva IM, Pisarenko O, Shulzhenko V, Serebryakova L, Tskitishvili O, Timoshin A, Fauconnier J, Meli AC, Thireau J, Roberge S, Lompre AM, Jacotot E, Marks AM, Lacampagne A, Dietel B, Altendorf R, Daniel WG, Kollmar R, Garlichs CD, Verduci L, Parente V, Balasso S, Pompilio G, Colombo G, Milano G, Squadroni L, Cotelli F, Pozzoli O, Capogrossi MC, Ajiro Y, Saegusa N, Iwade K, Giles WR, Stafforini DM, Spitzer KW, Sirohi R, Candilio L, Babu G, Roberts N, Lawrence D, Sheikh A, Kolvekar S, Yap J, Hausenloy DJ, Yellon DM, Aslam M, Rohrbach S, Schlueter KD, Piper HM, Noll T, Guenduez D, Malinova L, Ryabukho VP, Lyakin DV, Denisova TP, Montoro-Garcia S, Shantsila E, Lip GYH, Kalaska B, Sokolowska E, Kaminski K, Szczubialka K, Kramkowski K, Mogielnicki A, Nowakowska M, Buczko W, Stancheva N, Mekenyan E, Gospodinov K, Tisheva S, Darago A, Rutkai I, Kalasz J, Czikora A, Orosz P, Bjornson HD, Edes I, Papp Z, Toth A, Riches K, Warburton P, O'regan DJ, Ball SG, Turner NA, Wood IC, Porter KE, Kogaki S, Ishida H, Nawa N, Takahashi K, Baden H, Ichimori H, Uchikawa T, Mihara S, Miura K, Ozono K, Lugano R, Padro T, Garcia-Arguinzonis M, Badimon L, Yin X, Ferraro F, Viner R, Ho J, Cutler D, Mayr M, Matchkov V, Aalkjaer C, Mangialardi G, Katare R, Oikawa A, Madeddu P, Krijnen PAJ, Hahn NE, Kholova I, Sipkens JA, Van Alphen FP, Simsek S, Schalkwijk CG, Van Buul JD, Van Hinsbergh VWM, Niessen HWM, Simova I, Katova T, Haralanov L, Caro CG, Seneviratne A, Monaco C, Hou D, Singh J, Gilson P, Burke MG, Heraty KB, Krams R, Coppola G, Albrecht K, Schgoer W, Wiedemann D, Bonaros N, Steger C, Theurl M, Stanzl U, Kirchmair R, Amadesi S, Fortunato O, Reni C, Katare R, Meloni M, Ascione R, Spinetti G, Cangiano E, Valgimigli M, Madeddu P, Caporali A, Meloni M, Miller AM, Cardinali A, Vierlinger K, Fortunato O, Spinetti G, Madeddu P, Emanueli C, Pagano G, Liccardo D, Zincarelli C, Femminella GD, Lymperopoulos A, De Lucia C, Koch WJ, Leosco D, Rengo G, Hinkel R, Husada W, Trenkwalder T, Di Q, Lee S, Petersen B, Bock-Marquette I, Niemann H, Di Maio M, Kupatt C, Nourian M, Yassin Z, Kelishadi R, Nourian M, Kelishadi R, Yassin Z, Memarian SH, Heidari A, Leuner A, Poitz DM, Brunssen C, Ravens U, Strasser RH, Morawietz H, Vogt F, Grahl A, Flege C, Marx N, Borinski M, De Geest B, Jacobs F, Muthuramu I, Gordts SC, Van Craeyveld E, Herijgers P, Weinert S, Poitz DM, Medunjanin S, Herold J, Schmeisser A, Strasser RH, Braun-Dullaeus RC, Wagner AH, Moeller K, Adolph O, Schwarz M, Schwale C, Bruehl C, Nobiling R, Wieland T, Schneider SW, Hecker M, Cross A, Strom A, Cole J, Goddard M, Hultgardh-Nilsson A, Nilsson J, Mauri C, Monaco C, Mitkovskaya NP, Kurak TA, Oganova EG, Shkrebneva EI, Kot ZHN, Statkevich TV, Molica F, Burger F, Matter CM, Thomas A, Staub C, Zimmer A, Cravatt B, Pacher P, Steffens S, Blanco R, Sarmiento R, Parisi C, Fandino S, Blanco F, Gigena G, Szarfer J, Rodriguez A, Garcia Escudero A, Riccitelli MA, Wantha S, Simsekyilmaz S, Megens RT, Van Zandvoort MA, Liehn E, Zernecke A, Klee D, Weber C, Soehnlein O, Lima LM, Carvalho MG, Gomes KB, Santos IR, Sousa MO, Morais CAS, Oliveira SHV, Gomes IF, Brandao FC, Lamego MRA, Lima LM, Fornai L, Angelini A, Kiss A, Giskes F, Eijkel G, Fedrigo M, Valente ML, Thiene G, Heeren RMA, Grdinic A, Vojvodic D, Djukanovic N, Grdinic AG, Obradovic S, Majstorovic I, Rusovic S, Vucinic Z, Tavciovski D, Ostojic M, Lin CS, Kuan TC, Lai SC, Chen MY, Wu HT, Gouweleeuw L, Oberdorf-Maass SU, De Boer RA, Van Gilst WH, Maass AH, Van Gelder IC, Azibani F, Benard L, Schlossarek S, Merval R, Tournoux F, Launay JM, Carrier L, Chatziantoniou C, Samuel JL, Delcayre C, Li C, Warren D, Shanahan CM, Zhang QP, Bye A, Vettukattil R, Aspenes ST, Giskeodegaard G, Gribbestad IS, Wisloff U, Bathen TF, Cubedo J, Padro T, Alonso R, Mata P, Badimon L, Ivic I, Vamos Z, Cseplo P, Kosa D, Torok O, Hamar J, Koller A, Norita K, De Noronha SV, Sheppard MN, Torre I, Amat-Roldan I, Iruretagoiena I, Psilodimitrakopoulos S, Gonzalez-Tendero A, Crispi F, Artigas D, Loza-Alvarez P, Gratacos E, Harrison JC, Smart SD, Besely EH, Kelly JR, Yao Y, Sammut IA, Hoepfner M, Kuzyniak W, Sekhosana E, Hoffmann B, Litwinski C, Pries A, Ermilov E, Fontoura D, Lourenco AP, Vasques-Novoa F, Pinto JP, Roncon-Albuquerque R, Leite-Moreira AF, Oyeyipo IP, Olatunji LA, Usman TO, Olatunji VA, Bacova B, Radosinska J, Viczenczova C, Knezl V, Dosenko V, Benova T, Goncalvesova E, Vanrooyen J, Tribulova N, Maulik SK, Seth S, Dinda AK, Jaiswal A, Mearini G, Khajetoorians D, Kraemer E, Gedicke-Hornung C, Precigout G, Eschenhagen T, Voit T, Garcia L, Lorain S, Carrier L, Mendes-Ferreira P, Maia-Rocha C, Adao R, Lourenco AP, Cerqueira RJ, Mendes MJ, Castro-Chaves P, De Keulenaer GW, Leite-Moreira AF, Bras-Silva C, Ruiter G, Wong YY, Lubberink M, Knaapen P, Raijmakers P, Lammertsma AA, Marcus JT, Westerhof N, Van Der Laarse WJ, Vonk-Noordegraaf A, Poitz DM, Steinbronn N, Koch E, Steiner G, Strasser RH, Berezin A, Lisovaya OA, Soldatova AM, Kuznetcov VA, Yenina TN, Rychkov AYU, Shebeko PV, Altara R, Hessel MHM, Hermans JJR, Janssen BJA, Blankesteijn WM, Soldatova AM, Kuznetcov VA, Yenina TN, Rychkov AYU, Shebeko PV, Berezin A, Berezina TA, Seden V, Bonanad C, Nunez J, Navarro D, Chilet MF, Sanchis F, Bodi V, Minana G, Chaustre F, Forteza MJ, Llacer A, Femminella GD, Rengo G, Galasso G, Zincarelli C, Liccardo D, Pagano G, De Lucia C. Poster session 3. Cardiovasc Res 2012. [DOI: 10.1093/cvr/cvr336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Strueber M, Birks E, Jansz P, O'Driscoll G, Wieselthaler G. 544: Clinical Results of the International HeartWare® LVAS Bridge to Transplant Trial. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Clark AL, Knosalla C, Birks E, Loebe M, Davos CH, Tsang S, Negassa A, Yacoub M, Hetzer R, Coats AJS, Anker SD. Heart transplantation in heart failure: The prognostic importance of body mass index at time of surgery and subsequent weight changes. Eur J Heart Fail 2007; 9:839-44. [PMID: 17532263 DOI: 10.1016/j.ejheart.2007.03.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2006] [Revised: 01/25/2007] [Accepted: 03/05/2007] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Heart transplantation is an important treatment for end-stage chronic heart failure. We studied the effect of body mass index (BMI), and the effect of subsequent weight change, on survival following transplantation in 1902 consecutive patients. METHODS AND RESULTS Patients were recruited from: London (n=553), Berlin (N=971) and Boston (N=378). Patients suitable for transplantation due to symptoms, low left ventricular ejection fraction (<or=30%) and peak oxygen consumption (<or=16 ml kg(-1) min(-1)) (N=237) were used as a comparator. In surviving transplanted patients, average duration of follow-up was 80 (SD 34) months. There were 805 deaths. One year survival was 72.7% (95% CI 72.68-72.72) and 5 year survival was 60.96% (61.94-61.99). Baseline BMI did not effect survival either as a continuous variable (hazard ratio (95% CI): 1.02; 0.99-1.04). Weight loss between transplant and 3 months was associated with worse survival (HR (95% CI) 2.6 (1.42-4.74)) compared with those who gained weight. In the reference group, increasing body mass index was related to survival. CONCLUSIONS Chronic heart failure patients with very low body weight can be transplanted successfully. The presence of underweight need not be an exclusion criterion for heart transplantation. Underweight patients appear to have a greater benefit from transplantation. Body weight increases after transplantation are not associated with adverse prognosis.
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Affiliation(s)
- Andrew L Clark
- Department of Cardiology, Univerity of Hull, and Department of Cardiac Surgery, Royal Brompton Hospital, London, UK.
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Haj-Yahia S, Mittal T, Birks E, Carby M, Petrou M, Pepper J, Dreyfus G, Amrani M. Lung fibrosis as a potential complication of the hemostatic tissue sealant, biologic glue (Bioglue). J Thorac Cardiovasc Surg 2007; 133:1387-8. [PMID: 17467473 DOI: 10.1016/j.jtcvs.2006.11.072] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 10/30/2006] [Accepted: 11/28/2006] [Indexed: 11/16/2022]
Affiliation(s)
- Saleem Haj-Yahia
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield Hospital, NHS Trust, London, UK.
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Knosalla C, Clark AL, Birks E, Loebe M, Davos CH, Tsang S, Yacoub M, Hetzer R, Coats AJ, Anker SD. Heart transplantation in heart failure: the prognostic importance of body mass index at time of surgery and subsequent weight changes. Thorac Cardiovasc Surg 2007. [DOI: 10.1055/s-2007-967486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Newell H, Smith JD, Rogers P, Birks E, Danskine AJ, Fawson RE, Rose ML. Sensitization following LVAD implantation using leucodepleted blood is not due to HLA antibodies. Am J Transplant 2006; 6:1712-7. [PMID: 16827875 DOI: 10.1111/j.1600-6143.2006.01342.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Implantation of left ventricular assist devices (LVAD) is associated with HLA antibody sensitization. The objective of this study was to determine the specificity of antibodies produced by LVAD recipients using a combination of ELISA, Luminex and microcytotoxicity assays. Fifty-one LVAD patients were studied, from 44 to 838 days post-implantation. No patient developed HLA antibodies, although 24 produced IgG antibodies detectable in both ELISA and Luminex assays. These antibodies manifest as positive reactions with class I and class II wells of the ELISA and also blank wells. In Luminex assays, they produce high MFI readings with the negative control beads. Antibodies were detected 18 to 228 days after implantation. This reactivity was found to be directed against bovine serum albumin (BSA), commonly used to block non-specific binding in ELISA and Luminex assays; absorption of sera with BSA-coated beads completely abrogated reactivity in all solid phase assays, but did not eliminate anti-HLA antibodies in control sera. Ten of the 24 patients have proceeded to transplantation, with a 1-year graft survival of 69%. In conclusion, it appears that implantation of LVADS disrupts immunoregulatory pathways leading to production of anti-albumin antibodies. These can be misinterpreted as anti-HLA antibodies in solid phase assays.
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Affiliation(s)
- H Newell
- Transplant Immunology, Harefield Hospital, Harefield, Middx UB9 6JH, UK
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46
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Tansley P, Yacoub M, Rimoldi O, Birks E, Hardy J, Hipkin M, Bowles C, Kindler H, Dutka D, Camici PG. Effect of left ventricular assist device combination therapy on myocardial blood flow in patients with end-stage dilated cardiomyopathy. J Heart Lung Transplant 2004; 23:1283-9. [PMID: 15539127 DOI: 10.1016/j.healun.2003.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2003] [Revised: 08/26/2003] [Accepted: 09/06/2003] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Changes in myocardial blood flow (MBF) and coronary flow reserve (CFR) are independent prognostic risk factors in idiopathic dilated cardiomyopathy (DCM). The aim of this study was to assess the impact of left ventricular unloading using left ventricular assist device (LVAD) combination therapy on resting MBF and CFR in patients with end-stage heart disease. METHODS We studied 11 patients with deteriorating end-stage DCM (New York Heart Association Class 4) treated with LVAD support combined with pharmacologic therapy in a recovery program. Absolute MBF was measured using oxygen-15-labeled water (H(2)(15)O) positron emission tomography (PET) at rest during LVAD support and 15 minutes after the LVAD was switched off. Data were corrected for rate pressure product (RPP) when appropriate. Hyperemic MBF (intravenous adenosine, 140 mug/kg . min) was also measured in 6 patients with the LVAD switched off. CFR was calculated as the ratio MBF adenosine/MBF LVAD off (corrected). Data are expressed as mean +/- SD. RESULTS At 317 +/- 193 days after device implantation, resting MBF was 0.95 +/- 0.29 (LVAD on) and 1.46 +/- 0.62 (LVAD off, corrected) ml/min . g (p = 0.01). MBF (LVAD on) was comparable with that of 11 age- and gender-matched normal controls (1.09 +/- 0.22 ml/min . g). CFR in the LVAD group was 1.49 +/- 0.99 compared with 3.56 +/- 1.42 in normal controls (p < 0.01). CONCLUSIONS During LVAD support, resting MBF (LVAD on) was comparable to MBF in normal controls and increased when the LVAD was switched off. However, CFR was significantly impaired, even though all patients studied showed varying degrees of myocardial recovery. The implications of these findings, particularly in the long term, require further study.
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Affiliation(s)
- Patrick Tansley
- Harefield Research Foundation, Harefield Hospital, Harefield, Middlesex, UK
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Hardy J, Terracciano C, Tansley P, Birks E, Bowles C, Khaghani A, Banner N, Yacoub M. Sustained reversal of electrical remodeling during and after left ventricular assist device (LVAD) support. J Heart Lung Transplant 2004. [DOI: 10.1016/j.healun.2003.11.033] [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: 11/26/2022] Open
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Hardy J, Tansley P, Birks E, Hipkin M, Khaghani A, Banner N, Yacoub M. Cardiac rhythm during and after explantation of left ventricular assist devices (LVAD) using the harefield recovery programme. J Heart Lung Transplant 2003. [DOI: 10.1016/s1053-2498(02)01090-2] [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] Open
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49
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Tansley P, Birks E, McDonald P, Hipkin M, Hardy J, Bowles C, Banner N, Khaghani A, Yacoub M. Serious abdominal complications of intra-peritoneal placement of left ventricular assist devices. J Heart Lung Transplant 2003. [DOI: 10.1016/s1053-2498(02)01089-6] [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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50
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Tansley P, Yacoub M, Rimoldi O, Birks E, Hardy J, Hipkin M, Bowles C, Dutka D, Camici P. The effect on microvascular function of combined mechanical circulatory support and pharmacological therapy during induction of myocardial recovery. J Heart Lung Transplant 2003. [DOI: 10.1016/s1053-2498(02)01070-7] [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] Open
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