Journal ArticleEchocardiography · November 2025
INTRODUCTION: Placement of a percutaneous coronary sinus catheter (CSC) for retrograde cardioplegia delivery in minimally invasive cardiac surgery has been implemented at various centers. While several techniques have been described for catheter placement, ...
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Journal ArticleAnn Thorac Surg · August 27, 2025
BACKGROUND: The optimal timing of operation for infective endocarditis with preoperative stroke remains unclear. METHODS: Adults undergoing an operation for acute aortic or mitral valve infective endocarditis were reviewed from our institutional database f ...
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Journal ArticleAnn Thorac Surg Short Rep · March 2025
BACKGROUND: Although the likelihood of needing a permanent pacemaker (PPM) after tricuspid valve (TV) repair has been thought to be low compared with TV replacement, the incidence and determinants are controversial. This study aimed to evaluate the inciden ...
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Journal ArticleJournal of Cardiac Surgery · January 1, 2025
Background: Mitral valve repair with the edge-to-edge technique (Alfieri stitch) has been described for over 20 years, yet little is published on late durability and potential risk of mitral stenosis remains controversial. The primary objective of this stu ...
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Journal ArticleInnovations (Phila) · 2025
OBJECTIVE: Axillary artery cannulation techniques continue to improve and find application throughout cardiac surgery. Yet, early outcomes are poorly documented versus femoral or central arterial cannulation in right minithoracotomy mitral surgery. METHODS ...
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Journal ArticleInnovations (Phila) · 2025
OBJECTIVE: The Alfieri stitch is a mitral repair technique that can easily be applied in less invasive approaches to the mitral valve. However, the Alfieri stitch is seldom used and has raised concerns about producing mitral stenosis or recurrent regurgita ...
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Journal ArticleAnn Thorac Surg · November 2024
BACKGROUND: Debate persists regarding the outcomes of leaflet resection (RESECT) vs chordal replacement (CHORD) for degenerative mitral regurgitation. Our aim was to compare early and late outcomes of the RESECT vs CHORD techniques for degenerative mitral ...
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Journal ArticleAnn Thorac Surg · October 2024
BACKGROUND: Debate continues regarding the superiority of porcine vs pericardial bioprostheses, and data relevant to this comparison are scant. This study compared late survival and structural valve deterioration of porcine and pericardial mitral valve pro ...
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ConferenceJTCVS open · October 2024
ObjectiveBiologic valves dominate tricuspid valve replacement, yet data on different valve types are lacking. We compare the survival and durability of porcine and pericardial tricuspid prostheses.MethodsA retrospective review of consecut ...
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Journal ArticleEchocardiography · October 2024
INTRODUCTION: The hemodynamic effects of mitral valve repair (MVr) with respect to transmitral pressure gradients (TMPGs) have not been described well in patients undergoing leaflet preservation techniques. In a population of patients undergoing robotic MV ...
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Journal ArticleJ Thorac Cardiovasc Surg · February 2024
OBJECTIVE: The effects of stroke and delirium on postdischarge cognition and patient-centered health outcomes after surgical aortic valve replacement (SAVR) are not well characterized. Here, we assess the impact of postoperative stroke and delirium on thes ...
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Journal ArticleAnn Thorac Surg · February 2024
BACKGROUND: The long-term effectiveness of minithoracotomy over redo median sternotomy for reoperative mitral operation is not well described. Here we present long-term survival after reoperative mitral operation based on operative approach. METHODS: Adult ...
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ConferenceJTCVS Tech · December 2023
OBJECTIVE: We developed a hybrid technique for repairing post-myocardial infarction (MI) ventricular septal defect (VSD) that combines infarct exclusion with patch and a nitinol-mesh septal occluder device (SOD) to provide a scaffold to support the damaged ...
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Journal ArticleAnn Thorac Surg Short Rep · September 2023
BACKGROUND: Permanent pacemaker (PPM) placement after mitral valve (MV) repair is affected by concomitant procedures, yet existing literature reports conflicting rates. We aimed to characterize the effect of concomitant operation on risk of need for postop ...
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Journal ArticleEur Heart J · June 1, 2023
AIMS: Severe tricuspid regurgitation (TR) exhibits high 1-year morbidity and mortality, yet long-term cardiovascular risk overall and by subgroups remains unknown. This study characterizes 5-year outcomes and identifies distinct clinical risk profiles of s ...
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Journal ArticleJ Am Coll Cardiol · February 14, 2023
BACKGROUND: The impact of transcatheter edge-to-edge repair (TEER) on national surgical mitral valve repair (MVr) volume and outcomes is unknown. OBJECTIVES: This study aims to assess the impact of TEER availability on MVr volumes and outcomes for degenera ...
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Journal ArticleAnn Thorac Surg · October 2022
BACKGROUND: Concerns regarding long-term durability of surgical repair for functional mitral regurgitation are based on short-term data, with few comparisons of ischemic mitral regurgitation (IMR) versus nonischemic functional mitral regurgitation (NIFMR) ...
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Journal ArticleCirc Cardiovasc Imaging · September 2022
Mitral annular disjunction is increasingly recognized as an important anatomic feature of mitral valve disease. The presence of mitral annular disjunction, defined as separation between the left atrial wall at the point of mitral valve insertion and the le ...
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Journal ArticleJ Robot Surg · February 2022
The literature for robotic mitral repair is dominated by a small number of large volume institutions, and intermediate-term outcomes out to 5 years are rare. Whether and under what circumstances a lower volume institution could obtain durable outcomes is n ...
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Journal ArticleJ Card Surg · February 2022
BACKGROUND: The durability of surgical repair for degenerative versus ischemic mitral regurgitation (MR) is thought to be markedly different. We, therefore, examined late outcomes and durability for mitral repair in a large cohort of patients receiving a s ...
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Journal ArticleJ Thorac Cardiovasc Surg · December 2021
OBJECTIVES: To determine the frequency and risk factors for non-home discharge (NHD) and its association with clinical outcomes and quality of life (QOL) at 1 year following cardiac surgery in patients with ischemic mitral regurgitation (IMR). METHODS: Dis ...
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Journal ArticleJ Card Surg · December 2021
BACKGROUND: Techniques and results of aortic valve repair remain challenging. AIMS: Safari et al. seek to improve aortic valve repair by either aortic patching or valve sparing root replacement. MATERIALS AND METHODS: The results of bicuspid aortic valve ( ...
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Journal ArticleJ Card Surg · September 2021
Zubarevich et al. present the 30 day and 1-year outcomes of redo mitral valve replacement in 58 high-risk patients. The authors conclude that careful patient selection and risk stratification provides acceptable surgical results in this cohort. This series ...
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Journal ArticleJ Card Surg · July 2021
Habertheuer et al. present a risk scoring system for predicting morbidity and mortality in 1181 patients undergoing surgery for drug associated endocarditis. The authors conclude that drug-related endocarditis is associated with significant morbidity and m ...
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Journal ArticleJ Card Surg · June 2021
BACKGROUND: Infective endocarditis (IE) involving the aortic valve and root is associated with high risk requiring thoughtful surgical decision-making. The impact of valve and conduit choices and patient factors on long-term outcomes in this patient popula ...
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Journal ArticleJ Card Surg · April 2021
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BACKGROUND: Port-access (PORT) and robotic (ROBO) mitral repair are well established, but differences in patient selection and outcomes are not well documented. METHODS: A retrospective analysis was performed on 129 ROBO and 628 PORT mitral repairs at one ...
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Journal ArticleJ Am Coll Cardiol · February 16, 2021
BACKGROUND: Whether to repair nonsevere tricuspid regurgitation (TR) during surgery for ischemic mitral valve regurgitation (IMR) remains uncertain. OBJECTIVES: The goal of this study was to investigate the incidence, predictors, and clinical significance ...
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Journal ArticleJ Card Surg · January 2021
Maeda et al. present what may be the second reported case of transcatheter aortic valve replacement (TAVR) followed by staged open surgical aortic valve replacement (SAVR) in a high-risk patient. The authors propose that TAVR may serve as a bridge procedur ...
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Journal ArticleJ Thorac Cardiovasc Surg · June 2020
OBJECTIVE: The Cardiothoracic Surgical Trials Network reported that left ventricular reverse remodeling at 2 years did not differ between patients with moderate ischemic mitral regurgitation randomized to coronary artery bypass grafting plus mitral valve r ...
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Journal ArticleJACC Cardiovasc Interv · December 9, 2019
OBJECTIVES: The aim of this study was to assess the real-world impact of transcatheter mitral valve repair (TMVR) on hospitalizations and Medicare costs pre- versus post-TMVR. BACKGROUND: TMVR is effective in degenerative mitral regurgitation (MR) and appr ...
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Journal ArticleHeart · November 2019
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OBJECTIVES: This study evaluates the 5-year clinical outcomes of transcatheter mitral valve (MV) repair with the MitraClip device in patients at high risk for MV surgery treated in the Endovascular Valve Edge-to-Edge Repair (EVEREST) II High Risk Study (HR ...
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Journal ArticleJACC Cardiovasc Interv · July 22, 2019
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OBJECTIVES: The aim of this study was to examine the relation between institutional experience and procedural results of transcatheter mitral valve repair. BACKGROUND: Transcatheter mitral valve repair for the treatment of mitral regurgitation (MR) is a co ...
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Journal ArticleAnesthesiology · June 2019
BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ...
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Journal ArticleJ Am Coll Cardiol · May 21, 2019
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BACKGROUND: The incidence of permanent pacemaker (PPM) implantation is higher following mitral valve surgery (MVS) with ablation for atrial fibrillation (AF) compared with MVS alone. OBJECTIVES: This study identified risk factors and outcomes associated wi ...
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Journal ArticleCirc Cardiovasc Interv · May 2019
BACKGROUND: Clinical event committees are commonly employed for event validation in clinical studies, but little is known about the comparative performance of administrative claims data versus clinician-triggered event adjudication for ascertainment of adv ...
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Journal ArticleCurr Cardiol Rep · March 4, 2019
PURPOSE OF REVIEW: Detail the current strategies for the management of valve dysfunction in Marfan syndrome (MFS), understand the limitations of surgical interventions, and delineate the likely direction of future innovations. RECENT FINDINGS: Significant ...
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Journal ArticleCirculation · January 2, 2019
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BACKGROUND: Secondary mitral regurgitation (SMR) occurs in the absence of organic mitral valve disease and may develop as the left ventricle dilates or remodels or as a result of leaflet tethering with impaired coaptation, most commonly from apical and lat ...
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Journal ArticleJ Thorac Cardiovasc Surg · January 2019
OBJECTIVE: To use novel statistical methods for analyzing the effect of lesion set on (long-standing) persistent atrial fibrillation (AF) in the Cardiothoracic Surgical Trials Network trial of surgical ablation during mitral valve surgery (MVS). METHODS: T ...
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Journal ArticleAnn Thorac Surg · November 2018
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BACKGROUND: National outcomes of robotic mitral valve repair (rMVr) compared with sternotomy (sMVr) in older patients are currently unknown. METHODS: From 2011 to 2014, all patients aged 65 years and older undergoing MVr in The Society of Thoracic Surgeons ...
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Journal ArticleAm Heart J · November 2018
BACKGROUND: Patients with heart failure (HF) and symptomatic secondary mitral regurgitation (SMR) have a poor prognosis, with morbidity and mortality directly correlated with MR severity. Correction of isolated SMR with surgery is not well established in t ...
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Journal ArticleCASE (Phila) · October 2018
•A Gerbode VSD is a communication between the left ventricle and right atrium.•Etiologies include trauma, infective endocarditis, and iatrogenic causes.•Echocardiographic evaluation for this defect requires a careful interrogation. ...
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Journal ArticleAm Heart J · September 2018
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BACKGROUND: We aimed to determine the association of MR severity and type with all-cause death in a large, real-world, clinical setting. METHODS: We reviewed full echocardiography studies at Duke Echocardiography Laboratory (01/01/1995-12/31/2010), classif ...
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Journal ArticleJ Thorac Cardiovasc Surg · April 2018
OBJECTIVE: To analyze patient risk factors and processes of care associated with secondary surgical-site infection (SSI) after coronary artery bypass grafting (CABG). METHODS: Data were collected prospectively between February and October 2010 for consenti ...
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Journal ArticleAnn Thorac Surg · April 2018
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BACKGROUND: Outcome of mitral valve replacement in extreme scenarios of small mitral annulus with the use of the Regent mechanical aortic valve is not well documented. METHODS: Records were examined in 31 consecutive patients who underwent mitral valve rep ...
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Journal ArticleAnesthesiology · April 2018
BACKGROUND: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patie ...
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Journal ArticleHum Brain Mapp · February 2018
OBJECTIVES: Older adults often display postoperative cognitive decline (POCD) after surgery, yet it is unclear to what extent functional connectivity (FC) alterations may underlie these deficits. We examined for postoperative voxel-wise FC changes in respo ...
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Journal ArticleInnovations (Phila) · 2018
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The right 2nd interspace minithoracotomy has advantages over femoral arterial cannulation providing an alternative that should be in the arsenal of the minimally invasive surgeon; we describe here the method, the advantages, and the pitfalls. ...
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Chapter · January 1, 2018
The mitral valve is the most easily recognized moving structure in the heart. Because of its rapid back and forth motion, the mitral valve serves as “home base” for almost all echocardiographic examinations. When the transducer is directed posteriorly from ...
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Journal ArticleAnesth Analg · October 2017
BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ...
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Journal ArticleAm Heart J · July 2017
UNLABELLED: MitraClip is an approved therapy for mitral regurgitation (MR); however, health care resource utilization pre- and post-MitraClip remains understudied. METHODS: Patients with functional and degenerative MR at high surgical risk in the EVEREST I ...
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Journal ArticleJ Heart Valve Dis · March 2017
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous co ...
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Journal ArticleReg Anesth Pain Med · 2017
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient und ...
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Journal ArticleJ Card Surg · September 2016
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We report a case of catastrophic antiphospholipid syndrome in a patient following mitral valve replacement. The pathophysiology and management of this rare condition is discussed. ...
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Journal ArticleJ Card Surg · August 2016
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BACKGROUND: Systolic anterior motion (SAM) of the mitral valve, left ventricular outflow tract (LVOT) obstruction, and mitral regurgitation (MR) are known adverse outcomes that can occur after septal myectomy for hypertrophic obstructive cardiomyopathy. Th ...
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Journal ArticleEur Heart J · July 21, 2016
AIMS: We aimed to determine the frequency of aortic valve surgery (AVR) with or without coronary artery bypass grafting (CABG), among patients with moderate/severe aortic stenosis (AS) and left ventricular systolic dysfunction (LVSD), and its relationship ...
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Journal ArticleAnn Thorac Surg · January 2016
BACKGROUND: With initiation of transcatheter aortic valve replacement (TAVR) programs, centers may see changes in surgical aortic valve replacement (SAVR) populations and related outcomes because of more high-risk patients undergoing TAVR rather than SAVR. ...
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Journal ArticleJ Am Coll Cardiol · December 29, 2015
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BACKGROUND: In EVEREST II (Endovascular Valve Edge-to-Edge Repair Study), treatment of mitral regurgitation (MR) with a novel percutaneous device showed superior safety compared with surgery, but less effective reduction in MR at 1 year. OBJECTIVES: This s ...
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Journal ArticleEur Heart J · October 21, 2015
AIMS: The management and outcomes of patients with functional moderate/severe mitral regurgitation and severe left ventricular (LV) systolic dysfunction are not well defined. We sought to determine the characteristics, management strategies, and outcomes o ...
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Journal ArticleKidney Int · October 2015
Acute kidney injury (AKI) is a common, serious complication of cardiac surgery. Since prior studies have supported a genetic basis for postoperative AKI, we conducted a genome-wide association study (GWAS) for AKI following coronary bypass graft (CABG) sur ...
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Journal ArticleAnn Thorac Surg · August 2015
BACKGROUND: Bioprosthetic options are increasingly used for surgical aortic valve replacement (AVR). However, current decision making regarding bioprosthetic valve choice is not data-driven given incomplete information on comparative long-term outcomes aft ...
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Journal ArticleAnn Thorac Surg · August 2015
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BACKGROUND: The efficacy of conventional median sternotomy versus a right minithoracotomy (RT) approach to mitral valve surgery was evaluated in a single high-volume institution. METHODS: A retrospective analysis of a single institution's experience was pe ...
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Journal ArticleAm J Cardiol · January 1, 2015
We aimed to characterize the hemodynamic progression of aortic stenosis (AS) in a contemporary unselected cohort of patients with preserved left ventricular ejection fraction. Current guidelines recommend echocardiographic surveillance of hemodynamic progr ...
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Journal ArticleCirc Cardiovasc Interv · January 2015
BACKGROUND: Chronic kidney disease (CKD) is strongly related to outcome in cardiovascular diseases. The relationship between treatment of mitral regurgitation (MR) and renal function is not well described. We sought to evaluate renal function before and af ...
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OtherCirc Cardiovasc Genet · October 2014
BACKGROUND: We hypothesized that genetic variations in the adrenergic signaling pathway and cytochrome P450 2D6 enzyme are associated with new-onset atrial fibrillation (AF) in patients who underwent coronary artery bypass grafting and were treated with pe ...
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Journal ArticleJ Am Coll Cardiol · July 15, 2014
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BACKGROUND: The EVEREST II (Endovascular Valve Edge-to-Edge REpair STudy) High-Risk registry and REALISM Continued Access Study High-Risk Arm are prospective registries of patients who received the MitraClip device (Abbott Vascular, Santa Clara, California ...
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Journal ArticleJ Am Coll Cardiol · July 15, 2014
BACKGROUND: Surgical mitral valve repair (SMVR) remains the gold standard for severe degenerative mitral regurgitation (DMR). However, the results with transcatheter mitral valve repair (TMVR) in prohibitive-risk DMR patients have not been previously repor ...
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Journal ArticleJ Heart Valve Dis · November 2013
BACKGROUND AND AIM OF THE STUDY: Detailed analyses of risk-adjusted outcomes after mitral valve surgery have documented significant survival decrements with tissue valves at any age. Several recent studies of prosthetic aortic valve replacement (AVR) also ...
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Journal ArticleCirculation · October 8, 2013
BACKGROUND: MitraClip has been shown to reduce mitral regurgitation (MR) severity safely but to a lesser degree than surgery. No data exist on the magnitude of MR reduction necessary to reverse left ventricular (LV) and left atrial (LA) dilation in patient ...
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Journal ArticleJ Am Coll Cardiol · July 23, 2013
OBJECTIVES: This study sought to evaluate 4-year outcomes of percutaneous repair versus surgery for mitral regurgitation. BACKGROUND: Transcatheter therapies are being developed to treat valvular heart disease. In the EVEREST (Endovascular Valve Edge-to-Ed ...
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Journal ArticleCirc Cardiovasc Imaging · July 2013
BACKGROUND: Percutaneous repair of mitral regurgitation (MR) permits examination of the effect of MR reduction without surgery and cardiopulmonary bypass on left ventricular (LV) dimensions and function. The goal of this analysis was to determine the exten ...
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Journal ArticleJ Thorac Cardiovasc Surg · April 2013
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OBJECTIVE: Coronary artery bypass grafting with multiple internal thoracic artery grafts is currently controversial. This study assessed single institutional outcomes with multiple internal thoracic artery grafting for guidance with future clinical decisio ...
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Journal ArticleAnn Thorac Surg · April 2013
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BACKGROUND: This study aims to analyze the midterm outcomes of minimally invasive edge-to-edge mitral valve repair (MVR) with artificial chords (CHORD) or without artificial chords (noCHORD) in patients with mitral regurgitation (MR). METHODS: Records of a ...
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Journal ArticleHeart Lung Vessel · 2013
INTRODUCTION: Ischemic mitral regurgitation can be defined as moderate to severe mitral leak precipitated by acute myocardial infarction. Valve repair is now the procedure of choice, but some cases can pose difficult anatomy. This review will illustrate cu ...
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Journal ArticleInnovations (Phila) · 2013
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OBJECTIVE: Compared with median sternotomy, a right thoracotomy (RT) approach to mitral surgery is associated with decreased postoperative acute renal failure. Therefore, we examined propensity-matched patients with chronic renal impairment to compare outc ...
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Journal ArticleAm J Cardiol · November 1, 2012
Mitral valve prolapse may involve 1 leaflet or 2 leaflets, yet management guidelines do not differentiate posterior leaflet (PML) from bileaflet (BML) prolapse. We hypothesized that patients with BML have a prolonged natural history with more severe atrial ...
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Journal ArticleJ Am Coll Cardiol · October 9, 2012
Surgical approaches to correct mitral regurgitation (MR) have evolved over 50 years and form much of the basis for percutaneous approaches to the mitral valve. Surgical mitral repairs have been more durable with use of annuloplasty, but recurrent regurgita ...
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Journal ArticleEur J Heart Fail · August 2012
AIMS: To evaluate the haemodynamic effect of acute procedural success (APS) after MitraClip therapy in patients with haemodynamic decompensation. METHODS AND RESULTS: Of 107 patients, 79 achieved APS after MitraClip implantation. The increase in cardiac in ...
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Journal ArticleJ Am Coll Cardiol · April 3, 2012
OBJECTIVES: The purpose of this study was to characterize patients with mitral regurgitation (MR) and atrial fibrillation (AF) treated percutaneously using the MitraClip device (Abbott Vascular, Abbott Park, Illinois) and compare the results with surgery i ...
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Journal ArticleJ Thorac Cardiovasc Surg · April 2012
OBJECTIVE: The Endovascular Valve Edge-to-Edge Repair Study (EVEREST II) is a prospective, multicenter, randomized controlled trial comparing percutaneous repair with the MitraClip device to mitral valve (MV) surgery in the treatment of mitral regurgitatio ...
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Journal ArticleCurr Probl Cardiol · February 2012
Percutaneous therapies for the treatment of mitral regurgitation have emerged rapidly over the past several years. Most of the percutaneous approaches are modifications of existing surgical approaches to mitral annuloplasty or leaflet repair. Most of the p ...
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Journal ArticleJ Am Coll Cardiol · January 10, 2012
OBJECTIVES: The EVEREST II (Endovascular Valve Edge-to-Edge Repair) High Risk Study (HRS) assessed the safety and effectiveness of the MitraClip device (Abbott Vascular, Santa Clara, California) in patients with significant mitral regurgitation (MR) at hig ...
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Journal ArticleInnovations (Phila) · July 2011
In every common mitral pathology studied to date, repairing the patient's own diseased valve to adequate function has yielded superior long-term results as compared with prosthetic valve replacement with either tissue or mechanical devices. Thus, increasin ...
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Journal ArticleAnn Thorac Surg · June 2011
BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ...
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Journal ArticleJ Am Coll Cardiol · April 19, 2011
OBJECTIVES: The objective of this study was to evaluate the acute hemodynamic consequences of mitral valve (MV) repair with the MitraClip device (Abbott Vascular, Menlo Park, California). BACKGROUND: Whether surgical correction of mitral regurgitation (MR) ...
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Journal ArticleN Engl J Med · April 14, 2011
BACKGROUND: Mitral-valve repair can be accomplished with an investigational procedure that involves the percutaneous implantation of a clip that grasps and approximates the edges of the mitral leaflets at the origin of the regurgitant jet. METHODS: We rand ...
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Journal ArticleCirculation · April 5, 2011
BACKGROUND: The safety and effectiveness of the MitraClip device (Abbott Vascular, Menlo Park, CA) is being evaluated in the Endovascular Valve Edge-to-Edge Repair Study (EVEREST) clinical studies. The healing response after device implantation has not pre ...
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Journal ArticleHeart · February 2011
BACKGROUND: Optimal timing of surgery in degenerative mitral regurgitation (MR) remains a controversial topic. The impact of current ACC/AHA guideline recommendations about optimal timing of surgery on outcomes is untested and contemporary data are lacking ...
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Journal ArticleJ Thorac Cardiovasc Surg · January 2011
OBJECTIVE: Operation for infective endocarditis is associated with the highest mortality of any valve disease, with overall rates of in-hospital mortality exceeding 20%. The Society of Thoracic Surgeons Adult Cardiac Surgery Database was examined to develo ...
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Journal ArticleAm J Cardiol · December 15, 2010
Whether prognosis differs in acute renal failure (ARF) after coronary artery bypass grafting (CABG) in patients with and without recovery of renal function is not known. We studied patients who had CABG at Duke University Medical Center (1995 to 2008). ARF ...
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Journal ArticleAnn Thorac Surg · November 2010
BACKGROUND: Previous studies suggest that mitral valve replacement is comparable to repair in the elderly, and a national trend exists toward tissue valves. However, few direct comparison data are available, and this study evaluated the effects of patient ...
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Journal ArticleInnovations (Phila) · November 2010
OBJECTIVE: : The effects and benefits of a transaortic endoclamp for mitral valve operation through right minithoracotomy have not been established. METHODS: : The records were examined in 671 patients undergoing mitral valve operation using aortic cannula ...
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Journal ArticleInnovations (Phila) · September 2010
OBJECTIVE: To define the role and early results of aortic valve surgery through a right minithoracotomy. METHODS: A retrospective analysis was performed on 306 consecutive patients undergoing aortic valve replacement through an 8-cm right minithoracotomy i ...
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Journal ArticleAm Heart J · July 2010
BACKGROUND: Mitral valve surgery is the standard of care for patients with symptomatic mitral regurgitation (MR) or asymptomatic MR with evidence of left ventricular dysfunction or dilation. Whether an endovascular approach to repair can offer comparable e ...
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Journal ArticleAnn Thorac Surg · June 2010
Postinfarction ventricular septal defects (VSDs) are associated with high mortality and typically these are treated urgently with surgery for exclusion patch repair. Percutaneous closure of postinfarction VSDs using occlusion devices is feasible in some pa ...
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Journal ArticleAnn Thorac Surg · January 2010
BACKGROUND: Percutaneous mitral repair with the MitraClip device (Evalve, Menlo Park, CA) has been reported. Preserving conventional surgical options in the event of percutaneous treatment failure is important. We describe surgical treatment at varying int ...
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Journal ArticleInnovations (Phila) · January 2010
OBJECTIVE: : The relative outcomes of sternotomy versus thoracotomy for tricuspid valve operation were examined over a 22-year period. METHODS: : Three hundred four consecutive patients undergoing tricuspid valve operation using right minithoracotomy (THOR ...
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Chapter · December 1, 2009
The mitral valve is the most easily recognized moving structure in the heart. Because of its rapid to and fro motion, the mitral valve serves as home base for almost all echocardiographic examinations. When the transducer is directed posteriorly from the c ...
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Journal ArticleAnn Thorac Surg · December 2009
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BACKGROUND: Reports of minimally invasive tricuspid valve operations are rare. We reviewed our experience and results of tricuspid valve operation using mini-thoracotomy during an 11-year period. METHODS: Consecutive patients (n = 141) undergoing tricuspid ...
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Journal ArticleAnn Thorac Surg · December 2009
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BACKGROUND: Recent advances in surgical technique allow repair of most mitral valves with degenerative disease. However, few long-term data exist to support the superiority of repair versus prosthetic valve replacement, and repair could be limited by late ...
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Journal ArticleAnn Thorac Surg · October 2009
BACKGROUND: Undersized ring annuloplasty and surgical revascularization are commonly used to correct ischemic mitral regurgitation (MR), but published series have failed to demonstrate a benefit compared with revascularization alone. We hypothesized that s ...
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Journal ArticleInnovations (Phila) · September 2009
OBJECTIVE: : To examine early outcomes of mitral valve repair using Alfieri repair via a right mini-thoracotomy approach. METHODS: : Records were examined in 68 consecutive patients undergoing Alfieri mitral repair via 6 cm right mini-thoracotomy. Most rep ...
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Journal ArticleJ Am Coll Cardiol · August 18, 2009
OBJECTIVES: We undertook a prospective multicenter single-arm study to evaluate the feasibility, safety, and efficacy of the MitraClip system (Evalve Inc., Menlo Park, California). BACKGROUND: Mitral valve repair for mitral regurgitation (MR) has been perf ...
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Journal ArticleJ Heart Valve Dis · May 2009
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BACKGROUND AND AIM OF THE STUDY: Pure annular dilation (PAD) is a recognized etiology of mitral regurgitation, yet few data exist to define the prognostic profile of this disorder relative to other etiologies, such as ischemia or myxomatous prolapse. METHO ...
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Journal ArticleCirculation · April 7, 2009
BACKGROUND: Human myocardial metabolism has been incompletely characterized in the setting of surgical cardioplegic arrest and ischemia/reperfusion. Furthermore, the effect of preexisting ventricular state on ischemia-induced metabolic derangements has not ...
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Journal ArticleStroke · March 2009
BACKGROUND AND PURPOSE: Cognitive decline after cardiac surgery remains common and diminishes patients' quality of life. Based on experimental and clinical evidence, this study assessed the potential of intravenously administered lidocaine to reduce postop ...
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Journal ArticleEuroIntervention · January 2009
AIMS: Percutaneous repair of mitral regurgitation (MR) by leaflet apposition using a clip deployed via transseptal catheterisation is undergoing evaluation. METHODS AND RESULTS: In order to detect the potential for clinically significant left ventricular i ...
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Journal ArticleAnn Thorac Surg · September 2008
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BACKGROUND: Ischemic mitral regurgitation (IMR) has an adverse prognosis, but survival characteristics and management are controversial. This study reviewed a 20-year series of IMR patients managed with multiple approaches to assess and refine surgical str ...
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Journal ArticleCirculation · February 19, 2008
BACKGROUND: There exist few studies that characterize contemporary clinical features and outcomes or risk factors for operative mortality in cardiogenic shock (CS) patients undergoing coronary artery bypass grafting (CABG). METHODS AND RESULTS: We evaluate ...
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Journal ArticleNat Clin Pract Cardiovasc Med · February 2008
Surgical valve repair for mitral regurgitation (MR) has been used for decades. Percutaneous approaches to mitral valve repair have been undergoing evaluation in trials over the last few years, and could offer less-invasive alternatives to surgery for the t ...
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Journal ArticleJ Heart Valve Dis · November 2007
BACKGROUND AND AIM OF THE STUDY: Valvular endocarditis occurring in patients with dialysis-dependent renal failure increases the risk of mortality following valve surgery, but few specific data are available to guide surgical selection. The study aim was t ...
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Journal ArticleAnn Thorac Surg · March 2007
BACKGROUND: In patients with multivessel coronary artery disease, performing multiple internal mammary artery (MIMA) grafts to two coronary systems during coronary artery bypass grafting (CABG) improves clinical outcome. Few databases have decades of follo ...
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Journal ArticleAm Heart J · October 2006
BACKGROUND: Increasing number of patients undergo percutaneous intervention of saphenous vein grafts (SVGs). However, the clinical factors associated with long-term mortality after SVG interventions are currently less known. Accordingly, the goal of presen ...
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Journal ArticleAnn Thorac Surg · September 2006
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BACKGROUND: Approaches to the mitral valve include left atriotomy (LA) through the interatrial groove and transseptal approach (TS) through the right atrium. Left atriotomy is more commonly used, but TS offers better mitral visualization in difficult cases ...
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Journal ArticleJ Surg Res · September 2006
OBJECTIVE: Transplantation of autologous skeletal myoblasts (SKMB) into infarcted heart (or cellular cardiomyoplasty, CCM) augments myocardial performance in animal models of myocardial infarction. However, the effect of CCM in the setting of ventricular a ...
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Journal ArticleAnn Thorac Surg · August 2006
BACKGROUND: Few studies have directly evaluated outcomes in patients undergoing aortic root replacement with St. Jude mechanical conduits or aortic allografts (ALLO), yet both approaches have been advocated. The purpose of this study was to provide a detai ...
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Journal ArticleAnn Thorac Surg · April 2006
Achieving a stable repair of mitral valve prolapse can be difficult in complex pathologies, and a 5% to 20% late reoperation rate exists with leaflet resection and reconstruction. During an 8-year period, prolapse was managed uniformly with "adjustable" Go ...
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Journal ArticleJ Thorac Cardiovasc Surg · March 2006
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OBJECTIVE: In some respects, outcome reporting in valvular surgery has been hampered by focusing on specific populations, reluctance to publish high-risk subgroups, and possibly skewed or inadequate samples. The goal of this study was to evaluate risk fact ...
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OtherScand J Infect Dis · 2006
The purpose of this investigation was to study the influence of diabetes mellitus (DM) on outcomes of infective endocarditis (IE). Outcomes were compared between 150 diabetic and 905 non-diabetic patients with IE from the International Collaboration on End ...
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Journal ArticleInnovations (Phila) · 2006
BACKGROUND: : Patient demand for less invasive surgery and interest in avoiding sternotomy has led to the increased use of the minithoracotomy for mitral valve surgery. Although the feasibility of this approach has been established, few data are available ...
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Journal ArticleJ Heart Valve Dis · November 2005
BACKGROUND AND AIM OF THE STUDY: Pulmonary dysfunction/multiorgan failure (PD/MF), usually due to refractory pulmonary infection, is an important cause of mortality and morbidity after cardiac operations. Moreover, the incidence of PD/MF may be increasing ...
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Journal ArticleAnn Thorac Surg · October 2005
BACKGROUND: The utility of mitral valve repair (MV repair) has been well documented in patients with normal left ventricular function. Few studies, however, have specifically examined outcomes of isolated MV repair in patients with decreased left ventricul ...
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Journal ArticleCirculation · August 30, 2005
BACKGROUND: It is unclear if mild or moderate mitral valve regurgitation (MR) should be repaired at the time of coronary artery bypass grafting (CABG). We sought to determine the long-term effect of uncorrected MR, measured by intraoperative transesophagea ...
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Journal ArticleJ Thorac Cardiovasc Surg · April 2005
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BACKGROUND: Ischemic mitral regurgitation has been associated with diminished survival compared with nonischemic mitral regurgitation. Conversion from mitral valve replacement to valve repair has improved prognosis, but it is unclear whether ischemic mitra ...
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Journal ArticleJ Heart Lung Transplant · February 2005
BACKGROUND: Pre-clinical and clinical studies suggest that transplantation of bone marrow-derived stem cells can improve global cardiac function. However, no quantitative assessment of regional systolic contraction and correlation with phenotype has been m ...
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Journal ArticleCirculation · September 14, 2004
BACKGROUND: The long-term clinical advantages of using routine multiple internal mammary artery (IMA) grafts for coronary artery bypass (CAB) are not clear. This study was designed to test the hypothesis that multiple IMA grafts would provide better 15-yea ...
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Journal ArticleAnn Thorac Surg · July 2004
PURPOSE: Currently, cells are transplanted into injured myocardium either through thoracotomy for open surgical delivery or through catheterization for endoventricular or intracoronary delivery; both methods have limitations. Open surgical delivery limits ...
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Journal ArticleJ Heart Valve Dis · May 2004
BACKGROUND AND AIM OF THE STUDY: A retrospective evaluation was made of a small personal series of patients undergoing mitral valve repair in order to address four contemporary questions: (i) What is the best method of achieving a stable repair in mitral v ...
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Journal ArticleJ Cardiothorac Vasc Anesth · December 2003
OBJECTIVE: The purpose of this study was to compare the use of a double-lumen endotracheal tube to a single-lumen tube combined with a bronchial blocker for lung isolation during Port-Access cardiac surgery. DESIGN: Prospective, randomized, controlled tria ...
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Journal ArticleEur J Heart Fail · December 2003
BACKGROUND: To date, no data exist on the linearity and, therefore, the usefulness of the preload recruitable stroke work (PRSW) and end-systolic pressure-volume (ESPVR) relationships during acute afterload changes in heart failure. AIMS: Our aim was, ther ...
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Journal ArticleCurr Treat Options Cardiovasc Med · December 2003
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Aortic regurgitation may be the most treacherous of the valvular lesions due to subtlety of symptoms and physical findings and due to difficulty in timing surgical intervention to prevent permanent cardiac dysfunction. Cardiac imaging (eg, echocardiography ...
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OtherBr J Anaesth · November 2003
BACKGROUND: Aortic atheromatous disease is known to be associated with an increased risk of perioperative stroke in the setting of cardiac surgery. In this study, we sought to determine the relationship between cerebral microemboli and aortic atheroma burd ...
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Journal ArticleJ Thorac Cardiovasc Surg · November 2003
OBJECTIVE: To determine whether early identification of physiologic variances associated with interstage death would reduce mortality, we developed a home surveillance program. METHODS: Patients discharged before initiation of home surveillance (group A, n ...
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Journal ArticleCirculation · September 9, 2003
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BACKGROUND: The most appropriate treatment for patients with ischemic mitral regurgitation (IMR) is often debated. We compared the survival rates of patients with IMR undergoing different treatment strategies, namely: medical therapy, percutaneous coronary ...
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Journal ArticleCirculation · September 9, 2003
BACKGROUND: Multiple cell types are being proposed for cardiac repair, but side-by-side comparisons are lacking. We tested the hypothesis that intracardiac transplantation of autologous bone marrow- or skeletal muscle-derived progenitor cells improve regio ...
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Journal ArticleMol Ther · August 2003
Although percutaneous, adenoviral-mediated intracoronary gene delivery to the heart has been demonstrated in some species, consistent and safe methodology is needed before clinical applicability is possible. In this study, we examine the effects of alterin ...
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Journal ArticleAnn Thorac Surg · March 2003
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BACKGROUND: Many outcomes and complications of minimally invasive and conventional cardiac surgery await comparison. Patients undergoing mitral valve surgery commonly sustain renal injury. Using peak postoperative fractional change of serum creatinine as a ...
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Journal ArticleJ Thorac Cardiovasc Surg · November 2002
OBJECTIVE: Limitations in clinical understanding of right ventricular relaxation can be attributed to the paucity of information from basic studies in animal models of right ventricular disease. This study examined, in the conscious state, right ventricula ...
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Journal ArticleAnn Thorac Surg · October 2002
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BACKGROUND: In reoperation for mitral valve disease, minimally invasive Port-Access (PORT) is a new alternative to standard median sternotomy (STER) or right thoracotomy (THOR); yet, the results of PORT in this setting have not been defined. The aim of thi ...
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Journal ArticleAnn Thorac Surg · July 2002
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BACKGROUND: Port-access techniques performed through a right mini-thoracotomy have been extensively described for both the mitral and aortic valves. However, reports of tricuspid valve operations using the port-access approach are rare. A technique for min ...
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OtherAnesth Analg · July 2002
UNLABELLED: Renal dysfunction is common after coronary artery bypass graft (CABG) surgery. We have previously shown that CABG procedures complicated by stroke have a threefold greater peak serum creatinine level relative to uncomplicated surgery. However, ...
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Journal ArticleAnn Thorac Surg · May 2002
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A technique is described for combined aortic and mitral valve operation utilizing the minimally invasive Port-Access technique. Two patients are repaired with excellent chest wall healing and avoidance of sternotomy. ...
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Journal ArticleHeart Surg Forum · 2002
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BACKGROUND: Outcomes for a port-access (PA) approach for tricuspid valve operations have not been reported or compared to those using median sternotomy (MS). METHODS: Retrospective analysis was performed for 88 consecutive patients undergoing tricuspid val ...
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OtherAnesth Analg · January 2002
UNLABELLED: Neurocognitive dysfunction is a common complication after cardiac surgery. We evaluated in this prospective study the effect of rewarming rate on neurocognitive outcome after hypothermic cardiopulmonary bypass (CPB). After IRB approval and info ...
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Journal ArticleAnn Thorac Surg · November 2001
BACKGROUND: Increased right ventricular (RV) afterload results in RV hypertrophy and dysfunction, as well as increased levels of intracellular beta-adrenergic receptor kinase (betaARK1). We hypothesize that gene transfer of a betaARK1 inhibitor (betaARKct) ...
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Journal ArticleJ Thorac Cardiovasc Surg · September 2001
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OBJECTIVE: We sought to compare 10-year survival in patients after mitral valve replacement with biologic or mechanical valve prostheses. METHODS: Retrospective survival analysis was performed on data from 1139 consecutive patients older than 18 years of a ...
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Journal ArticleCirculation · March 6, 2001
BACKGROUND: Genetic manipulation to reverse molecular abnormalities associated with dysfunctional myocardium may provide novel treatment. This study aimed to determine the feasibility and functional consequences of in vivo beta-adrenergic receptor kinase ( ...
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Journal ArticleHeart Surg Forum · 2001
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BACKGROUND: The predictors of operative time and the effects of learning in isolated valve operations using port-access techniques have not been defined. METHODS: Analysis of covariance was used to examine the determinants of procedure time, pump time, and ...
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Journal ArticleAm Heart J · November 2000
OBJECTIVE: Previous studies have been inconsistent in defining a clinical benefit to the bicaval cardiac transplantation technique relative to the standard technique, and many major centers have not adopted this newer approach. The purpose of this study wa ...
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Journal ArticleJ Thorac Cardiovasc Surg · September 2000
OBJECTIVES: Ex vivo perfusion of the cardiac allograft during organ procurement is an ideal environment for adenoviral vectors with transgenes that target improving graft contractility. One such target is the beta-adrenergic receptor-signaling system, in w ...
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Journal ArticleJ Thorac Cardiovasc Surg · August 2000
OBJECTIVE: Right ventricular dysfunction is a poorly understood but persistent clinical problem. This study was undertaken to evaluate ventricular performance and beta-adrenergic receptor signaling in a tricuspid regurgitation model of right ventricular ov ...
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Journal ArticleJ Thorac Cardiovasc Surg · June 2000
INTRODUCTION: Calcitonin gene-related peptide, a potent vasodilating inotropic agent, increases coronary artery perfusion when administered exogenously and reduces ischemic injury in nonmyocardial tissue. However, it is unclear whether this agent improves ...
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Journal ArticleProc Natl Acad Sci U S A · May 9, 2000
When the heart fails, there is often a constellation of biochemical alterations of the beta-adrenergic receptor (betaAR) signaling system, leading to the loss of cardiac inotropic reserve. betaAR down-regulation and functional uncoupling are mediated throu ...
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Journal ArticleAnn Thorac Surg · February 2000
BACKGROUND: While internal mammary artery (IMA) use predicts improved survival after coronary bypass grafting (CABG), it remains unknown whether patients undergoing concomitant aortic valve replacement (AVR) realize a similar benefit. METHODS: All patients ...
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Journal ArticleCirculation · February 1, 2000
BACKGROUND: Genetic modulation of ventricular function may offer a novel therapeutic strategy for patients with congestive heart failure. Myocardial overexpression of beta(2)-adrenergic receptors (beta(2)ARs) has been shown to enhance contractility in tran ...
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Journal ArticleCell Transplant · 2000
Cellular cardiomyoplasty (CCM), or introduction of immature cells into terminally injured heart, can mediate repair of chronically injured myocardium. Several different cell types, ranging from embryonic stem cells to autologous skeletal myoblasts, have be ...
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Journal ArticleJ Am Coll Surg · January 2000
BACKGROUND: Staphylococcus aureus is a frequent cause of infection and bacteremia in the postoperative patient. Unfortunately, there have been no prospective studies evaluating these patients, so the incidence of complications, subsequent treatment algorit ...
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Journal ArticleJ Am Soc Echocardiogr · October 1999
Because minimally invasive methods of preload variation are not validated for load-insensitive indexes of cardiac performance, intravenous nitroglycerin (NTG), phenylephrine, and saline solution (VOL) boluses were used in blocked and intact autonomic state ...
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Journal ArticleAnn Thorac Surg · October 1999
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BACKGROUND: Differences in outcome after direct aortic cannulation (AORT) in the chest versus standard femoral arterial cannulation (FEM) have not been defined for minimally invasive cardiac operations utilizing the port-access approach. METHODS: A retrosp ...
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Journal ArticleJ Surg Res · August 1999
BACKGROUND: Acute myocardial infarction leads to loss of functional myocytes and structural integrity that often decreases diastolic compliance and increases resting myocardial segment length (diastolic creep). Successfully engrafting autologous skeletal m ...
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Journal ArticleJ Clin Invest · July 1999
Exogenous gene delivery to alter the function of the heart is a potential novel therapeutic strategy for treatment of cardiovascular diseases such as heart failure (HF). Before gene therapy approaches to alter cardiac function can be realized, efficient an ...
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Journal ArticleGene Ther · July 1999
Gene transfer to modify donor heart function during transplantation has significant therapeutic implications. Recent studies by our laboratory in transgenic mice have shown that overexpression of beta2-adrenergic receptors (beta2-ARs) leads to significantl ...
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OtherJ Thorac Cardiovasc Surg · July 1999
BACKGROUND: The transcription factor nuclear factor kappaB mediates the expression of a number of inflammatory genes involved in the whole-body inflammatory response to injury. We and others have found that dithiocarbamates specifically inhibit nuclear fac ...
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Journal ArticleJ Thorac Cardiovasc Surg · May 1999
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OBJECTIVE: The purpose of this study was to optimize selection criteria of biologic versus mechanical valve prostheses for aortic valve replacement. METHODS: Retrospective analysis was performed for 841 patients undergoing isolated, first-time aortic valve ...
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Journal ArticleAnn Thorac Surg · January 1999
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BACKGROUND: For minimally invasive cardiac operations to be widely applicable, the risks must be equivalent to those of standard open-chest operations. This study analyzed the outcomes of patients recorded in the multicenter Port Access (PA) International ...
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Journal ArticleAnn Thorac Surg · January 1999
BACKGROUND: Adult heart lacks stem cells and cannot effectively regenerate. In contrast, skeletal muscle is constantly undergoing repair. We proposed to transplant immature skeletal myoblasts into injured myocardium. METHODS: Approximately 7x10(6) soleus s ...
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Journal ArticleAnn Thorac Surg · December 1998
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BACKGROUND: The determinants of long-term outcome 15 years or more after porcine valve replacement are poorly documented. METHODS: A retrospective review was performed of patients undergoing valve replacement with standard Carpentier-Edwards aortic (n = 53 ...
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Journal ArticleCirculation · November 10, 1998
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BACKGROUND: Percutaneous balloon mitral valvuloplasty and durable mitral prostheses have made the role of open mitral commissurotomy (OMC) uncertain. METHODS AND RESULTS: Results from the use of St Jude mitral valve replacement (SJMVR) were compared with t ...
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Journal ArticleAm J Physiol · November 1998
Although cardiomyocyte damage is normally irreversible, gene therapy and somatic cell transfer offer potential for improving function in damaged regions of the heart. However, in ischemic models of injury, variability in depth, size, and location of damage ...
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Journal ArticleEur J Cardiothorac Surg · October 1998
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OBJECTIVE: The advantages and disadvantages of minimally invasive Port Access mitral valve operation have not been defined relative to standard median sternotomy. A study was therefore designed to delineate differences in outcome from mitral operation via ...
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Journal ArticleNat Med · August 1998
The adult heart lacks reserve cardiocytes and cannot regenerate. Therefore, a large acute myocardial infarction often develops into congestive heart failure. To attempt to prevent this progression, we transplanted skeletal myoblasts into cryoinfarcted myoc ...
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Journal ArticlePacing Clin Electrophysiol · July 1998
The effects of ventricular pacing on left ventricular (LV) dynamic geometry, function, and myocardial oxygen consumption (MVO2) were measured in 12 conscious dogs using sonomicrometry, micromanometry, ultrasonic flow probes, and oximetry catheters during r ...
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Journal ArticleAnn Thorac Surg · June 1998
Minimally invasive approaches for cardiac operations currently are gaining increasing attention. Some of these approaches require cannulation of the femoral vessels for cardiopulmonary bypass. A potential complication of femoral cannulation is ischemic inj ...
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Journal ArticleAnn Thorac Surg · June 1998
BACKGROUND: The Ross procedure has become an accepted and sometimes preferred alternative to mechanical aortic valve replacement. One criticism of the Ross procedure is that it may have a higher operative mortality, morbidity, and cost. Several groups have ...
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Journal ArticleJ Thorac Cardiovasc Surg · March 1998
OBJECTIVE: The ability to transfer genes to adult myocardium may have therapeutic implications for cardiac transplantation. We investigated the feasibility of adenovirus-mediated transfer of marker genes LacZ and Luciferase, as well as the potentially ther ...
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ConferenceProceedings of SPIE the International Society for Optical Engineering · December 1, 1997
We describe an active contour based on the elliptical Fourier series, and its application to matrix-array ultrasound. Matrix-array ultrasound is a new medical imaging modality that scans a 3D-volume electronically without physically moving the transducer, ...
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Journal ArticleCirculation · November 4, 1997
BACKGROUND: Alterations in cardiac efficiency may signal pathologic stresses and energetic adaptation during aortic regurgitation (AR). METHODS AND RESULTS: LV systolic function, left coronary blood flow, and AVO2 difference were measured in conscious dogs ...
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Journal ArticleProc Natl Acad Sci U S A · October 28, 1997
Cardiovascular gene therapy is a novel approach to the treatment of diseases such as congestive heart failure (CHF). Gene transfer to the heart would allow for the replacement of defective or missing cellular proteins that may improve cardiac performance. ...
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OtherAnn Thorac Surg · September 1997
BACKGROUND: Changes in memory and cognition frequently follow cardiac operations. We hypothesized that patients with the apolipoprotein E-epsilon 4 allele are genetically predisposed to cognitive dysfunction after cardiac operations. METHODS: The apolipopr ...
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Journal ArticleAnn Thorac Surg · July 1997
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BACKGROUND: Whether biological or mechanical valves should be used in patients on chronic dialysis therapy remains to be clearly defined. METHODS: A retrospective review was performed on 19 consecutive patients from our institution with end-stage renal dis ...
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OtherJ Thorac Cardiovasc Surg · June 1997
OBJECTIVES: Reports of improved ejection fraction, coupled with decreased filling pressures, have prompted a number of centers to begin evaluating the efficacy of heart reduction surgery to ameliorate symptoms of heart failure. However, the impact of this ...
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Journal ArticleProc Assoc Am Physicians · May 1997
Myocardial repair after injury is limited because the adult heart cannot regenerate. We propose using autologous skeletal muscle cells (myoblasts) as a source of reserve cells for repair of regions of damaged myocardium. This report examines two potential ...
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Journal ArticleJ Thorac Cardiovasc Surg · January 1997
OBJECTIVE: Cardiac failure as a result of valvular heart disease remains a major clinical problem that frequently leads to ventricular dysfunction, myocardial failure, and even death. The development of irreversible myocardial damage may be especially insi ...
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ConferenceFASEB Journal · December 1, 1996
Adaptations of right ventricular (RV) systolic performance to chronic pulmonary stenosis (PS) in clinical RV failure are poorly understood. Therefore, 7 dogs underwent chronic implantation of pneumatic pulmonary artery occluders, and epicardial dimension t ...
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ConferenceFASEB Journal · December 1, 1996
Demonstrating the efficacy of Cardiac Gene Therapy (CGT) remains hindered by the inability to measure changes in in vivo cardiac function in small animals. Post-implantation of transfected biopsy-derived skeletal muscle cells into the left ventricle (LV) o ...
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Journal ArticleSurg Endosc · October 1996
BACKGROUND: Carbon dioxide (CO2) pneumoperitoneum has been shown to adversely affect hemodynamics in patients. This study specifically examines the potential contribution of altered left ventricular contractility (LVC) to hemodynamic changes observed durin ...
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OtherJ Thorac Cardiovasc Surg · September 1996
The costs of heart operations and the problems related to anticoagulation after prosthetic valve replacement are among the limitations faced by patients in nonindustrialized countries with mitral stenosis caused by chronic rheumatic heart disease. The youn ...
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Journal ArticleJ Mol Cell Cardiol · May 1996
Evaluating cardiac gene therapy in the intact animal requires an index of cardiac function capable of detecting regional differences in contractility in a load-independent fashion. Potentially load-insensitive measures of ventricular performance were there ...
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Journal ArticleJ Am Soc Echocardiogr · 1996
The Frank-Starling relationship between left ventricular stroke work and end-diastolic minor-axis cross-sectional area was evaluated as a load-insensitive measure of inotropic state by two-dimensional echocardiography in 10 conscious dogs. Stroke work was ...
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Journal ArticleJ Thorac Cardiovasc Surg · May 1995
Porcine bioprostheses are often used for tricuspid valve replacement, yet the long-term outcome after this procedure is not well documented. Therefore, the records of 129 patients undergoing tricuspid valve replacement with Carpentier-Edwards (n = 88) or H ...
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Journal ArticleAnn Thorac Surg · May 1995
Despite major advances in cardiopulmonary bypass technology, surgical techniques, and anesthesia management, central nervous system complications remain a common problem after cardiopulmonary bypass. The etiology of neuropsychologic dysfunction after cardi ...
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Journal ArticleAnn Thorac Surg · December 1994
Few data exist regarding functional results and long-term survival after coronary bypass in patients on dialysis. Therefore, a retrospective analysis was performed of 21 consecutive patients with dialysis-dependent renal failure who were undergoing coronar ...
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Journal ArticleCirculation · November 1994
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BACKGROUND: To identify the optimal use of anticoagulants after Carpentier-Edwards valve replacement, a retrospective study of all patients undergoing Carpentier-Edwards aortic (N = 378) or mitral (N = 370) valve replacement was done. METHODS AND RESULTS: ...
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Journal ArticleCirculation · November 1994
BACKGROUND: Percutaneous balloon aortic valvuloplasty is limited by a high risk of procedural morbidity, transient clinical benefit, and a high restenosis rate. The management of patients with symptomatic aortic valve restenosis after percutaneous balloon ...
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Journal ArticleCirculation · May 1994
BACKGROUND: Survival after coronary artery bypass graft surgery (CABG) and medical therapy in patients with coronary artery disease (CAD) has been studied in both randomized trials and observational treatment comparisons. Over the past decade, the use of c ...
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Journal ArticleJ Thorac Cardiovasc Surg · February 1994
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During the period of 1977 to 1990, 960 Carpentier-Edwards standard prostheses (Baxter Healthcare Corp., Santa Ana, Calif.) were placed in 875 operations. Freedom from reoperation at 10 years was 57% +/- 4%, 76% +/- 3%, and 95% +/- 5% for mitral, aortic, an ...
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Journal ArticleAnn Biomed Eng · 1994
We developed and validated a new, more accurate, and easily applied method for calculating the parameters of the three-element Windkessel to quantitate arterial properties and to investigate ventriculoarterial coupling. This method is based on integrating ...
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Journal ArticleAnn Thorac Surg · December 1993
To determine the optimal role for percutaneous balloon mitral valvuloplasty or open mitral commissurotomy, the outcome of 164 consecutive patients undergoing either percutaneous balloon mitral valvuloplasty, open mitral commissurotomy, or mitral valve repl ...
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Journal ArticleCirculation · November 1993
BACKGROUND: To identify the determinants of survival in patients with severe (> 75%) stenosis of the left main coronary artery (LM) and an acute (48 hours) anterolateral myocardial infarction (AAMI), we retrospectively analyzed the course of 34 such patien ...
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Journal ArticleJ Surg Res · June 1993
To define the effects of altered left ventricular (LV) geometry on regional myocardial function during ischemia and recovery, regional and global LV geometry and transmural pressure (P) were measured in seven conscious dogs with sonomicrometry and microman ...
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Journal ArticleJ Surg Res · April 1993
After surgical revascularization of ischemic myocardium, temporary ventricular pacing is often used, yet no data exist to indicate whether pacing ischemic versus nonischemic myocardium affects myocardial recovery. Therefore, chronically instrumented consci ...
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Journal ArticleJ Clin Epidemiol · March 1993
The cost of treating disease depends on patient characteristics, but standard tools for analyzing the clinical predictors of cost have deficiencies. To explore whether survival analysis techniques might overcome some of these deficiencies in the analysis o ...
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Journal ArticleCirculation · November 1992
BACKGROUND: The purpose of this study was to describe the long-term event-free survival patterns of patients with significant coronary artery disease treated medically versus patterns of those treated surgically and to evaluate the factors associated with ...
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Journal ArticleAm J Cardiol · September 1, 1992
Although coronary artery bypass grafting (CABG) effectively eliminates or diminishes symptoms of myocardial ischemia, the overall performance status and functional outcome in elderly patients undergoing CABG is poorly documented. Therefore, 86 consecutive ...
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Journal ArticleAnn Thorac Surg · August 1992
Concurrent aortic stenosis and patent ductus arteriosus are not infrequent in children but are rare in adults. An adult case is described with diagnosis by cardiac catheterization and magnetic resonance imaging and with management by combined aortic valve ...
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Journal ArticleAnn Intern Med · May 15, 1992
OBJECTIVE: To determine whether a gender bias exists in referral for coronary bypass graft surgery among patients with catheterization-documented coronary artery disease. DESIGN: Historical cohort study (1969 to 1984). SETTING: A referral medical center. P ...
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Journal ArticleJ Am Coll Cardiol · February 1992
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In seven chronically instrumented conscious dogs, micromanometers measured left ventricular pressure, and ultrasonic dimension transducers measured left ventricular minor-axis diameter; the latter recording was filtered to examine data between 20 and 100 H ...
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Journal ArticleJ Vasc Surg · February 1992
Improvements in the operative management of acute traumatic thoracic aortic aneurysm have resulted in safe and expeditious repair. Nonetheless, multisystem injuries continue to inflict significant numbers of deaths. From 1970 to 1990, 108 patients with acu ...
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Journal ArticleBiomater Artif Cells Immobilization Biotechnol · 1992
An initial evaluation of PEG-bHb was performed using a modified hypovolemic shock model. PEG-bHb had a substantially longer intravascular half-life than native Hb and no measurable hemoglobinuria was observed in the canine. PEG-bHb allowed successful resus ...
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ConferenceProceedings Computers in Cardiology Cic 1992 · January 1, 1992
Computer software for the IBM PC was developed to assess the contractile properties of the right and left ventricles simultaneously. Four indices of systolic function were computed from pressure and volume data. These four indices consist of the slopes and ...
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Journal ArticleBiomaterials, Artificial Cells, and Immobilization Biotechnology · 1992
An initial evaluation of PEG-bHb was performed using a modified hypovolemic shock model. PEG-bHb had a substantially longer intravascular half-life than native Hb and no measurable hemoglobinuria was observed in the canine. PEG-bHb allowed successful resus ...
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Journal ArticleProceedings Computers in Cardiology Cic 1992 · January 1, 1992
Error in a simulated conductance catheter volume system was reduced over 60% by statistically incorporating a priori information through training. The conventional deterministic model uses a specific cylindrical geometry but does not otherwise incorporate ...
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ConferenceProceedings of the Annual Conference on Engineering in Medicine and Biology · December 1, 1991
An impedance catheter volume measurement system was modeled in spherical and spheroidal configurations to see if geometric and conductivity parameters could be estimated from measured potentials. Good results were obtained in both noise free and noise adde ...
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Journal ArticleCirculation · November 1991
The effect of diabetes on survival after coronary bypass surgery is uncertain. Also, although the overall clinical benefits of internal mammary artery (IMA) grafting are well established, the survival benefit attributable to IMA grafting in diabetics is no ...
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Journal ArticleJ Thorac Cardiovasc Surg · September 1991
Forty-seven patients with aortic dissection resulting from a primary tear located in the transverse aortic arch underwent surgical treatment. Twenty-six patients had acute type A, 7 had acute type B, 7 had chronic type A, and 7 had chronic type B aortic di ...
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Journal ArticleCirc Res · September 1991
The role of myocardial anisotropy in determining change in left ventricular shape during diastolic filling has not yet been demonstrated. Therefore, 11 conscious dogs were instrumented with global ultrasonic dimension transducers to measure left ventricula ...
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Journal ArticleJ Thorac Cardiovasc Surg · July 1991
Two hundred fifty-two patients underwent operation for type A aortic dissection at Stanford University Medical Center from 1963 to 1987 and Duke University Medical Center from 1975 to 1988. Sixty-seven percent had an acute type A dissection and 33% had a c ...
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Journal ArticleAnn Surg · July 1991
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All 163 patients admitted to one institution between 1975 and 1988 with aortic dissection were reviewed. Type I and type II patients received grafting of the ascending aorta, with an intraoperative mortality rate of 11%. For type III dissection, management ...
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Journal ArticleCirculation · November 1990
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To guide the choice of medical versus surgical therapy for patients with descending (type B) aortic dissection (tear in the descending aorta without involvement of the ascending aorta), multivariate survival analysis was applied to 136 patients admitted to ...
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Journal ArticleJ Thorac Cardiovasc Surg · November 1990
Dopamine frequently is used to improve cardiac performance after acute myocardial ischemia. Inotropic agents, however, increase myocardial oxygen demand and could potentially delay recovery from ischemic injury. To evaluate this problem, we studied eight c ...
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Journal ArticleCirculation · November 1990
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The superior patency and clinical advantages of internal mammary artery (IMA) grafting are well established. However, the relative benefits of routine multiple IMA grafting remain uncertain. To determine whether routine multiple compared with single IMA ut ...
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Journal ArticleAnn Thorac Surg · January 1990
Candida mediastinitis is a rare condition characterized by a high mortality and chronic morbidity, Including the present review, only 39 cases have been described, 67% occurring after a cardiac operation. Candida mediastinitis has a 55% mortality in the po ...
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Journal ArticleCirculation · January 1, 1990
The superior patency and clinical advantages of internal mammary artery (IMA) grafting are well established. However, the relative benefits of routine multiple IMA grafting remain uncertain. To determine whether routine multiple compared with single IMA ut ...
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Journal ArticleCirc Res · July 1989
In seven conscious, chronically instrumented dogs, left ventricular volume was calculated with an ellipsoidal model from the anteroposterior, septal-free wall, and base-to-apex left ventricular dimensions, measured by implanted ultrasonic transducers. Matc ...
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Journal ArticleAm J Physiol · July 1988
Quantification of myocardial performance after regional ischemic injury is difficult because available performance indexes are markedly dependent on concurrent load changes. To develop a more load-insensitive index of myocardial function during ischemia, e ...
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Journal ArticleJ Thorac Cardiovasc Surg · May 1988
On the basis of recent investigation, controversy has arisen regarding which of several cardiopulmonary resuscitation methods optimizes hemodynamics. The present study was designed to compare five recently described chest compression techniques: high-impul ...
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Journal ArticleJ Thorac Cardiovasc Surg · March 1988
Adequate coronary blood flow is a major determinant for successful resuscitation from cardiopulmonary arrest. To develop compression techniques that optimize coronary blood flow, we implanted in eight dogs electromagnetic flow probes that measured circumfl ...
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Journal ArticleCirc Res · June 1987
Although prolonged functional abnormalities after transient myocardial ischemia have been well described, the interrelationship between postischemic systolic and diastolic alterations remains controversial. Therefore, 24 chronically instrumented conscious ...
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Journal ArticleCirculation · June 1987
The end-systolic pressure-volume relationship (ESPVR) has been shown to be an afterload-insensitive descriptor of ventricular inotropic state in the isolated heart. The purpose of this study was to examine the effects of changes in afterload, heart rate, i ...
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Journal ArticleCardiovasc Res · May 1987
Since abnormalities in regional myocardial function and nucleotide metabolism persist for a prolonged period after a brief coronary occlusion the temporal relation between the resolution of myocardial dysfunction and repletion of nucleotide pools in postis ...
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Journal ArticleCirculation · December 1986
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Considerable effort has been expended in recent years by a number of laboratories to improve methods of cardiopulmonary resuscitation. This article briefly summarizes 5 years of investigation by our group on hemodynamic support during external cardiac mass ...
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Journal ArticleCirculation · May 1985
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The Frank-Starling relationship generally has been examined with filling pressure as the index of preload, resulting in a curvilinear function that plateaus at higher filling pressures. To investigate this relationship further in the intact heart, 32 dogs ...
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Otherundefined · December 1, 1984
Eight adult dogs were chronically instrumented with ascending and descending aortic flow probes while matched micromanometers measured aortic and left ventricular pressures. Coronary perfusion pressure was calculated as the difference between mean diastoli ...
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Journal ArticleAm J Physiol · November 1984
Pulse transit sonomicrometry is a well-accepted method for assessing cardiac dimensions and function in research animals. Unfortunately, this technique has been hampered in chronic applications by a significant incidence of transducer failure secondary to ...
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Journal ArticleJ Thorac Cardiovasc Surg · August 1984
Although periprosthetic leak is presently uncommon after mitral valve replacement, suture line disruption still occurs and may be significant in some patients. Suture technique is obviously an important factor in preventing disruption, but few authors have ...
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Journal ArticleAm J Vet Res · May 1984
Graphic simulation of ventricular activation for a typical ruminant with complete endocardial-epicardial penetration of Purkinje's fibers was performed. Voltages recorded from points on the torso simulating electrodes V10 and aVF were predicted. These comp ...
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Journal ArticleJ Thorac Cardiovasc Surg · October 1983
It has been suggested that mitral valve replacement for mitral regurgitation can precipitate acute myocardial failure by increasing left ventricular afterload. However, most studies of this problem have involved anesthesia, acute surgical trauma, or ischem ...
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Journal ArticleAdv Myocardiol · 1982
Previous studies from our laboratory utilized an isolated isovolumic Langendorff heart preparation to study myocardial metabolism and preservation of left ventricular function following global ischemia and reperfusion. The present study employed a similar ...
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Journal ArticleCirculation · August 1979
Nifedipine, a slow-channel calcium blocker, is thought to provide useful myocardial protection during prolonged total ischemia and reperfusion. An isolated, isovolumic, feline heart model was used to asses the effectiveness of nifedipine in both cardiopleg ...
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ConferenceAmerican Society of Mechanical Engineers Paper · January 1, 1974
The dependence of ion-chamber current on the density of the filling gas has been investigated, experimentally and analytically, to explore the use of an ion chamber as a high-pressure gas densitometer. A flat-plate ion chamber with a self-contained beta-pa ...
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Journal ArticleSemin Thorac Cardiovasc Surg
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Port-access mitral valve surgery has been around since 1995; and many variations upon the technique have been developed. Since 1996, we have performed more than 2500 port-access mitral valve surgeries, and thus gained a substantial experience. The purpose ...
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