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

Featured Works

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

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

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

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

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

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

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

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

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

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 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

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

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

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

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

Right ventricular rupture during off-pump coronary bypass surgery.

Journal article J Cardiothorac Vasc Anesth · February 2003 Featured Publication Full text Link to item 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

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

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

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