Search Our Scientific Publications & Authors

ASAIO J 2021 Apr 21. Epub 2021 Apr 21.

From the Duke University Medical Center, Durham, North Carolina University of Alabama at Birmingham, Birmingham, Alabama University of Louisville, Louisville, Kentucky Washington Hospital Center, Washington, DC MedStar Washington Hospital Center, Washington, DC Washington University, St Louis, Missouri Intermountain Medical Center, Murray, Utah University of Washington, Seattle, Washington University of Michigan, Ann Arbor, Michigan.

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. Read More

ASAIO J 2021 Apr 21. Epub 2021 Apr 21.

From the The Christ Hospital Health Network, Cincinnati, Ohio The "Lindner" Research Center, Cincinnati, Ohio Advanced Heart Failure/Transplantation Program, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania Advanced Cardiac and Pulmonary Vascular Disease, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

The impact of preoperative end-diastolic left ventricular dimension (preLVEDD) on long-term outcomes with centrifugal continuous-flow left ventricular assist device (CF-LVAD) is not well established. Accordingly, we performed an analysis of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) registry to study this relationship. All patients with centrifugal CF-LVAD in the INTERMACS registry from June 2006 to December 2017 were screened. Read More

ASAIO J 2021 Apr 21. Epub 2021 Apr 21.

From the Section of Neurocritical Care and Emergency Neurology, Department of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland Division of Thoracic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland University of Maryland School of Medicine, Baltimore, Maryland Division of Surgical Critical Care, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.

Extracorporeal cardiopulmonary resuscitation (ECPR)-veno-arterial extracorporeal membrane oxygenation (ECMO) for refractory cardiac arrest-has grown rapidly, but its widespread adoption has been limited by frequent neurologic complications. With individual centers developing best practices, utilization may be increasing with an uncertain effect on outcomes. This study describes the recent ECPR experience at the University of Maryland Medical Center from 2016 through 2018, with attention to neurologic outcomes and predictors thereof. Read More

ASAIO J 2021 May;67(5):e94

From the Cardiovascular Center, Tufts Medical Center, Boston, MA.

ASAIO J 2021 May;67(5):583-587

Department of Cardiovascular Medicine.

To our knowledge, natural history has not been reported for cardiac sarcoidosis (CS) diagnosed by pathologic evaluation of the apical core at left ventricular assist device (LVAD) implantation or cardiac transplantation. We retrospectively identified 232 consecutive patients meeting CS criteria. Of these patients, 54 were diagnosed by pathologic confirmation of CS, 10 after evaluation of the apical core (LVAD implant) or explanted heart (transplant). Read More

ASAIO J 2021 May;67(5):573-582

From the Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan.

Clotting, anticoagulation, platelet consumption, and poor platelet function are major factors in clinical extracorporeal circulation (ECC). We have shown that nitric oxide-releasing (NOReL) coatings prevent thrombosis in a rabbit model of ECC without systemic anticoagulation. Nitric oxide-releasing prevents platelet adhesion and activation, resulting in preserved platelet count and function. Read More

ASAIO J 2021 May;67(5):572

ASAIO J 2021 May;67(5):529-535

Institute of Biocybernetics and Biomedical Engineer, Polish Academy of Science, Warsaw, Poland.

The purpose of this work was to investigate, using a lumped parameter model, the feasibility of increasing the pulsatility of a continuous-flow ventricular assist device (VAD) by implanting an active valvulated outflow cannula. A lumped parameter model was adopted for this study. VAD was modeled, starting from its pressure-flow characteristics. Read More

ASAIO J 2021 05;67(5):496-502

Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.

The role of extracorporeal membrane oxygenation (ECMO) in the management of severely ill patients with coronavirus disease 2019 (COVID-19) continues to evolve. The purpose of this study is to review a multi-institutional clinical experience in 100 consecutive patients, at 20 hospitals, with confirmed COVID-19 supported with ECMO. This analysis includes our first 100 patients with complete data who had confirmed COVID-19 and were supported with ECMO. Read More

ASAIO J 2021 Apr 22. Epub 2021 Apr 22.

From the Product Development Group Zurich, ETH Zurich, Zurich, Switzerland DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Cardiovascular Surgery, Berlin, Germany German Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany Division for Surgical Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland Steinbeis University Berlin, Institute (STI) of Cardiovascular Perfusion, Berlin, Germany Radiology, Stanford University, Stanford, California Cardiovascular Institute, Stanford University, Stanford, California.

Left ventricular end-diastolic volume (EDV) is an important parameter for monitoring patients with left ventricular assist devices (LVADs) and might be useful for automatic LVAD work adaptation. However, continuous information on the EDV is unavailable to date. The depolarization amplitude (DA) of the noncontact intracardiac electromyogram (iEMG) is physically related to the EDV. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania Department of Pediatrics, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania Department of Comparative Medicine, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.

We have miniaturized and optimized our implantable rotary blood pump developed to provide long-term mechanical right heart support for patients who have failing Fontan circulation. The objective of this study was to evaluate the miniaturized Fontan circulation assist device (mini-FCAD) during 30-day sheep studies (n = 5). A complete right heart bypass was performed and all return flow was supported by the pump. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Department of Cardiovascular Surgery, University Hospital Freiburg, Freiburg, Germany Department of Microsystems Engineering (IMTEK), Laboratory for Chemistry and Physics of Interfaces, University of Freiburg, Freiburg, Germany.

Blood compatible materials are a well-researched scientific field as such materials are required in a wide range of applications, for example, in heart-lung machines or ventricular assist devices. Surfaces coated with certain surface-bound neutral, water-swellable polymer networks have the ability to repel cells such as platelets and exhibit a significantly improved hemocompatibility. In this study, we investigate the interaction of platelets from whole blood with surfaces coated with photochemically generated surface-attached polymer networks based on polydimethyl acrylamide. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Germany Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany Department of Cardiovascular Surgery, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany Institute of Experimental and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Freiburg, Freiburg, Germany Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA.

Even after the introduction of extracorporeal cardiopulmonary resuscitation (ECPR), survival after cardiac arrest remains poor. Excess release of vasoactive cytokines may be a reason for cardiovascular instability and death after ECPR. Recently, an extracorporeal cytokine adsorption device (CytoSorb) to reduce elevated levels of circulating cytokines has been introduced. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, New York Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York.

Left ventricular assist devices (LVADs) are associated with the development of antihuman leukocyte antigen (HLA) antibodies, which can create a challenge for future transplantation in these patients. The differential effects of Heartmate 3 (HM3) versus Heartmate II (HMII) on de novo HLA allosensitization remain unknown. Patients who underwent HMII or HM3 implantation and had no prior HLA antibodies by solid-phase assay (Luminex) testing were included in this study. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York Department of Pediatrics, Columbia University Medical Center, New York Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee.

Decompensated right ventricular failure (RVF) in patients with pulmonary hypertension (PH) is fatal, with limited treatment options. Novel mechanical circulatory support systems have therapeutic potential for RVF, but the development of these devices requires a large animal disease model that replicates the pathophysiology observed in humans. We previously reported an effective disease model of PH in sheep through ligation of the left pulmonary artery (PA) and progressive occlusion of the main PA. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Department of Pediatrics, Division of Pediatric Critical Care, University of Mississippi Medical Center, Jackson, Mississippi Department of Pediatrics, Division of Pediatric Cardiology, University of Mississippi Medical Center, Jackson, Mississippi Department of Pediatrics, Division of Pediatric Critical Care, Studer Family Children's Hospital at Sacred Heart, Pensacola, Florida School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi.

Extracorporeal membrane oxygenation (ECMO) in pediatrics has rapidly progressed in recent years; however, there continues to be considerable variation in anticoagulation practices. In 2016, we implemented a standardized anticoagulation protocol in effort to reduce clotting and bleeding complications. A single-center retrospective analysis of pediatric patients requiring ECMO between 2014 and 2018 was performed. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.

We describe a technique for insertion of the Impella RP device that does not require fluoroscopy. Venous cannulation was performed via the superior vena cava and femoral vein percutaneously. After right atriotomy, the Impella RP is percutaneously inserted and advanced to the right atrium under transesophageal echocardiography guidance. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC, Australia Baker Heart and Diabetes Institute, Melbourne, VIC, Australia Cardio-Respiratory Engineering and Technology Laboratory (CREATELab), Monash University, Clayton, VIC, Australia Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia The Department of Cardiology, The Alfred Hospital, Melbourne, VIC, Australia Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, Medical Faculty, RWTH Aachen University, Germany Chair of Engineering Organ Support Technologies, Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, The Netherlands †Laboratory for Turbulence Research in Aerospace and Combustion (LTRAC), Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC, Australia.

Thrombosis is a potentially life-threatening complication in veno-arterial extracorporeal membrane oxygenation (ECMO) circuits, which may originate from the drainage cannula due to unfavorable blood flow dynamics. This study aims to numerically investigate the effect of cannula design parameters on local fluid dynamics, and thus thrombosis potential, within ECMO drainage cannulas. A control cannula based on the geometry of a 17 Fr Medtronic drainage cannula concentrically placed in an idealized, rigid-walled geometry of the right atrium and superior and inferior vena cava was numerically modeled. Read More

ASAIO J 2021 Apr 19. Epub 2021 Apr 19.

From the Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Division of Cardiothoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Angiotensin receptor-neprilysin inhibitors (ARNIs) greatly benefit functional capacity and longevity in heart failure with reduced ejection fraction (HFrEF). Angiotensin receptor-neprilysin inhibitors remain underutilized and unstudied, however, in left ventricular assist device (LVAD) recipients, in spite of their underlying HFrEF. In this case series, we studied the feasibility and short-term efficacy of ARNI utilization in 21 LVAD patients. Read More

ASAIO J 2021 Apr 7. Epub 2021 Apr 7.

From the Division of Pediatric Critical Care, Norton Children's Hospital, University of Louisville, Louisville, Kentucky.

Use of viscoelastic tests (VETs), including thromboelastography (TEG) and rotational thromboelastometry (ROTEM), is increasing in the management of anticoagulation in extracorporeal membrane oxygenation (ECMO) patients. A retrospective review of data on 265 pediatric (<20 years old) ECMO patients who underwent VET and were submitted to the Pediatric ECMO Outcomes Registry (PEDECOR) was conducted to describe common coagulopathies in patients who underwent VET; associations between the VET parameters and traditional tests of coagulation; and comparisons in blood product usage in patients who underwent VET with those who did not. We calculated patient-level summary statistics and assessed differences between the groups using χ2 tests (categorical variables) and Kruskal-Wallis and Wilcoxon rank-sum tests (continuous variables). Read More

ASAIO J 2021 Apr 7. Epub 2021 Apr 7.

From the Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada The Johns Hopkins Hospital, Baltimore, Maryland Nationwide Children's Hospital, Columbus, Ohio Kirklin Institute for Research in Surgical Outcomes (KIRSO), The University of Alabama at Birmingham, Birmingham, Alabama Abbott Northwestern Hospital, Minneapolis, Minnesota Mayo Clinic College of Medicine, Rochester, Minnesota The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.

While clinical status at the time of ventricular assist device (VAD) implant can negatively affect outcomes, it is unclear if early improvement after implant can have a positive effect. Therefore, the objectives of this study were to describe the clinical status of pediatric patients supported with a VAD and determine the impact of clinical status on the 1-month follow-up form on survival and ability to discharge. This was a retrospective analysis of data collected prospectively by the Pediatric Interagency Registry for Mechanical Circulatory Support Registry (Pedimacs) Registry. Read More

ASAIO J 2021 05;67(Suppl 1):1-42

ASAIO J 2021 Mar 29. Epub 2021 Mar 29.

From the School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy Center for Preclinical Research, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy Department of Anesthesia and Critical Care, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Veno-venous extracorporeal membrane oxygenation (vv-ECMO) represents one of the most advanced respiratory support for patients suffering from severe acute respiratory distress syndrome. During vv-ECMO a certain amount of extracorporeal oxygenated blood can flow back from the reinfusion into the drainage cannula without delivering oxygen to the patient. Detection and quantification of this dynamic phenomenon, defined recirculation, are critical to optimize the ECMO efficiency. Read More

ASAIO J 2021 Mar 29. Epub 2021 Mar 29.

From the Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania The Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland.

This study evaluates the impact of the recent United Network for Organ Sharing (UNOS) allocation policy change on outcomes of patients bridged with durable left ventricular assist devices (LVADs) to orthotopic heart transplantation (OHT). Adults bridged to OHT with durable LVADs between 2010 and 2019 were included. Patients were stratified based on the temporal relationship of their OHT to the UNOS policy change on October 18, 2018. Read More

ASAIO J 2021 Mar 29. Epub 2021 Mar 29.

From the Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio Department of Surgery, Cincinnati Children's Hospital, Cincinnati, Ohio Department of Mechanical Engineering, Clemson University, Clemson, South Carolina Department of Bioengineering, Clemson University, Clemson, South Carolina.

Clinical outcomes of ventricular assist device (VAD) support for shunted single ventricle patients trail the larger population due in part to the challenges in optimizing VAD support and balancing systemic and pulmonary circulations. We sought to understand the response to VAD titration in the shunted circulation using a lumped-parameter network modeling six patient-specific clinical cases. Hemodynamic data from six patients (mean body surface area = 0. Read More

ASAIO J 2021 Mar 29. Epub 2021 Mar 29.

From the Department of Pharmacy, Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montréal, Québec, Canada Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 900 rue Saint-Denis, Montréal, Québec, Canada Innovation Hub Axis, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, 900 rue Saint-Denis, Montréal, Québec, Canada Microbiology, Infectious Diseases and Immunology Department, Université de Montréal, 2900 Boulevard Édouard Montpetit, Montréal, Québec, Canada Department of Laboratory Medicine, Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montréal, Québec, Canada Department of Anesthesiology, Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montréal, Québec, Canada.

The increasing use of extracorporeal membrane oxygenation (ECMO) in critical care introduces new challenges with medication dosing. Voriconazole, a commonly used antifungal and the first-choice agent for the treatment of invasive aspergillosis, is a poorly water-soluble and highly protein-bound drug. Significant sequestration in ECMO circuits can be expected; however, no specific dosing recommendations are available. Read More

ASAIO J 2021 Mar 29. Epub 2021 Mar 29.

From the Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York.

We describe the successful transplantation of a brain-dead donor supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac arrest secondary to pulmonary embolism. The donor was a 50-year-old female who developed massive pulmonary embolism complicated by cardiac arrest requiring initiation of VA-ECMO. An initial echocardiogram revealed severe right ventricular dysfunction which recovered after 6 days of VA-ECMO confirmed by transthoracic echocardiogram and right heart catheterization. Read More

ASAIO J 2021 May;67(5):463-475

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.

These guidelines are applicable to neonates and children with cardiac failure as indication for extracorporeal life support. These guidelines address patient selection, management during extracorporeal membrane oxygenation, and pathways for weaning support or bridging to other therapies. Equally important issues, such as personnel, training, credentialing, resources, follow-up, reporting, and quality assurance, are addressed in other Extracorporeal Life Support Organization documents or are center-specific. Read More

ASAIO J 2021 04;67(4):e81-e85

From the Department of Cardiovascular Diseases.

In patients with advanced heart failure (HF), temporary mechanical circulator support (TMCS) is used to improve hemodynamics, via left ventricular unloading, and end-organ function as a bridge to definitive therapy. While listed for cardiac transplantation, use of TMCS may be prolonged, preventing adequate mobility. Here, we describe the technique for placement of a percutaneous axillary intra-aortic balloon pump (IABP) using single-site arterial access to facilitate ambulation and subsequent safe removal without surgery or a closure device. Read More

ASAIO J 2021 04;67(4):457-462

From the Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.

Patients with respiratory failure requiring inotropes or vasopressors are often placed on venoarterial (VA) extracorporeal membrane oxygenation (ECMO), as venovenous (VV) ECMO does not provide direct circulatory support. This retrospective multicenter study compared outcomes for 103 pediatric patients, with hemodynamic compromise, placed on VV ECMO for respiratory failure to those placed on VA ECMO. The primary outcome was survival to hospital discharge. Read More