Scholars@Duke
Madhav Swaminathan

Madhav Swaminathan

Adjunct Professor in the Department of Anesthesiology
Anesthesiology, Cardiothoracic
madhav.swaminathan@duke.edu
Box 3094 Med Ctr, Durham, NC 27710
Erwin Rd, 5691F Hafs Building, Durham, NC 27710

Selected Publications

The Odyssey of Diastolic Function: No Time to Relax.

Journal Article Anesth Analg · January 1, 2025 Full text Link to item Cite

An Automated Machine Learning-Based Quantitative Multiparametric Approach for Mitral Regurgitation Severity Grading.

Journal Article JACC Cardiovasc Imaging · January 2025 BACKGROUND: Considering the high prevalence of mitral regurgitation (MR) and the highly subjective, variable MR severity reporting, an automated tool that could screen patients for clinically significant MR (≥ moderate) would streamline the diagnostic/ther ... Full text Link to item Cite

Tricuspid Regurgitation after Orthotopic Heart Transplantation: Trajectories and Association With Mortality.

Journal Article Clin Transplant · January 2025 BACKGROUND: Tricuspid regurgitation (TR) is common immediately after orthotopic heart transplantation (OHT), though the expected outcomes of TR over time remain undefined. In this study, we examined the natural trajectory of TR in the first 120 days post-t ... Full text Link to item Cite

Development of and recovery from acute kidney injury after cardiac surgery: Randomized phase 2 trial of the hepatocyte growth factor mimetic ANG-3777.

Journal Article J Thorac Cardiovasc Surg · November 26, 2024 OBJECTIVES: To investigate the safety and efficacy of ANG-3777, a hepatocyte growth factor mimetic, in mitigating the risk of acute kidney injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS: In this double-blind placeb ... Full text Link to item Cite

Continuous Urine Output-Based Alert Identifies Cardiac Surgery-associated Acute Kidney Injury Earlier Than Serum Creatinine: A Prospective and Retrospective Observational Study.

Journal Article J Cardiothorac Vasc Anesth · October 2024 OBJECTIVE(S): Acute kidney injury (AKI) is defined and staged by reduced urine output (UO) and increased serum creatinine (SCr). UO is typically measured manually and documented in the electronic health record, making early and reliable detection of oligur ... Full text Link to item Cite

Efficacy and safety of therapeutic alpha-1-microglobulin RMC-035 in reducing kidney injury after cardiac surgery: a multicentre, randomised, double-blind, parallel group, phase 2a trial

Journal Article eClinicalMedicine · October 1, 2024 Background: Cardiac surgery invariably triggers acute kidney stress causing adverse renal outcomes. The AKITA study evaluated the efficacy and safety of RMC-035, a novel analogue of alpha-1-microglobulin, for reducing cardiac surgery-associated kidney inju ... Full text Cite

Integrating tailored approaches in perioperative care strategies for neurodivergent individuals.

Journal Article EClinicalMedicine · October 2024 Neurodivergent (ND) individuals exhibit variations in communication, behaviors, and cognition, which present both opportunities and challenges in healthcare settings. Anesthesiologists can offer personalized and compassionate care to ND patients throughout ... Full text Open Access Cite

Intraoperative Echocardiography: Guide to Decision-Making.

Journal Article Curr Cardiol Rep · June 2024 PURPOSE OF REVIEW: This review aims to provide a concise overview of key recommendations, with a specific focus on common challenges faced by intraoperative echocardiographers when dealing with frequently encountered valvular pathologies and mechanical cir ... Full text Link to item Cite

Practical Considerations for Obtaining Perioperative Transesophageal Echocardiography Accreditation: Collective Experiences at Early-Adopting Centers.

Journal Article J Cardiothorac Vasc Anesth · March 2024 The Intersocietal Accreditation Commission (IAC) is a nonprofit accrediting organization committed to ensuring the quality of diagnostic imaging and related procedures. It comprises a collaboration of stakeholders spanning numerous medical professionals an ... Full text Link to item Cite

Multimodality Cardiac Imaging and the Imaging Workforce in the United States: Diversity, Disparities, and Future Directions.

Journal Article Circ Cardiovasc Imaging · February 2024 Innovations in cardiac imaging have fundamentally advanced the understanding and treatment of cardiovascular disease. These advances in noninvasive cardiac imaging have also expanded the role of the cardiac imager and dramatically increased the demand for ... Full text Link to item Cite

Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging: A Report From the American Society of Echocardiography Developed in Collaboration With the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography.

Journal Article J Am Soc Echocardiogr · January 2024 In patients with significant cardiac valvular disease, intervention with either valve repair or valve replacement may be inevitable. Although valve repair is frequently performed, especially for mitral and tricuspid regurgitation, valve replacement remains ... Full text Link to item Cite

American Society of Echocardiography COVID-19 Statement Update: Lessons Learned and Preparation for Future Pandemics.

Journal Article J Am Soc Echocardiogr · November 2023 The COVID-19 pandemic has evolved since the publication of the initial American Society of Echocardiography (ASE) statements providing guidance to echocardiography laboratories. In light of new developments, the ASE convened a diverse, expert writing group ... Full text Link to item Cite

Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery.

Journal Article Circulation · October 24, 2023 BACKGROUND: Right ventricular failure (RVF) is a leading driver of morbidity and death after major cardiac surgery for advanced heart failure, including orthotopic heart transplantation and left ventricular assist device implantation. Inhaled pulmonary-sel ... Full text Open Access Link to item Cite

Organizational Core Values: The ASE Cares Perspective.

Journal Article J Am Soc Echocardiogr · October 2023 Full text Link to item Cite

Inhaled Pulmonary Vasodilator Therapy in Adult Lung Transplant: A Randomized Clinical Trial.

Journal Article JAMA Surg · January 1, 2022 IMPORTANCE: Inhaled nitric oxide (iNO) is commonly administered for selectively inhaled pulmonary vasodilation and prevention of oxidative injury after lung transplant (LT). Inhaled epoprostenol (iEPO) has been introduced worldwide as a cost-saving alterna ... Full text Open Access Link to item Cite

Pharmacological effects of ex vivo mesenchymal stem cell immunotherapy in patients with acute kidney injury and underlying systemic inflammation.

Journal Article Stem Cells Transl Med · December 2021 Mesenchymal stem cells (MSCs) have natural immunoregulatory functions that have been explored for medicinal use as a cell therapy with limited success. A phase Ib study was conducted to evaluate the safety and immunoregulatory mechanism of action of MSCs u ... Full text Link to item Cite

Teprasiran, a Small Interfering RNA, for the Prevention of Acute Kidney Injury in High-Risk Patients Undergoing Cardiac Surgery: A Randomized Clinical Study.

Journal Article Circulation · October 5, 2021 BACKGROUND: Acute kidney injury (AKI) affects up to 30% of patients undergoing cardiac surgery, leading to increased in-hospital and long-term morbidity and mortality. Teprasiran is a novel small interfering RNA that temporarily inhibits p53-mediated cell ... Full text Link to item Cite

Conventional Ultrafiltration During Elective Cardiac Surgery and Postoperative Acute Kidney Injury.

Journal Article J Cardiothorac Vasc Anesth · May 2021 OBJECTIVE: Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) serves to hemoconcentrate blood volume to avoid allogeneic blood transfusions. Previous studies have determined CUF volumes as a continuous variable are associated with posto ... Full text Open Access Link to item Cite

ASE Statement on Adapting Pediatric, Fetal, and Congenital Heart Disease Echocardiographic Services to the Evolving COVID-19 Pandemic.

Journal Article J Am Soc Echocardiogr · May 2021 Over the 12 months since the start of the coronavirus disease 2019 pandemic, an explosion of investigation and an increase in experience have led to vast improvement in our knowledge about this disease. However, coronavirus disease 2019 remains a huge publ ... Full text Link to item Cite

Representation of Female Faculty at US Medical Schools and Success in Obtaining National Institutes of Health Funding, 2008-2018.

Journal Article JAMA Netw Open · March 1, 2021 This cross-sectional study assesses the representation and success of female faculty at US medical schools and their success in obtaining funding from the National Institutes of Health (NIH) between 2008 and 2018. ... Full text Open Access Link to item Cite

Of Heights, Lengths, and Distances.

Journal Article J Am Soc Echocardiogr · January 2021 Full text Link to item Cite

Hepatocyte Growth Factor Mimetic ANG-3777 for Cardiac Surgery-Associated Acute Kidney Injury.

Journal Article Kidney Int Rep · December 2020 INTRODUCTION: Nearly one-third of patients undergoing cardiac surgery involving cardiopulmonary bypass (CPB) experience cardiac surgery-associated (CSA) acute kidney injury (AKI); 5% require renal replacement therapy. ANG-3777 is a hepatocyte growth factor ... Full text Link to item Cite

Transesophageal Echocardiographic Evaluation of Novel Extracellular Matrix Valve for Tricuspid Valve Endocarditis.

Journal Article CASE (Phila) · October 2020 • Intravenous drug abuse is a common cause of infective TV endocarditis. • The use of a novel ECM valve is a surgical alternative to TV replacement. • TEE evaluation is a useful tool to evaluate the unique valve appearance and function. ... Full text Link to item Cite

Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study.

Journal Article Transpl Int · August 2020 Acute kidney injury (AKI) and primary graft dysfunction (PGD) are serious complications after heart transplantation (HT). The relationship between AKI and PGD is poorly understood. We sought to examine the incidence of AKI and identify risk factors associa ... Full text Link to item Cite

ASE Statement on the Reintroduction of Echocardiographic Services during the COVID-19 Pandemic.

Journal Article J Am Soc Echocardiogr · August 2020 • Echocardiography services have been interrupted by the COVID pandemic. • Services are being gradually reintroduced as healthcare facilities reopen. • Operational, workflow and prioritization considerations are suggested. ... Full text Link to item Cite

ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak: Endorsed by the American College of Cardiology.

Journal Article J Am Coll Cardiol · June 23, 2020 • ASE guidance for patient and provider protection during echo exams in the COVID-19 pandemic. • Triaging approach for prioritizing echo exams during the COVID-19 pandemic. • Recommended imaging approach and appropriate PPE use during echo exams. ... Full text Link to item Cite

Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach: From the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons.

Journal Article J Am Soc Echocardiogr · June 2020 Intraoperative transesophageal echocardiography is a standard diagnostic and monitoring tool employed in the management of patients undergoing an entire spectrum of cardiac surgical procedures, ranging from "routine" surgical coronary revascularization to ... Full text Link to item Cite

ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak: Endorsed by the American College of Cardiology.

Journal Article J Am Soc Echocardiogr · June 2020 • ASE guidance for patient and provider protection during echo exams in the COVID-19 pandemic. • Triaging approach for prioritizing echo exams during the COVID-19 pandemic. • Recommended imaging approach and appropriate PPE use during echo exams. ... Full text Link to item Cite

Specific Considerations for the Protection of Patients and Echocardiography Service Providers When Performing Perioperative or Periprocedural Transesophageal Echocardiography during the 2019 Novel Coronavirus Outbreak: Council on Perioperative Echocardiography Supplement to the Statement of the American Society of Echocardiography Endorsed by the Society of Cardiovascular Anesthesiologists.

Journal Article J Am Soc Echocardiogr · June 2020 • TEE carries a high risk for SARS-CoV-2 spread. • TEE should be performed when clinical benefits outweigh the risks. • Proper handling and cleaning of equipment is critical. • Airborne precautions should be used in patients suspected or confirmed COVID-19 ... Full text Link to item Cite

Managing Change in the Aftermath of a Pandemic.

Journal Article J Am Soc Echocardiogr · June 2020 Full text Link to item Cite

Pluralism and Growth: Specialty Interest Groups at ASE.

Journal Article J Am Soc Echocardiogr · May 2020 Full text Link to item Cite

Finding Equity in an Unequal World.

Journal Article J Am Soc Echocardiogr · April 2020 Full text Link to item Cite

Differentiating Principles and Defining our "Why".

Journal Article J Am Soc Echocardiogr · March 2020 Full text Link to item Cite

Temporal Resolution in the New Decade.

Journal Article J Am Soc Echocardiogr · January 2020 Full text Link to item Cite

Impact of gender equity on editorial boards on journal quality

Conference ANESTHESIA AND ANALGESIA · 2020 Cite

Early Versus Delayed Acute Kidney Injury After Cardiac Surgery

Conference ANESTHESIA AND ANALGESIA · 2020 Cite

Perioperative Assessment of Diastolic Function

Chapter · January 1, 2020 Cardiac surgery is commonly performed on patients with some degree of functional impairment of myocardial function. In fact, heart failure is a frequent presenting feature for most patients who require surgical treatment. Despite the evidence surrounding t ... Full text Cite

Ase Statement on Protection of Patients and Echocardiography Service Providers during the 2019 Novel Coronavirus Outbreak

Journal Article Journal of the Indian Academy of Echocardiography and Cardiovascular Imaging · January 1, 2020 Full text Cite

Steve Jobs and The Value of Interventional Imagers.

Journal Article J Am Soc Echocardiogr · October 2019 Full text Link to item Cite

Social Media as a Strategic Opportunity.

Journal Article J Am Soc Echocardiogr · September 2019 Full text Link to item Cite

Creating a Caring Society.

Journal Article J Am Soc Echocardiogr · July 2019 Full text Link to item Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal Article Anesthesiology · 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 ... Full text Open Access Link to item Cite

Tricuspid Valve Regurgitation Immediately After Heart Transplant and Long-Term Outcomes.

Journal Article Ann Thorac Surg · May 2019 BACKGROUND: Tricuspid valve regurgitation (TR) is a common finding immediately after cardiac transplantation. However, there is a scarcity of data regarding its implication if left untreated on long-term outcomes and the role of early surgical repair. METH ... Full text Link to item Cite

Differences in Two- and Three-Dimensional Assessment of the Mitral Valve by Novices and Experts, Illustrated Using Anterior Mitral Valve Leaflet Length.

Journal Article J Cardiothorac Vasc Anesth · April 2019 OBJECTIVES: In this measurement validation study, the authors evaluated agreement between 2-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE), measuring anterior mitral valve leaflet length by both novice and experienced ec ... Full text Link to item Cite

Predictors and Changes in Cardiac Hemodynamics and Geometry With Transcatheter Aortic Valve Implantation.

Journal Article Am J Cardiol · March 1, 2019 The introduction of transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of patients with severe aortic stenosis (AS). However, despite the great clinical success of TAVI, less is known about the cardiac hemodynamics and structur ... Full text Link to item Cite

Renal Angina Is a Sensitive, but Nonspecific Identifier of Postcardiac Surgery Acute Kidney Injury.

Journal Article J Cardiothorac Vasc Anesth · February 2019 OBJECTIVES: Acute kidney injury (AKI) is a common complication of cardiac surgery, and early detection is difficult. This study was performed to determine the sensitivity, specificity, positive predictive value, negative predictive value, and statistical p ... Full text Link to item Cite

Intraoperative Assessment of Mitral Regurgitation

Journal Article Journal of the Indian Academy of Echocardiography and Cardiovascular Imaging · January 1, 2019 Since its advent, transesophageal echocardiography (TEE) has played an important role in the surgical management of patients undergoing mitral valve (MV) surgery. Mitral regurgitation (MR) assessment and surgical decision making remains one of the most cha ... Full text Cite

Building a Global and Diverse Community of Echo Enthusiasts

Journal Article Journal of the Indian Academy of Echocardiography and Cardiovascular Imaging · January 1, 2019 Full text Cite

The Perioperative Management of Ascending Aortic Dissection.

Journal Article Anesth Analg · December 2018 Acute aortic syndromes are a distinct group of pathologies involving the wall of the aorta that present acutely and can be potentially fatal unless treated in a timely fashion. The syndrome is dominated by aortic dissections, which comprise ≥95% of all suc ... Full text Link to item Cite

Development and validation of machine learning models to identify high-risk surgical patients using automatically curated electronic health record data (Pythia): A retrospective, single-site study.

Journal Article PLoS Med · November 2018 BACKGROUND: Pythia is an automated, clinically curated surgical data pipeline and repository housing all surgical patient electronic health record (EHR) data from a large, quaternary, multisite health institute for data science initiatives. In an effort to ... Full text Link to item Cite

Utility of Angle Correction for Hemodynamic Measurements with Doppler Echocardiography.

Journal Article J Cardiothorac Vasc Anesth · August 2018 OBJECTIVES: The routine application angle correction (AnC) in hemodynamic measurements with transesophageal echocardiography currently is not recommended but potentially could be beneficial. The authors hypothesized that AnC can be applied reliably and may ... Full text Link to item Cite

The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.

Journal Article Ann Thorac Surg · July 2018 BACKGROUND: Acute kidney injury (AKI) is a common serious complication after cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (in ... Full text Link to item Cite

Primary graft dysfunction after heart transplantation: Incidence, trends, and associated risk factors.

Journal Article Am J Transplant · June 2018 Changes in heart transplantation (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, and associated risk factors by analyzing consecutiv ... Full text Link to item Cite

ECHOCARDIOGRAPHIC MEASUREMENT OF CARDIAC TWIST: A SYSTEMATIC REVIEW AND META-ANALYSIS

Conference Journal of the American College of Cardiology · March 2018 Full text Cite

A Perioperative Medicine Model for Population Health: An Integrated Approach for an Evolving Clinical Science.

Journal Article Anesth Analg · February 2018 Health care delivery in the United States continues to balance on the tight rope that connects its transition from volume to value. Value in economic terms can be defined as the amount something exceeds its commodity price and is determined by extraordinar ... Full text Link to item Cite

Allogeneic Mesenchymal Stem Cells for Treatment of AKI after Cardiac Surgery.

Journal Article J Am Soc Nephrol · January 2018 AKI after cardiac surgery remains strongly associated with mortality and lacks effective treatment or prevention. Preclinical studies suggest that cell-based interventions may influence functional recovery. We conducted a phase 2, randomized, double-blind, ... Full text Link to item Cite

Occam's Foil: When One Diagnosis Isn't Enough.

Journal Article J Cardiothorac Vasc Anesth · December 2017 Full text Link to item Cite

Interleukin-8 and Tumor Necrosis Factor Predict Acute Kidney Injury After Pediatric Cardiac Surgery.

Journal Article Ann Thorac Surg · December 2017 BACKGROUND: Inflammation is a key component of both acute kidney injury (AKI) and response to cardiopulmonary bypass. Because AKI poses risks to children after cardiac surgery, we investigated the value of inflammatory biomarkers interleukin-8 (IL-8) and t ... Full text Link to item Cite

Ultrafiltration on CPB Predicts AKI and Transfusion

Conference CIRCULATION · November 14, 2017 Link to item Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal Article Anesth 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 ... Full text Open Access Link to item Cite

Using Ultrasound Wisely: A Tool to Enhance Good Clinical Practice.

Journal Article J Cardiothorac Vasc Anesth · October 2017 Full text Link to item Cite

Left Atrial Appendage Membrane in a Patient Presenting with Stroke.

Journal Article CASE (Phila) · October 2017 • LAA membranes are a rare abnormality of the LAA. • Left-sided cardiac myxomas may be associated with LAA membranes. • Comprehensive perioperative TEE should be performed in cardiac surgery. ... Full text Link to item Cite

Friday at Five: The Art of Medicine.

Journal Article J Cardiothorac Vasc Anesth · August 2017 Full text Link to item Cite

Urinalysis findings and urinary kidney injury biomarker concentrations.

Journal Article BMC Nephrol · July 6, 2017 INTRODUCTION: Urinary biomarkers of kidney injury are presumed to reflect renal tubular damage. However, their concentrations may be influenced by other factors, such as hematuria or pyuria. We sought to examine what non-injury related urinalysis factors a ... Full text Link to item Cite

Mitral Regurgitation After Orthotopic Lung Transplantation: Natural History and Impact on Outcomes.

Journal Article J Cardiothorac Vasc Anesth · June 2017 OBJECTIVE: Progression of mitral regurgitation (MR) after orthotopic lung transplantation (OLT) may be an underrecognized phenomenon due to the overlapping symptomatology of pulmonary and valvular disease. Literature evaluating the progression of MR after ... Full text Open Access Link to item Cite

Neuroendocrine stress response: implications for cardiac surgery-associated acute kidney injury.

Journal Article Rom J Anaesth Intensive Care · April 2017 Surgical stress causes biochemical and physiologic perturbations of every homeostatic axis. These alterations include volume/baroreceptor regulation, sympathetic activation, parasympathetic suppression, neuroendocrine activation, acute phase response prote ... Full text Link to item Cite

Management of 1-Lung Ventilation in a Patient With Failing Fontan Circulation.

Journal Article A A Case Rep · October 15, 2016 The number of patients reaching adulthood after undergoing Fontan palliation for the repair of a congenital heart defect continues to increase. In this case report, we present the anesthetic management of a patient with a history of tricuspid atresia treat ... Full text Link to item Cite

Grading Aortic Stenosis With Mean Gradient and Aortic Valve Area: A Comparison Between Preoperative Transthoracic and Precardiopulmonary Bypass Transesophageal Echocardiography.

Journal Article J Cardiothorac Vasc Anesth · October 2016 OBJECTIVE: The authors hypothesized that average precardiopulmonary bypass (pre-CPB) transesophageal echocardiographic (TEE) mean gradient (PGm) and aortic valve area (AVA) values would be significantly different from preoperative transthoracic (TTE) value ... Full text Open Access Link to item Cite

Association of cardiac biomarkers with acute kidney injury after cardiac surgery: A multicenter cohort study.

Journal Article J Thorac Cardiovasc Surg · July 2016 OBJECTIVE: Acute kidney injury is common after cardiac surgery and associated with postoperative mortality. Perioperative cardiac biomarkers may predict acute kidney injury and mortality. We evaluated whether cardiac biomarkers were associated with severe ... Full text Link to item Cite

Discordance in Grading Methods of Aortic Stenosis by Pre-Cardiopulmonary Bypass Transesophageal Echocardiography.

Journal Article Anesth Analg · April 2016 BACKGROUND: Current guidelines define severe aortic valve stenosis (AS) as an aortic valve area (AVA) ≤1.0 cm by the continuity equation and mean gradient (ΔPm) ≥ 40 mm Hg. However, these measurements can be discordant when classifying AS severity. Approxi ... Full text Open Access Link to item Cite

First Post-Operative Urinary Kidney Injury Biomarkers and Association with the Duration of AKI in the TRIBE-AKI Cohort.

Journal Article PLoS One · 2016 BACKGROUND: We previously demonstrated that assessment of the duration of AKI, in addition to magnitude of rise in creatinine alone, adds prognostic information for long-term survival. We evaluated whether post-operative kidney injury biomarkers in urine c ... Full text Link to item Cite

Urine Biomarkers and Perioperative Acute Kidney Injury: The Impact of Preoperative Estimated GFR.

Journal Article Am J Kidney Dis · December 2015 BACKGROUND: The interaction between baseline kidney function and the performance of biomarkers of acute kidney injury (AKI) on the development of AKI is unclear. STUDY DESIGN: Post hoc analysis of prospective cohort study. SETTING & PARTICIPANTS: The 1,219 ... Full text Link to item Cite

Genome-wide association study of acute kidney injury after coronary bypass graft surgery identifies susceptibility loci.

Journal Article Kidney 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 ... Full text Open Access Link to item Cite

Diastolic dysfunction, diagnostic and perioperative management in cardiac surgery.

Journal Article Curr Opin Anaesthesiol · February 2015 PURPOSE OF REVIEW: The review focuses on recent findings on the role of diastolic dysfunction in the perioperative period and on recent advances in the diagnosis and perioperative management of diastolic function. RECENT FINDINGS: Left ventricular diastoli ... Full text Link to item Cite

Use of mobile tablet devices and reduction in time to perioperative transesophageal echocardiography reporting: a historical cohort study.

Journal Article Can J Anaesth · January 2015 PURPOSE: Timely communication of intraoperative transesophageal echocardiography (TEE) findings to the postoperative care team is critical to optimizing patient care. We compared the use of a personal computer (PC) system with the use of a mobile tablet de ... Full text Open Access Link to item Cite

Association of Perioperative Plasma Neutrophil Gelatinase-Associated Lipocalin Levels with 3-Year Mortality after Cardiac Surgery: A Prospective Observational Cohort Study.

Journal Article PLoS One · 2015 BACKGROUND: Higher levels of plasma neutrophil gelatinase-associated lipocalin (pNGAL) are an early marker of acute kidney injury and are associated with increased risk of short-term adverse outcomes. The independent association between pNGAL and long-term ... Full text Link to item Cite

Pulmonary dysfunction after lung transplantation: the dilemma of coexisting mitral regurgitation.

Journal Article J Cardiothorac Vasc Anesth · December 2014 A case of MR progression after single-lung transplant as a significant contributor to postoperative respiratory failure is reported. Pre-existing MR may progress due to the decompressive effects of lung transplantation on RV dimension and consequent altera ... Full text Open Access Link to item Cite

Acute kidney injury after ex vivo lung perfusion (EVLP).

Journal Article Transplant Proc · December 2014 BACKGROUND: Ex vivo lung perfusion (EVLP) identifies viability for marginal organs but complicates and lengthens lung transplantation surgery. Preliminary evidence supports equivalency for EVLP-assisted versus traditional (non-EVLP) procedures regarding gr ... Full text Link to item Cite

G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving β-blockers.

Other Circ 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 ... Full text Link to item Cite

Caval thrombosis: imaging and managing a moving target.

Journal Article J Cardiothorac Vasc Anesth · October 2014 Full text Link to item Cite

Blood transfusions are associated with urinary biomarkers of kidney injury in cardiac surgery.

Journal Article J Thorac Cardiovasc Surg · August 2014 OBJECTIVE: Cardiac surgery is a major cause of acute kidney injury. In this setting, receipt of blood transfusions seems to be associated with a higher risk of acute kidney injury, as measured using serum creatinine values. We examined this association fur ... Full text Link to item Cite

When i do a TEE, am I ready for what comes next?

Journal Article J Cardiothorac Vasc Anesth · August 2014 Full text Link to item Cite

Quantitative assessment of mitral valve coaptation using three-dimensional transesophageal echocardiography.

Journal Article Ann Thorac Surg · June 2014 BACKGROUND: Functional mitral regurgitation (FMR) occurs as a consequence of left ventricular remodeling and is an independent predictor of adverse outcome. FMR is assessed qualitatively with two-dimensional echocardiography, but accurate quantitation of t ... Full text Link to item Cite

Diastolic dysfunction in patients undergoing cardiac surgery: the role of gender and age-gender interaction.

Journal Article J Cardiothorac Vasc Anesth · June 2014 OBJECTIVES: To test the hypothesis that females presenting for coronary artery bypass graft (CABG) surgery are at a higher risk of left ventricular diastolic dysfunction (LVDD) and that age and gender interact to influence this risk. DESIGN: Retrospective ... Full text Link to item Cite

Perioperative Diastolic Dysfunction: A Comprehensive Approach to Assessment by Transesophageal Echocardiography.

Journal Article Semin Cardiothorac Vasc Anesth · June 2014 Left ventricular diastolic dysfunction (LVDD) has only recently been recognized as an important determinant of perioperative morbidity. Intraoperative echocardiographers have been slow to adopt assessment of LVDD into clinical practice. This has been partl ... Full text Link to item Cite

Urinary biomarkers of AKI and mortality 3 years after cardiac surgery.

Journal Article J Am Soc Nephrol · May 2014 Urinary biomarkers of AKI provide prognostic value for in-hospital outcomes, but little is known about their association with longer-term mortality after surgery. We sought to assess the association between kidney injury biomarkers and all-cause mortality ... Full text Link to item Cite

The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone.

Journal Article Ann Thorac Surg · March 2014 BACKGROUND: Postoperative acute kidney injury (AKI) is a common serious consequence of cardiac surgery. One recent study found higher AKI rates when anemia and hypotension occurred during cardiopulmonary bypass (CPB) relative to anemia alone. To revalidate ... Full text Link to item Cite

Predictors of electrocerebral inactivity with deep hypothermia.

Journal Article J Thorac Cardiovasc Surg · March 2014 OBJECTIVE: Cooling to electrocerebral inactivity (ECI) by electroencephalography (EEG) remains the gold standard to maximize cerebral and systemic organ protection during deep hypothermic circulatory arrest (DHCA). We sought to determine predictors of ECI ... Full text Link to item Cite

Multinational institutional survey on patterns of intraoperative transesophageal echocardiography use in adult cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · February 2014 OBJECTIVES: To assess institutional patterns of perioperative transesophageal echocardiography (TEE) usage. DESIGN: The authors hypothesized that TEE is performed more frequently and comprehensively in academic centers, mainly by anesthesiologists, and bar ... Full text Link to item Cite

Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography.

Journal Article J Cardiothorac Vasc Anesth · February 2014 OBJECTIVE: Perioperative transesophageal echocardiography is essential for decision-making for mitral valve surgery. While two-dimensional transesophageal echocardiography represents the standard of care, tracking of dynamic changes using three-dimensional ... Full text Link to item Cite

Dyssynchrony: a different kind of mitral regurgitation.

Journal Article J Cardiothorac Vasc Anesth · December 2013 Full text Link to item Cite

Mitral regurgitation: focusing on the cause rather than the effect.

Journal Article J Cardiothorac Vasc Anesth · December 2013 Full text Link to item Cite

Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery.

Journal Article Stroke · December 2013 BACKGROUND AND PURPOSE: Neurocognitive decline occurs frequently after cardiac surgery and persists in a significant number of patients. Magnesium is thought to provide neuroprotection by preservation of cellular energy metabolism, blockade of the N-methyl ... Full text Link to item Cite

Preoperative angiotensin-converting enzyme inhibitors and angiotensin receptor blocker use and acute kidney injury in patients undergoing cardiac surgery.

Journal Article Nephrol Dial Transplant · November 2013 BACKGROUND: Using either an angiotensin-converting enzyme inhibitor (ACEi) or an angiotensin receptor blocker (ARB) the morning of surgery may lead to 'functional' postoperative acute kidney injury (AKI), measured by an abrupt increase in serum creatinine. ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · July 2013 Full text Link to item Cite

Effect of pharmacologic increases in afterload on left ventricular rotation and strain in a rabbit model.

Journal Article J Am Soc Echocardiogr · June 2013 BACKGROUND: Assessment of left ventricular rotational mechanics and myocardial deformation may provide new insight into both systolic and diastolic function. However, the effects of increasing afterload on these measures of cardiac function are poorly unde ... Full text Link to item Cite

Delayed postmyectomy ventricular septal defect.

Journal Article J Cardiothorac Vasc Anesth · April 2013 Full text Link to item Cite

Serum cystatin C- versus creatinine-based definitions of acute kidney injury following cardiac surgery: a prospective cohort study.

Journal Article Am J Kidney Dis · December 2012 BACKGROUND: The primary aim of this study was to compare the sensitivity and rapidity of acute kidney injury (AKI) detection by cystatin C level relative to creatinine level after cardiac surgery. STUDY DESIGN: Prospective cohort study. SETTINGS & PARTICIP ... Full text Link to item Cite

En face view of the mitral valve: definition and acquisition.

Journal Article Anesth Analg · October 2012 A 3-dimensional echocardiographic view of the mitral valve, called the "en face" or "surgical view," presents a view of the mitral valve similar to that seen by the surgeon from a left atrial perspective. Although the anatomical landmarks of this view are ... Full text Link to item Cite

Three-dimensional transesophageal echocardiography for perioperative right ventricular assessment.

Journal Article Ann Thorac Surg · August 2012 BACKGROUND: In high-risk cardiac procedures, dynamic analysis of right ventricular (RV) performance is desirable, but the geometric complexity of the RV limits the applicability of current two-dimensional echocardiographic imaging techniques. This study ai ... Full text Link to item Cite

Severe tricuspid valve regurgitation: a case for laminar flow.

Journal Article J Cardiothorac Vasc Anesth · June 2012 Full text Link to item Cite

Going with the flow: the dilemma of a laminar jet.

Journal Article J Cardiothorac Vasc Anesth · June 2012 Full text Link to item Cite

Preoperative serum brain natriuretic peptide and risk of acute kidney injury after cardiac surgery.

Journal Article Circulation · March 20, 2012 BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is associated with poor outcomes and is difficult to predict. We conducted a prospective study to evaluate whether preoperative brain natriuretic peptide (BNP) levels predict postoperative AKI amo ... Full text Link to item Cite

A comparative evaluation of transesophageal and transthoracic echocardiography for measurement of left ventricular systolic strain using speckle tracking.

Journal Article J Cardiothorac Vasc Anesth · February 2012 Featured Publication OBJECTIVE: The authors hypothesized that the measurement of strain by speckle tracking with transesophageal echocardiography (TEE) is feasible and comparable to transthoracic echocardiography (TTE). DESIGN: A prospective observational comparative study. SE ... Full text Link to item Cite

Thoracoabdominal aortic aneurysms

Chapter · January 18, 2012 Cite

Ventricular Function

Chapter · December 7, 2011 Full text Cite

Atherosclerosis of the aorta and prevention of neurological dysfunction after cardiac surgery

Journal Article · December 1, 2011 On May 6, 1953, John H Gibbon Jr., a Philadelphia surgeon, performed the world's first successful open heart procedure in which total heart-lung bypass was employed.1 Since that time, aortic manipulation and postoperative neurological complications have co ... Full text Cite

Renal protection strategies

Chapter · December 1, 2011 The well-known quote from the renal physiologist Dr. Homer Smith as he proposed that the composition of the blood is determined not by what the mouth ingests but by what the kidneys keep.1 highlights not only the kidneys' domain of influence, but why even ... Full text Cite

Aortic stenosis and mitral regurgitation: not as simple as it looks.

Journal Article J Cardiothorac Vasc Anesth · October 2011 Featured Publication Full text Link to item Cite

Clinical impact of concomitant tricuspid valve procedures during left ventricular assist device implantation.

Journal Article Ann Thorac Surg · October 2011 Featured Publication BACKGROUND: Almost 50% of patients referred for implantable left ventricular assist device (LVAD) have significant tricuspid regurgitation (TR). Preoperative TR is associated with negative outcomes but the clinical benefit of concomitant tricuspid valve pr ... Full text Link to item Cite

Postoperative biomarkers predict acute kidney injury and poor outcomes after adult cardiac surgery.

Journal Article J Am Soc Nephrol · September 2011 Acute kidney injury (AKI) is a frequent complication of cardiac surgery and increases morbidity and mortality. The identification of reliable biomarkers that allow earlier diagnosis of AKI in the postoperative period may increase the success of therapeutic ... Full text Link to item Cite

Inhaled nitric oxide after left ventricular assist device implantation: a prospective, randomized, double-blind, multicenter, placebo-controlled trial.

Journal Article J Heart Lung Transplant · August 2011 Featured Publication BACKGROUND: Used frequently for right ventricular dysfunction (RVD), the clinical benefit of inhaled nitric oxide (iNO) is still unclear. We conducted a randomized, double-blind, controlled trial to determine the effect of iNO on post-operative outcomes in ... Full text Link to item Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2011 Featured Publication 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 ... Full text Link to item Cite

Impact of tricuspid valve regurgitation in patients treated with implantable left ventricular assist devices.

Journal Article Ann Thorac Surg · May 2011 Featured Publication BACKGROUND: The progression of tricuspid valve regurgitation (TR) and the impact of preoperative TR on postoperative outcomes in patients having left ventricular assist device (LVAD) implantation has not been studied. METHODS: One hundred seventy-six conse ... Full text Link to item Cite

Thinking beyond the aortic valve: implications of a diseased aorta.

Journal Article J Cardiothorac Vasc Anesth · April 2011 Featured Publication Full text Link to item Cite

Aortic stenosis and coronary artery disease... and a challenging aorta.

Journal Article J Cardiothorac Vasc Anesth · April 2011 Featured Publication Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · February 2011 Full text Link to item Cite

Systolic anterior motion and mitral valve reserve function: which one should we care about?

Journal Article J Cardiothorac Vasc Anesth · October 2010 Featured Publication Full text Link to item Cite

Perioperative outcomes among patients with end-stage renal disease following coronary artery bypass surgery in the USA.

Journal Article Nephrol Dial Transplant · July 2010 Featured Publication BACKGROUND: Patients with end-stage renal disease (ESRD) requiring chronic haemodialysis who undergo coronary artery bypass graft surgery (CABG) are at significant risk for perioperative mortality. However, the impact of changes in ESRD patient volume and ... Full text Link to item Cite

Combined valvular disease: when echocardiography provides the questions and the answers.

Journal Article J Cardiothorac Vasc Anesth · April 2010 Featured Publication Full text Link to item Cite

Impact of early renal recovery on survival after cardiac surgery-associated acute kidney injury.

Journal Article Ann Thorac Surg · April 2010 Featured Publication BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major postoperative complication. Although some early recovery is common, its effect on long-term outcomes is unclear. We tested the hypothesis that early renal recovery after CSA-AK ... Full text Link to item Cite

Ordinary images--extraordinary stories: echo challenges and clinical decisions.

Journal Article J Cardiothorac Vasc Anesth · February 2010 Featured Publication Full text Link to item Cite

Mitral valve repair for degenerative disease: a 20-year experience.

Journal Article Ann Thorac Surg · December 2009 Featured Publication 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 ... Full text Link to item Cite

Cardiac surgery and acute kidney injury: emerging concepts.

Journal Article Curr Opin Crit Care · December 2009 Featured Publication PURPOSE OF REVIEW: To review recent advances in understanding of the occurrence, pathophysiology, prophylaxis and treatment of cardiac surgery-associated acute kidney injury (AKI). RECENT FINDINGS: New definitions and prompt diagnostic tools, enhanced risk ... Full text Link to item Cite

Mitral gradients and frequency of recurrence of mitral regurgitation after ring annuloplasty for ischemic mitral regurgitation.

Journal Article Ann Thorac Surg · October 2009 Featured Publication 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 ... Full text Link to item Cite

Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography's Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography.

Journal Article J Am Soc Echocardiogr · September 2009 Featured Publication Full text Link to item Cite

Increasing healthcare resource utilization after coronary artery bypass graft surgery in the United States.

Journal Article Circ Cardiovasc Qual Outcomes · July 2009 Featured Publication BACKGROUND: Despite declining lengths of stay, postdischarge healthcare resource utilization may be increasing because of shifts to nonacute care settings. Although changes in hospital stay after coronary artery bypass graft (CABG) surgery have been descri ... Full text Link to item Cite

A phase II multicenter double-blind placebo-controlled study of ethyl pyruvate in high-risk patients undergoing cardiac surgery with cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · June 2009 Featured Publication OBJECTIVE: Ethyl pyruvate (EP) is an investigational drug that has been shown to protect animals in several models of critical illness including myocardial or mesenteric ischemia/reperfusion injury, sepsis, and hemorrhagic shock. The purpose of this study ... Full text Link to item Cite

Mortality trends associated with acute renal failure requiring dialysis after CABG surgery in the United States.

Journal Article Blood Purif · 2009 Featured Publication BACKGROUND/AIMS: Acute renal failure is associated with a high risk of mortality when it complicates coronary artery bypass graft (CABG) surgery. We examined a large nationwide database from 1988 to 2003 and hypothesized that mortality in CABG-associated a ... Full text Link to item Cite

Trends in cardiac surgery-associated acute renal failure in the United States: a disproportionate increase after heart transplantation.

Journal Article Ren Fail · 2009 Featured Publication Acute renal failure (ARF) is common after cardiac surgery and more frequent after complex cardiac surgery. While the incidence of ARF is increasing after coronary artery bypass graft (CABG) surgery, trends in other forms of cardiac surgery remain unclear. ... Full text Link to item Cite

Institutional response to FDA warning on aprotinin and impact on outcomes.

Journal Article HSR Proc Intensive Care Cardiovasc Anesth · 2009 INTRODUCTION: New evidence of potential risks of aprotinin in 2006 generated public concern about a previously approved drug that was routinely used. In response, we assembled a team of experts within the institution to form guidelines for the appropriate ... Link to item Cite

Thinking from inside the box.

Journal Article Semin Cardiothorac Vasc Anesth · December 2008 Featured Publication Full text Link to item Cite

Endovascular approaches to complex thoracic aortic disease.

Journal Article Semin Cardiothorac Vasc Anesth · December 2008 Featured Publication Diseases of the thoracic aorta remain among the most lethal and difficult to treat conditions. In 2005, the US Food and Drug Administration approved the first endoprosthesis for the treatment of aneurysms of the descending thoracic aorta; at present, there ... Full text Link to item Cite

Emerging concepts in acute kidney injury following cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · December 2008 Featured Publication Acute kidney injury (AKI) remains a significant cause of morbidity and mortality following cardiac surgery. Through a more thorough understanding of perioperative genomics and the evolving role of early biomarkers of AKI, the authors seek to improve meanin ... Full text Link to item Cite

"Real world" thoracic endografting: results with the Gore TAG device 2 years after U.S. FDA approval.

Journal Article Ann Thorac Surg · November 2008 Featured Publication BACKGROUND: The Gore TAG thoracic endoprosthesis (W. L. Gore and Associates, Flagstaff, AZ) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of thoracic aortic aneurysms on March 23, 2005, and remains the only FDA approved thor ... Full text Link to item Cite

Survival prognosis and surgical management of ischemic mitral regurgitation.

Journal Article Ann Thorac Surg · September 2008 Featured Publication 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 ... Full text Link to item Cite

Acute kidney injury and chronic kidney disease after cardiac surgery.

Journal Article Adv Chronic Kidney Dis · July 2008 Featured Publication Kidney dysfunction is common after cardiac surgery and predicts mortality risk and poorer long-term outcome, particularly when acute injury superimposes upon chronic kidney disease. Numerous insults contribute to perioperative renal impairment including ma ... Full text Link to item Cite

Fatal Thrombosis After Factor VII Administration During Extracorporeal Membrane Oxygenation.

Journal Article J Cardiothorac Vasc Anesth · April 2008 Featured Publication Full text Link to item Cite

Trends in coronary artery bypass graft surgery among ESRD patients

Conference AMERICAN JOURNAL OF KIDNEY DISEASES · April 1, 2008 Link to item Cite

The effect of aprotinin on outcome after coronary-artery bypass grafting.

Journal Article N Engl J Med · February 21, 2008 Featured Publication BACKGROUND: Aprotinin has recently been associated with adverse outcomes in patients undergoing cardiac surgery. We reviewed our experience with this agent in patients undergoing cardiac surgery at Duke University Medical Center. METHODS: We retrieved data ... Full text Link to item Cite

Cardiac surgery-associated acute kidney injury: putting together the pieces of the puzzle.

Journal Article Nephron Physiol · 2008 Featured Publication BACKGROUND: Acute kidney injury (AKI) is a common problem in the context of cardiac surgery. There are both similarities and differences with AKI occurring in other clinical scenarios. In this paper, we discuss those aspects of AKI that are particular to c ... Full text Link to item Cite

The assessment of publication quality

Journal Article Anesthesia and Analgesia · January 1, 2008 Full text Cite

The role of biomarkers in cardiac surgery-associated acute kidney injury

Journal Article · December 1, 2007 Cardiac surgery associated-acute kidney injury (AKI) is common, affecting up to 40 % of heart surgery patients (depending on the definition used) [1]. Five to ten percent of these patients will require new renal replacement therapy, and this carries a high ... Full text Cite

A bibliometric analysis of global clinical research by anesthesia departments.

Journal Article Anesth Analg · December 2007 Featured Publication BACKGROUND: Few studies have investigated the diversity in research conducted by anesthesia-based researchers. We examined global clinical research attributed to anesthesia departments using Medline and Ovid databases. We also investigated the impact of ec ... Full text Link to item Cite

Deterioration of regional wall motion immediately after coronary artery bypass graft surgery is associated with long-term major adverse cardiac events.

Journal Article Anesthesiology · November 2007 Featured Publication BACKGROUND: Patients undergoing coronary artery bypass graft (CABG) surgery frequently develop wall motion abnormalities diagnosed by intraoperative transesophageal echocardiography. However, the relation between deterioration in wall motion and postoperat ... Full text Link to item Cite

Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly.

Journal Article Anesthesiology · October 2007 Featured Publication BACKGROUND: Strategies for neuroprotection including hypothermia and hemodilution have been routinely practiced since the inception of cardiopulmonary bypass. Yet postoperative neurocognitive deficits that diminish the quality of life of cardiac surgery pa ... Full text Link to item Cite

Trends in acute renal failure associated with coronary artery bypass graft surgery in the United States.

Journal Article Crit Care Med · October 2007 Featured Publication OBJECTIVE: Acute renal failure remains a major complication of coronary artery bypass graft surgery that is strongly associated with in-hospital mortality. Based on similar observations in other clinical settings, we tested the hypothesis that the diagnosi ... Full text Link to item Cite

Neurophysiologic intraoperative monitoring during endovascular stent graft repair of the descending thoracic aorta.

Journal Article J Clin Neurophysiol · August 2007 Featured Publication Conventional surgery on the descending thoracic aorta for aneurysm or dissection repair typically involves open thoracotomy and cross-clamping of the aorta. These procedures are associated with the potential for significant neurologic morbidity due to spin ... Full text Link to item Cite

Endovascular thoracic aortic aneurysm repair with concomitant myocardial and carotid revascularization.

Journal Article Ann Thorac Surg · July 2007 Featured Publication A 73-year-old woman presented with a large saccular aneurysm involving the distal aortic arch. Preoperative aortography and cardiac catheterization revealed left main coronary artery and left common carotid artery stenoses. Concomitant coronary artery bypa ... Full text Link to item Cite

Left ventricular endocardial irregularity: evaluation using epicardial echocardiography.

Journal Article J Cardiothorac Vasc Anesth · April 2007 Featured Publication Full text Link to item Cite

Transesophageal echocardiography of the quadricuspid aortic valve.

Journal Article Anesth Analg · December 2006 Featured Publication Full text Link to item Cite

Reimplantation technique (David operation) for multiple sinus of valsalva aneurysms.

Journal Article Ann Thorac Surg · August 2006 Featured Publication Sinus of Valsalva aneurysms are relatively uncommon, and surgical repair is indicated at the time of diagnosis whether or not symptoms are present. This generally entails closure using a patch technique because usually only one sinus is involved. We report ... Full text Link to item Cite

Inflammatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery.

Journal Article Circulation · July 4, 2006 BACKGROUND: The inflammatory response triggered by cardiac surgery with cardiopulmonary bypass (CPB) is a primary mechanism in the pathogenesis of postoperative myocardial infarction (PMI), a multifactorial disorder with significant inter-patient variabili ... Full text Link to item Cite

Case report: optimizing intraoperative detection of pulmonary embolism using contrast-enhanced echocardiography.

Journal Article Can J Anaesth · July 2006 Featured Publication PURPOSE: Perioperative pulmonary embolism (PE) is associated with significant morbidity and mortality. Intraoperatively, the clinical management of patients with PE can be enhanced by the use of transesophageal echocardiography (TEE) to visualize emboli, a ... Full text Link to item Cite

Symmetry aortic connector devices and acute renal injury: a comparison of renal dysfunction after three different aortocoronary bypass surgery techniques.

Journal Article Anesth Analg · January 2006 Featured Publication Although the pathogenesis of acute renal injury after cardiac surgery is multifactorial, atherosclerosis of the ascending aorta and embolic burden are strong independent predictors. Use of the Symmetry aortic connector device (ACD) for proximal anastomosis ... Full text Link to item Cite

Association of neurocognitive function and quality of life 1 year after coronary artery bypass graft (CABG) surgery.

Journal Article Psychosom Med · 2006 Featured Publication OBJECTIVE: Although coronary artery bypass grafting (CABG) has been shown to improve quality of life and functional capacity for many patients, recent studies have demonstrated that a significant number of patients exhibit impairment in cognitive function ... Full text Link to item Cite

Cerebral physiology of cardiac surgical patients treated with the perfluorocarbon emulsion, AF0144.

Journal Article Ann Thorac Surg · October 2005 BACKGROUND: Perfluorooctyl bromide is a biologically inert compound with short biologic retention and high oxygen solubility. The purpose of this study was to assess the effect of the perfluorocarbon emulsion, AF0144 (Perflubron, Alliance Pharmaceutical Co ... Full text Link to item Cite

Genetic polymorphisms and the risk of stroke after cardiac surgery.

Journal Article Stroke · September 2005 BACKGROUND AND PURPOSE: Stroke represents a significant cause of morbidity and mortality after cardiac surgery. Although the risk of stroke varies according to both patient and procedural factors, the impact of genetic variants on stroke risk is not well u ... Full text Link to item Cite

Impact of mitral valve regurgitation evaluated by intraoperative transesophageal echocardiography on long-term outcomes after coronary artery bypass grafting.

Journal Article Circulation · August 30, 2005 Featured Publication 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 ... Full text Link to item Cite

Xenon and the inflammatory response to cardiopulmonary bypass in the rat.

Journal Article J Cardiothorac Vasc Anesth · August 2005 OBJECTIVE: The purpose of this study was to investigate the effect of xenon on the inflammatory response to cardiopulmonary bypass. DESIGN: Prospective, randomized experimental study. SETTING: University research laboratory. PARTICIPANTS: Sprague-Dawley ra ... Full text Link to item Cite

Postoperative hyperthermia following off-pump versus on-pump coronary artery bypass surgery.

Journal Article J Cardiothorac Vasc Anesth · August 2005 OBJECTIVE: Hyperthermia is common in the first 24 hours following coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB). An inflammatory response to CPB is often implicated in the pathophysiology of this fever. Unlike CABG with CPB, ... Full text Link to item Cite

Differential cardiac gene expression during cardiopulmonary bypass: ischemia-independent upregulation of proinflammatory genes.

Journal Article J Thorac Cardiovasc Surg · August 2005 OBJECTIVE: Cardiac surgery with cardiopulmonary bypass induces both systemic and local inflammatory responses implicated in the pathogenesis of myocardial dysfunction. Multifactorial perioperative sources of myocardial injury complicate understanding of th ... Full text Link to item Cite

Cognitive dysfunction after cardiac surgery: revisiting etiology.

Journal Article Semin Cardiothorac Vasc Anesth · June 2005 Cognitive dysfunction remains a frequent complication of cardiac surgery. Despite many years of research, few preventive strategies and no definitive therapeutic options exist for the management of this troublesome clinical problem. This shortcoming may be ... Full text Link to item Cite

Genetic factors contribute to bleeding after cardiac surgery.

Journal Article J Thromb Haemost · June 2005 BACKGROUND: Postoperative bleeding remains a common, serious problem for cardiac surgery patients, with striking inter-patient variability poorly explained by clinical, procedural, and biological markers. OBJECTIVE: We tested the hypothesis that genetic po ... Full text Link to item Cite

Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · June 2005 Featured Publication OBJECTIVE: The purpose of this study was to determine if patients receiving statin therapy before coronary artery bypass grafting surgery would have less cognitive dysfunction after cardiopulmonary bypass as a consequence of a diminished inflammatory respo ... Full text Link to item Cite

The influence of xenon, nitrous oxide and nitrogen on gas bubble expansion during cardiopulmonary bypass.

Journal Article Eur J Anaesthesiol · May 2005 BACKGROUND AND OBJECTIVE: Xenon may have favourable applications in the setting of cardiac surgery. Its advantages include a desirable haemodynamic profile as well as potential cardiac and neuroprotective properties. However, its low solubility may lead to ... Full text Link to item Cite

The impact of intraoperative echocardiography on clinical outcomes following adult cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · March 2005 Featured Publication Over the past 30 years, intraoperative echocardiography has become an invaluable diagnostic tool and monitor of cardiac performance for the management of cardiac surgical patients. The essential information provided by intraoperative echocardiography regar ... Full text Link to item Cite

Association of genetic polymorphisms with risk of renal injury after coronary bypass graft surgery.

Journal Article Am J Kidney Dis · March 2005 Featured Publication BACKGROUND: Post-cardiac surgery renal dysfunction is a common, serious, multifactorial disorder, with interpatient variability predicted poorly by preoperative clinical, procedural, and biological markers. Therefore, we tested the hypothesis that selected ... Full text Link to item Cite

G alpha(q)-coupled receptors in human atrium function through protein kinase C epsilon and delta.

Journal Article J Mol Cell Cardiol · February 2005 Cardiac G alpha(q)-coupled receptors (such as endothelin, angiotensin, and alpha1-adrenergic receptors) mediate cardiac inotropy and chronotropy, as well as the development of hypertrophy. These receptors signal through protein kinase C (PKC), a family of ... Full text Link to item Cite

Renal medullary hypoxia during experimental cardiopulmonary bypass: a pilot study.

Journal Article Perfusion · January 2005 OBJECTIVES: To determine the effect of cardiopulmonary bypass (CPB) on renal medullary oxygenation. DESIGN: Observational. SETTING: Laboratory. PARTICIPANTS: Pigs (n=3). INTERVENTIONS: Following induction of general anesthesia, a Paratrend blood gas probe ... Full text Link to item Cite

Brief report: The declining incidence of cerebral hyperthermia during cardiac surgery: a seven-year experience in 6,334 patients.

Journal Article Can J Anaesth · 2005 PURPOSE: Cerebral hyperthermia during rewarming from hypothermic cardiopulmonary bypass (CPB) commonly occurs and has been associated with postoperative neurocognitive dysfunction. Increased awareness of this has likely led to changes in rewarming strategi ... Full text Link to item Cite

Aortic atheroma burden and cognitive dysfunction after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · November 2004 BACKGROUND: Neurocognitive dysfunction (NCD) after coronary artery bypass graft (CABG) surgery is a common problem. Atherosclerotic disease of the aorta is a known risk factor for stroke after cardiac surgery, but its relationship to NCD is unclear. This s ... Full text Link to item Cite

Reply

Journal Article The Annals of Thoracic Surgery · November 2004 Full text Cite

Cardiopulmonary bypass reduces the minimum alveolar concentration for isoflurane.

Journal Article J Cardiothorac Vasc Anesth · October 2004 OBJECTIVE: The purpose of this investigation was to determine the influence of cardiopulmonary bypass (CPB) on the minimum alveolar concentration (MAC) of isoflurane in a rat model of CPB. DESIGN: Prospective. SETTING: University research laboratory. PARTI ... Full text Link to item Cite

Hemodilution during cardiopulmonary bypass increases cerebral infarct volume after middle cerebral artery occlusion in rats.

Journal Article Anesth Analg · October 2004 Although the optimal hematocrit during cardiopulmonary bypass (CPB) is not defined, excessive hemodilution may lead to organ ischemia via a reduction in oxygen-carrying capacity uncompensated by autoregulatory and/or rheologic increases in organ blood flow ... Full text Link to item Cite

Transcranial Doppler emboli count predicts rise in creatinine after coronary artery bypass graft surgery.

Journal Article J Cardiothorac Vasc Anesth · October 2004 OBJECTIVE: To examine the correlation between transcranial Doppler ultrasonography-detected emboli during coronary artery bypass graft surgery with cardiopulmonary bypass and renal dysfunction as determined by the postoperative change in creatinine. DESIGN ... Full text Link to item Cite

"Other" neurologic complications after cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · September 2004 Compared to the neurologic morbidity of stroke and cognitive dysfunction, "other" neurologic complications involving injuries to the brachial plexus, phrenic nerve, cranial nerves, other peripheral nerves, as well as the visual pathways, have been dispropo ... Full text Link to item Cite

Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming in combination with post-bypass body surface warming: a feasibility study.

Journal Article Anesth Analg · September 2004 Cerebral hyperthermia is common during the rewarming phase of cardiopulmonary bypass (CPB) and is implicated in CPB-associated neurocognitive dysfunction. Limiting rewarming may prevent cerebral hyperthermia but risks postoperative hypothermia. In a prospe ... Full text Link to item Cite

Preliminary report on the interaction of apolipoprotein E polymorphism with aortic atherosclerosis and acute nephropathy after CABG.

Journal Article Ann Thorac Surg · August 2004 Featured Publication BACKGROUND: Renal dysfunction is a serious complication of cardiac surgery that is highly associated with short- and long-term adverse outcome. While the apolipoprotein E (APOE) epsilon4 allele has been linked to the occurrence of both postcardiac surgery ... Full text Link to item Cite

Predictors of inotrope use during separation from cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · August 2004 Featured Publication OBJECTIVE: To identify the demographic, clinical, and echocardiographic features that predict the use of inotropic support at separation from cardiopulmonary bypass (CPB). DESIGN: Retrospective study of consecutive patients undergoing coronary artery bypas ... Full text Link to item Cite

Cardiac sarcoidosis: two cases with autopsy findings.

Journal Article Malays J Pathol · June 2004 Cardiac sarcoidosis is a disease of young adults. In most cases it presents with sudden death, arrhythmias, conduction disorders, heart failure or cardiomyopathy. The authors describe two cases of myocardial involvement by sarcoidosis that lead to death of ... Link to item Cite

A randomized controlled trial of the Arctic Sun Temperature Management System versus conventional methods for preventing hypothermia during off-pump cardiac surgery.

Journal Article Anesth Analg · February 2004 UNLABELLED: In this trial we compared the hypothermia avoidance abilities of the Arctic Sun Temperature Management System (a servo-regulated system that circulates temperature-controlled water through unique energy transfer pads adherent to the patient's b ... Full text Link to item Cite

Novel diagnostic test for acute stroke.

Journal Article Stroke · January 2004 BACKGROUND AND PURPOSE: The absence of a widely available and sensitive diagnostic test for acute cerebral ischemia remains a significant limitation in the diagnosis and management of stroke. The objective of this study was to examine the feasibility of de ... Full text Link to item Cite

The importance of intraoperative transesophageal echocardiography in endovascular repair of thoracic aortic aneurysms.

Journal Article Anesth Analg · December 2003 Featured Publication UNLABELLED: Endovascular repair of the aorta (EVAR) is a promising alternative to open repair. Transesophageal echocardiography (TEE) is a sensitive imaging modality for aortic disease. We reviewed our experience with TEE in thoracic EVAR. Seven patients u ... Full text Link to item Cite

Lung isolation during port-access cardiac surgery: double-lumen endotracheal tube versus single-lumen endotracheal tube with a bronchial blocker.

Journal Article J 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 ... Full text Link to item Cite

Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice.

Journal Article Anesthesiology · November 2003 BACKGROUND: Volatile anesthetics provide protection in experimental models of global cerebral ischemia. To date, all models evaluated have included profound systemic arterial hypotension as a component of the ischemic insult. This study was designed to det ... Full text Link to item Cite

Cerebral embolization during cardiac surgery: impact of aortic atheroma burden.

Other Br 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 ... Full text Link to item Cite

The neuroprotective effect of xenon administration during transient middle cerebral artery occlusion in mice.

Journal Article Anesthesiology · October 2003 BACKGROUND: Xenon has been shown to be neuroprotective in several models of in vitro and in vivo neuronal injury. However, its putative neuroprotective properties have not been evaluated in focal cerebral ischemia. The purpose of this study was to determin ... Full text Link to item Cite

Neuroprotection in cardiac surgery.

Journal Article Anesthesiol Clin North Am · September 2003 This article reviews past and present neuroprotective efforts and outlines a framework for the future development of techniques for neuroprotection during cardiac surgery. ... Full text Link to item Cite

An assessment of two different methods of left ventricular ejection time measurement by transesophageal echocardiography.

Journal Article Anesth Analg · September 2003 Featured Publication Left ventricular ejection time (LVET) is an important component in evaluating left ventricular performance. This measurement is usually made by measuring the timing of the transaortic valve flow velocity by continuous-wave Doppler. Although M-mode has also ... Full text Link to item Cite

The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery.

Journal Article Ann Thorac Surg · September 2003 Featured Publication BACKGROUND: Acute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hematocrit 22% to 24%) during cardiopulmonary ... Full text Link to item Cite

Preliminary evaluation of the Arctic Sun temperature-controlling system during off-pump coronary artery bypass surgery.

Journal Article Ann Thorac Surg · April 2003 BACKGROUND: Maintaining normothermia during off-pump coronary artery bypass (OPCAB) surgery is a challenge not met by currently available medical devices and strategies. The purpose of this study was to determine the efficacy of a new thermoregulatory devi ... Full text Link to item Cite

Xenon attenuates cardiopulmonary bypass-induced neurologic and neurocognitive dysfunction in the rat.

Journal Article Anesthesiology · March 2003 BACKGROUND: With clinical data suggesting a role for excitatory amino acid neurotransmission in the pathogenesis of cardiopulmonary bypass (CPB)-associated brain injury, the current study was designed to determine whether xenon, an N-methyl-D-aspartate rec ... Full text Link to item Cite

Postcardiac surgery complications: association of acute renal dysfunction and atrial fibrillation.

Journal Article Anesth Analg · March 2003 Featured Publication UNLABELLED: Postoperative creatinine increase is associated with adverse outcome after cardiac surgery. Although postoperative stroke and renal dysfunction are associated after cardiac surgery, suggesting a common systemic insult, a similar assessment of a ... Full text Link to item Cite

Mitral valve surgery and acute renal injury: port access versus median sternotomy.

Journal Article Ann Thorac Surg · March 2003 Featured Publication 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 ... Full text Link to item Cite

High spinal anesthesia for cardiac surgery: effects on beta-adrenergic receptor function, stress response, and hemodynamics.

Journal Article Anesthesiology · February 2003 BACKGROUND: This double-blind, randomized, controlled trial examined the effect of high-dose intrathecal bupivacaine in combination with general anesthesia on atrial beta-adrenergic receptor function, the stress response, and hemodynamics during coronary a ... Full text Link to item Cite

Right ventricular rupture during off-pump coronary bypass surgery.

Journal Article Journal of cardiothoracic and vascular anesthesia · February 2003 Featured Publication Cite

Renal dysfunction after vascular surgery.

Journal Article Curr Opin Anaesthesiol · February 2003 Featured Publication PURPOSE OF REVIEW: The purpose of this review is to focus on the static incidence of renal dysfunction, the lack of evidence of benefit of traditional renoprotective strategies, and newer techniques that may provide an insight into the mechanisms of acute ... Full text Link to item Cite

Cardiopulmonary bypass decreases G protein-coupled receptor kinase activity and expression in human peripheral blood mononuclear cells.

Journal Article Anesthesiology · February 2003 BACKGROUND: Cardiopulmonary bypass (CPB) has been implicated in the development of organ injury associated with cardiac surgery. At the molecular level, CPB is accompanied by a pronounced proinflammatory response including an increase in plasma interleukin ... Full text Link to item Cite

Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery.

Journal Article Stroke · February 2003 BACKGROUND AND PURPOSE: Although coronary artery bypass graft surgery (CABG) improves the quality of life and functional capacity for numerous patients, many also exhibit impairment in cognitive function immediately after surgery. Although the etiology of ... Full text Link to item Cite

Endovascular techniques: Less is not always better

Journal Article Seminars in Anesthesia Perioperative Medicine and Pain · January 1, 2003 Full text Cite

Hypocarbia in the ventilated preterm infant and its effect on intraventricular haemorrhage and bronchopulmonary dysplasia.

Journal Article J Paediatr Child Health · December 2002 OBJECTIVE: To examine the relationship between PaCO2 levels in ventilated very preterm infants and (i) the incidence of severe intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL); and (ii) bronchopulmonary dysplasia (BPD). METHODS: A ... Full text Link to item Cite

Change in plasma glutamate concentration during cardiac surgery is a poor predictor of cognitive outcome.

Journal Article J Cardiothorac Vasc Anesth · August 2002 OBJECTIVE: To develop a simple and reliable method for quantitating plasma glutamate concentration and apply this method to monitor systemic glutamate levels during coronary artery bypass graft (CABG) surgery, a procedure associated with neurologic deficit ... Full text Link to item Cite

Serum creatinine patterns in coronary bypass surgery patients with and without postoperative cognitive dysfunction.

Other Anesth Analg · July 2002 Featured Publication 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, ... Full text Link to item Cite

Unexpected transesophageal echocardiographic finding after septal myectomy.

Journal Article J Cardiothorac Vasc Anesth · June 2002 Featured Publication Full text Link to item Cite

Differential cerebral gene expression during cardiopulmonary bypass in the rat: evidence for apoptosis?

Journal Article Anesth Analg · June 2002 UNLABELLED: Cardiopulmonary bypass (CPB) is associated with a spectrum of cerebral injuries. The molecular changes in the brain that might contribute to these injuries are not clearly known. We sought to determine whether the expression of apoptotic genes ... Full text Link to item Cite

Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery.

Journal Article Stroke · February 2002 BACKGROUND AND PURPOSE: Temperature is a well-known modulator of experimental cerebral injury. We hypothesized that hyperthermia would be associated with a worsened cognitive outcome after coronary artery bypass graft surgery (CABG). METHODS: Three hundred ... Full text Link to item Cite

The impact of postoperative atrial fibrillation on neurocognitive outcome after coronary artery bypass graft surgery.

Journal Article Anesth Analg · February 2002 UNLABELLED: Neurocognitive decline is a continuing source of morbidity after cardiac surgery. Atrial fibrillation occurs often after cardiac surgery and has been linked to adverse neurologic events. We sought to determine whether postoperative atrial fibri ... Full text Link to item Cite

The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery.

Other Anesth 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 ... Full text Link to item Cite

Cardiopulmonary bypass induces neurologic and neurocognitive dysfunction in the rat.

Journal Article Anesthesiology · December 2001 BACKGROUND: Neurocognitive dysfunction is a common complication of cardiac surgery using cardiopulmonary bypass (CPB). Elucidating injury mechanisms and developing neuroprotective strategies have been hampered by the lack of a suitable long-term recovery m ... Full text Link to item Cite

Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery.

Journal Article Stroke · December 1, 2001 BACKGROUND AND PURPOSE: The importance of perioperative cognitive decline has long been debated. We recently demonstrated a significant correlation between perioperative cognitive decline and long-term cognitive dysfunction. Despite this association, some ... Full text Link to item Cite

Report of a substudy on warm versus cold cardiopulmonary bypass: changes in creatinine clearance.

Journal Article Ann Thorac Surg · November 2001 Featured Publication BACKGROUND: Renal dysfunction remains a major complication of cardiac operations. There is concern regarding the possibility of increased renal injury during warm cardiopulmonary bypass (CPB). Therefore, we tested the hypothesis that warm CPB is associated ... Full text Link to item Cite

Prospective randomized trial of normothermic versus hypothermic cardiopulmonary bypass on cognitive function after coronary artery bypass graft surgery.

Journal Article Anesthesiology · November 2001 BACKGROUND: Despite significant advances in cardiopulmonary bypass (CPB) technology, surgical techniques, and anesthetic management, central nervous system complications occur in a large percentage of patients undergoing surgery requiring CPB. Many centers ... Full text Link to item Cite

Effect of apolipoprotein E genotype on cerebral autoregulation during cardiopulmonary bypass.

Journal Article Stroke · July 2001 BACKGROUND AND PURPOSE: The presence of the apolipoprotein E epsilon4 (apoE4) allele has been associated with cognitive decline after cardiac surgery. We compared autoregulation of cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMRO(2)), an ... Full text Link to item Cite

Apolipoprotein E polymorphisms and age at first coronary artery bypass graft.

Journal Article Anesthesia and analgesia · April 2001 Apolipoprotein E (apoE) polymorphisms are heritable determinants of total and low-density lipoprotein cholesterol. The impact of apoE4 genotypes on the severity of atherosclerosis has been debated; however, recent studies have identified a correlation betw ... Cite

Aortic dissection after angioplasty and stenting of an aortic coarctation: detection by intravascular ultrasonography but not transesophageal echocardiography.

Journal Article J Am Soc Echocardiogr · January 2001 In this case report, an iatrogenic dissection of the descending aorta occurred during balloon angioplasty and stenting of a recurrent coarctation. The dissection was not seen by transesophageal echocardiography, but intravascular ultrasonography, performed ... Full text Link to item Cite

Neurological injury during cardiopulmonary bypass in the rat.

Journal Article Perfusion · January 2001 Cerebral injury is a well-known complication of cardiac surgery. Investigations of both injury mechanisms and neuroprotective strategies have partially been limited by the lack of an adequate preclinical model of small animal cardiopulmonary bypass (CPB). ... Full text Link to item Cite

Beta(2)-adrenergic and several other G protein-coupled receptors in human atrial membranes activate both G(s) and G(i).

Journal Article Circ Res · October 13, 2000 Cardiac G protein-coupled receptors that couple to Galpha(s) and stimulate cAMP formation (eg, beta-adrenergic, histamine, serotonin, and glucagon receptors) play a key role in cardiac inotropy. Recent studies in rodent cardiac myocytes and transfected cel ... Full text Link to item Cite

Preliminary report on the association of apolipoprotein E polymorphisms, with postoperative peak serum creatinine concentrations in cardiac surgical patients.

Journal Article Anesthesiology · August 2000 BACKGROUND: Renal dysfunction after cardiac surgery occurs in up to 8% of patients and is associated with major increases in morbidity, mortality, and cost. Genetic polymorphisms have been implicated as a factor in the progression of chronic renal disease, ... Full text Link to item Cite

Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome.

Journal Article Ann Thorac Surg · April 2000 BACKGROUND: The impact of alterable physiologic variables on neurologic outcome after coronary artery bypass grafting procedures is unknown. The purpose of this study was to determine whether minimum intraoperative hematocrit, maximum glucose concentration ... Full text Link to item Cite

Central nervous system complications of cardiac surgery.

Journal Article Br J Anaesth · March 2000 The neurological complications of cardiac surgery are associated with significantly increased mortality, morbidity and resource utilization. The use of new surgical techniques, introduction of wider indications for surgery and increased public expectation ... Full text Link to item Cite

A comparative evaluation of intrapleural and thoracic epidural analgesia for postoperative pain relief after minimally invasive direct coronary artery bypass surgery.

Journal Article J Cardiothorac Vasc Anesth · April 1998 Featured Publication OBJECTIVE: To compare the efficacy of thoracic epidural analgesia (TEA) and intrapleural analgesia (IPA) after minimally invasive direct coronary artery bypass (MIDCAB) surgery with regard to quality of analgesia and complications. DESIGN: A prospective, r ... Full text Link to item Cite

Case 12-2-1998. Noncardiac surgery and pacemaker cardioverter-defibrillator management.

Journal Article J Cardiothorac Vasc Anesth · April 1998 Featured Publication Full text Link to item Cite

Evaluation of Right Ventricular Function During CABG: Transesophageal Echocardiographic Assessment of Hepatic Venous Flow Versus Conventional Right Ventricular Performance Indices.

Journal Article Echocardiography · January 1998 Featured Publication The vulnerability of right ventricle (RV) to ischemic insult during cardiac surgery is being increasingly recognized. This study aims to evaluate right ventricular function by measuring hepatic venous flow (HVF) patterns using intraoperative transesophagea ... Full text Link to item Cite