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Sharon Lorraine McCartney

Associate Professor of Anesthesiology
Anesthesiology, Cardiothoracic

Selected Publications


Reduce intraoperative albumin utilisation in cardiac surgical patients: a quality improvement initiative.

Journal Article BMJ Open Qual · April 24, 2024 BACKGROUND: Albumin continues to be used routinely by cardiac anaesthesiologists perioperatively despite lack of evidence for improved outcomes. The Multicenter Perioperative Outcomes Group (MPOG) data ranked our institution as one of the highest intraoper ... Full text Link to item Cite

Intraoperative Echocardiography: Guide to Decision-Making.

Journal Article Curr Cardiol Rep · April 4, 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

Pain trajectories after bilateral orthotopic lung transplantation surgery performed via a clamshell incision.

Journal Article Clin Transplant · February 2024 INTRODUCTION: The nature, intensity, and progression of acute pain after bilateral orthotopic lung transplantation (BOLT) performed via a clamshell incision has not been well investigated. We aimed to describe acute pain after clamshell incisions using pai ... Full text Link to item Cite

Perioperative Blood Management Protocols Improve Outcomes: What Does the Future Hold?

Journal Article Current Anesthesiology Reports · December 1, 2023 Purpose of Review: This manuscript aims to review the current state of perioperative blood management as well as prognosticate future directions for the field. Recent Findings: Perioperative blood management is a broad topic with a core tenet of conserving ... Full text Cite

The Role of Recipient Thyroid Hormone Supplementation in Primary Graft Dysfunction After Heart Transplantation: A Propensity-Adjusted Analysis.

Journal Article J Cardiothorac Vasc Anesth · November 2023 OBJECTIVES: To investigate whether recipient administration of thyroid hormone (liothyronine [T3]) is associated with reduced rates of primary graft dysfunction (PGD) after orthotopic heart transplantation. DESIGN: Retrospective cohort study. SETTING: Sing ... 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

Health care resource utilization and clinical outcomes for adult heart transplant recipients with primary graft dysfunction.

Journal Article Clin Transplant · October 2023 INTRODUCTION: The advent of new technologies to reduce primary graft dysfunction (PGD) and improve outcomes after heart transplantation are costly. Adoption of these technologies requires a better understanding of health care utilization, specifically the ... Full text Link to item Cite

Splanchnic Nerve Modulation Effects on Surrogate Measures of Venous Capacitance.

Journal Article J Am Heart Assoc · July 18, 2023 Background Splanchnic nerve modulation (SNM) is an emerging procedure to reduce cardiac filling pressures in heart failure. Although the main contributor to reduction in cardiac preload is thought to be increased venous capacitance in the splanchnic circul ... Full text Link to item Cite

Pulmonary Vein Systolic Flow Reversal Seen With Severe Tricuspid Regurgitation.

Journal Article CASE (Phila) · July 2023 • Systolic PVF reversal is specific to severe MR. • We report systolic PVF reversal with severe TR and TS. • This may be caused by interatrial dependence due to elevated RAP. ... Full text Link to item Cite

Preparing cardiovascular patients for the operative theatre.

Journal Article Eur Heart J Acute Cardiovasc Care · April 3, 2023 Full text Link to item Cite

Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.

Journal Article J Cardiothorac Vasc Anesth · October 2022 OBJECTIVES: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support ... Full text Link to item Cite

ECMO Weaning and Decannulation

Chapter · August 11, 2022 This new edition presents an evidence-based review of extracorporeal membrane oxygenation (ECMO) for adults, with a particular focus on veno-venous (VV) ECMO. ... Link to item Cite

Abstract P1017: Tissue Engineered Human Acellular Blood Vessels For Coronary Artery Bypass Grafting

Conference Circulation Research · August 5, 2022 Objective: Conduit for coronary artery bypass grafting (CABG) can be limited due to poor quality or prior removal of saphenous veins. A human acellular vessel (HAV) bioengineered from vascular cells a ... Full text Cite

Surgical Management of Chronic Thromboembolic Pulmonary Hypertension.

Journal Article Cardiol Clin · February 2022 Chronic thromboembolic pulmonary hypertension is a progressive disease, which may lead to severe right ventricular dysfunction and debilitating symptoms. Pulmonary thromboendarterectomy (PTE) provides the best opportunity for complete resolution of obstruc ... 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

A clinical investigation into the benefits of using charge codes in perioperative and critical care epidemiology: A retrospective cohort database study.

Journal Article Int J Crit Illn Inj Sci · September 2020 CONTEXT: Epidemiologic studies in critical care routinely rely on the codes listed in International Classification of Diseases (ICD) manuals which are primarily intended for reimbursement of claims to payers. Standardized billing codes may minimize the mea ... 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

Reduce intraoperative albumin utilisation in cardiac surgical patients: a quality improvement initiative.

Journal Article BMJ Open Qual · April 24, 2024 BACKGROUND: Albumin continues to be used routinely by cardiac anaesthesiologists perioperatively despite lack of evidence for improved outcomes. The Multicenter Perioperative Outcomes Group (MPOG) data ranked our institution as one of the highest intraoper ... Full text Link to item Cite

Intraoperative Echocardiography: Guide to Decision-Making.

Journal Article Curr Cardiol Rep · April 4, 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

Pain trajectories after bilateral orthotopic lung transplantation surgery performed via a clamshell incision.

Journal Article Clin Transplant · February 2024 INTRODUCTION: The nature, intensity, and progression of acute pain after bilateral orthotopic lung transplantation (BOLT) performed via a clamshell incision has not been well investigated. We aimed to describe acute pain after clamshell incisions using pai ... Full text Link to item Cite

Perioperative Blood Management Protocols Improve Outcomes: What Does the Future Hold?

Journal Article Current Anesthesiology Reports · December 1, 2023 Purpose of Review: This manuscript aims to review the current state of perioperative blood management as well as prognosticate future directions for the field. Recent Findings: Perioperative blood management is a broad topic with a core tenet of conserving ... Full text Cite

The Role of Recipient Thyroid Hormone Supplementation in Primary Graft Dysfunction After Heart Transplantation: A Propensity-Adjusted Analysis.

Journal Article J Cardiothorac Vasc Anesth · November 2023 OBJECTIVES: To investigate whether recipient administration of thyroid hormone (liothyronine [T3]) is associated with reduced rates of primary graft dysfunction (PGD) after orthotopic heart transplantation. DESIGN: Retrospective cohort study. SETTING: Sing ... 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

Health care resource utilization and clinical outcomes for adult heart transplant recipients with primary graft dysfunction.

Journal Article Clin Transplant · October 2023 INTRODUCTION: The advent of new technologies to reduce primary graft dysfunction (PGD) and improve outcomes after heart transplantation are costly. Adoption of these technologies requires a better understanding of health care utilization, specifically the ... Full text Link to item Cite

Splanchnic Nerve Modulation Effects on Surrogate Measures of Venous Capacitance.

Journal Article J Am Heart Assoc · July 18, 2023 Background Splanchnic nerve modulation (SNM) is an emerging procedure to reduce cardiac filling pressures in heart failure. Although the main contributor to reduction in cardiac preload is thought to be increased venous capacitance in the splanchnic circul ... Full text Link to item Cite

Pulmonary Vein Systolic Flow Reversal Seen With Severe Tricuspid Regurgitation.

Journal Article CASE (Phila) · July 2023 • Systolic PVF reversal is specific to severe MR. • We report systolic PVF reversal with severe TR and TS. • This may be caused by interatrial dependence due to elevated RAP. ... Full text Link to item Cite

Preparing cardiovascular patients for the operative theatre.

Journal Article Eur Heart J Acute Cardiovasc Care · April 3, 2023 Full text Link to item Cite

Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.

Journal Article J Cardiothorac Vasc Anesth · October 2022 OBJECTIVES: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support ... Full text Link to item Cite

ECMO Weaning and Decannulation

Chapter · August 11, 2022 This new edition presents an evidence-based review of extracorporeal membrane oxygenation (ECMO) for adults, with a particular focus on veno-venous (VV) ECMO. ... Link to item Cite

Abstract P1017: Tissue Engineered Human Acellular Blood Vessels For Coronary Artery Bypass Grafting

Conference Circulation Research · August 5, 2022 Objective: Conduit for coronary artery bypass grafting (CABG) can be limited due to poor quality or prior removal of saphenous veins. A human acellular vessel (HAV) bioengineered from vascular cells a ... Full text Cite

Surgical Management of Chronic Thromboembolic Pulmonary Hypertension.

Journal Article Cardiol Clin · February 2022 Chronic thromboembolic pulmonary hypertension is a progressive disease, which may lead to severe right ventricular dysfunction and debilitating symptoms. Pulmonary thromboendarterectomy (PTE) provides the best opportunity for complete resolution of obstruc ... 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

A clinical investigation into the benefits of using charge codes in perioperative and critical care epidemiology: A retrospective cohort database study.

Journal Article Int J Crit Illn Inj Sci · September 2020 CONTEXT: Epidemiologic studies in critical care routinely rely on the codes listed in International Classification of Diseases (ICD) manuals which are primarily intended for reimbursement of claims to payers. Standardized billing codes may minimize the mea ... 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

EUROMACS-RHF Risk Score and 3D Echocardiography as Predictors of Right Heart Failure after Left Ventricular Assist Device Implantation

Conference The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · April 1, 2020 PURPOSE: Right heart failure (RHF) after LVAD implantation is associated with significant morbidity and mortality. Recently, the EUROMACS-RHF risk score was developed to predict postoperative RHF in this setting. In a single-center analysis, we assessed th ... Full text Cite

Planned right ventricular support for combined heart-liver transplantation.

Journal Article Interact Cardiovasc Thorac Surg · December 1, 2019 Right ventricular dysfunction post heart transplantation (HTx) is a common problem and its likelihood to occur after combined heart-liver transplantation is even higher. The placement of an extracorporeal planned right ventricular assist device following t ... Full text Link to item Cite

Functional Tricuspid Regurgitation in Mitral Valve Disease.

Journal Article Semin Cardiothorac Vasc Anesth · March 2019 Functional tricuspid regurgitation is a common finding in patients with left-sided heart disease. If left untreated, it may reduce survival, limit functional capacity and cause end-organ dysfunction. Annulus dilation and leaflet tethering due to right vent ... 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

Outcomes in Patients Undergoing Cardiac Surgery Who Decline Transfusion and Received Erythropoietin Compared to Patients Who Did Not: A Matched Cohort Study.

Journal Article Anesth Analg · August 2018 BACKGROUND: Erythropoiesis-stimulating agents, such as erythropoietin (EPO), can be used to treat preoperative anemia. Some studies suggest an increased risk of mortality and thrombotic events, and use in cardiovascular surgery remains off-label. This stud ... Full text Open Access Link to item Cite

Invited Commentary: A Case of Multiple Ventricular Gradients.

Journal Article J Cardiothorac Vasc Anesth · August 2018 Full text Link to item Cite

Intraoperative vasoplegia: methylene blue to the rescue!

Journal Article Curr Opin Anaesthesiol · February 2018 PURPOSE OF REVIEW: To evaluate the efficacy, dosing, and safety of methylene blue (MTB) in perioperative vasoplegic syndrome (VS). RECENT FINDINGS: Vasoplegic syndrome is a state of persistent hypotension with elevated cardiac output, low filling pressures ... Full text Open Access Link to item Cite

Emergency airway management

Chapter · January 1, 2018 Full text Cite

Post Mitral Valve Replacement: Paravalvular Leak or Unroofed Coronary Sinus?

Journal Article CASE (Phila) · December 2017 • A patient presented with symptoms of heart failure and severe mitral regurgitation. • On postbypass imaging after MVR a small paravalvular leak appeared to be present. • Color flow originated from an unroofed CS with predominantly right-to-left shunting. ... 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

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

Long-term outcomes and management of the heart transplant recipient.

Journal Article Best Pract Res Clin Anaesthesiol · June 2017 Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart ... Full text Open Access Link to item Cite

Use of Adjuncts Reduces Cardiopulmonary Bypass Time During Minimally Invasive Aortic Valve Replacement.

Journal Article J Heart Valve Dis · March 2017 BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous co ... 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

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

Jehovah's Witnesses and cardiac surgery: a single institution's experience.

Journal Article Transfusion · October 2014 BACKGROUND: Based on biblical doctrines, patients of the Jehovah's Witness faith refuse allogeneic blood transfusion. Cardiac surgery carries a high risk of blood transfusion, but has been performed in Jehovah's Witnesses for many years. The literature con ... Full text Open Access Link to item Cite

Invited commentary.

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