Publications by authors named "Aaron WeiSS"
Purpose Of Review: This article discusses a tailored approach to managing cardiogenic shock and temporary mechanical circulatory support (tMCS). We also outline specific mobilization strategies for patients with different tMCS devices and configurations, which can be enabled by this tailored approach to cardiogenic shock management.
Recent Findings: Safe and effective mobilization of patients with cardiogenic shock receiving tMCS can be accomplished.
Aims: As patients experience longer survival on HeartMate 3 left ventricular assist devices, there is a need to characterize long-term risks of adverse outcomes more precisely. This study characterized temporal variations in risks of mortality and adverse outcomes in patients with a HeartMate 3.
Methods And Results: From October 2015 to January 2023, 431 HeartMate 3 devices were implanted at Cleveland Clinic.
Objective: To characterize the clinical courses and outcomes of patients presenting with post-myocardial infarction (MI) ventricular septal rupture (VSR) receiving temporary microaxial transvalvular left ventricular assist device (tVAD) support.
Methods: Between December 2019 and July 2023, 10 consecutive patients presented with a post-MI VSR. All 10 patients received a tVAD.
We present a case of a 56 year old man presenting with cardiogenic shock from isolated right ventricular failure due to arrhythmogenic right ventricular cardiomyopathy who was successfully bridged to heart transplantation after 29 days on an Impella RP Flex right ventricular assist device. This represents the longest reported duration of support with the device to date and highlights the utility of this platform in the management of severe right ventricular failure.
View Article and Find Full Text PDFObjectives: To identify possible etiology-specific differences in preoperative risk factors for major adverse events during Impella 5.5 support in patients with ischemic (ICM) and nonischemic cardiomyopathy (NICM).
Methods: From October 2019 to January 2023, 228 Impella 5.
Background: Impella 5.5 is a temporary left ventricular assist device utilized to support patients with cardiogenic shock and those undergoing high-risk cardiac interventions.
Methods: From October 2019 to January 2023, 226 patients received Impella 5.
Article Synopsis
- A 66-year-old man with serious heart issues, including a rupture and aneurysm after a heart attack, was in critical condition and received a temporary heart assist device.
- This device helped stabilize his heart function and overall health, allowing him to eventually receive a successful heart transplant.
- The use of the temporary heart assist device shows promise for treating patients with specific complications following a heart attack, not just ruptures.
SciScribe: Automating and contextualizing literature reviews in cardiac surgery.
J Thorac Cardiovasc Surg
September 2024
Background: The task of writing structured content reviews and guidelines has grown stronger and more complex. We propose to go beyond search tools and toward curation tools by automating time-consuming and repetitive steps of extracting and organizing information.
Methods: SciScribe is built as an extension of IBM's Deep Search platform, which provides document processing and search capabilities.
Background: Health care workers (HCW) in Emergency Medical Services (EMS) frequently come into contact with carriers of methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains and may acquire and transmit them to patients. However, there is little data on MSSA and MRSA colonization of medical personnel in the emergency services. Additionally, few studies have analyzed the association between personal hygiene of staff and colonization.
View Article and Find Full Text PDFArticle Synopsis
- Clinical trials by the Intergroup Rhabdomyosarcoma Study Group and the Children's Oncology Group have set the standards for diagnosing and treating rhabdomyosarcoma (RMS), but new biological insights complicate these processes.* -
- The rarity of RMS makes it difficult to conduct large phase 3 clinical trials, highlighting the need for careful planning to explore drug effectiveness, response markers, treatment toxicity, and patient quality of life.* -
- The Children's Oncology Group Soft Tissue Sarcoma Committee proposes a strategic plan for future RMS trials that includes identifying new agents, improving trial efficiency, expanding knowledge opportunities, reducing treatment toxicity, and enhancing patient engagement.*
Article Synopsis
- Desmoid tumors (DT) are rare, aggressive growths that have historically been treated primarily with surgery, but recent trends suggest a shift towards less invasive treatment options.
- A consensus meeting held in Milan in June 2023 aimed to update global guidelines for DT management, bringing together over 90 experts and patient advocates to discuss new strategies and treatments.
- The updated guidelines emphasize the importance of local therapies and include information on the latest medical agents, particularly γ-secretase inhibitors, to ensure informed and effective management of DT in specialized referral centers.
Phentermine is an amine anorectic that acts as a sympathomimetic agent and undergoes hepatic metabolism predominantly through CYP3A4. It is commonly used as a mediation to facilitate weight loss. Side effects of phentermine can include pulmonary hypertension, valvular heart disease, palpitations, increased heart rate or blood pressure, diarrhea, and cognitive impairment.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on outcomes for pediatric low-grade non-rhabdomyosarcoma soft tissue sarcoma (NRSTS), analyzing data from patients under 30 years old enrolled in a specific clinical trial.
- Low-risk patients were treated with surgery alone, leading to high survival rates (90% event-free and 100% overall), while intermediate- and high-risk groups had significantly lower survival rates (55% event-free and 25% overall) despite aggressive treatment.
- Findings suggest that most low-risk patients can be effectively managed with surgery only, and the current grading system may over-treat some patients who do not need additional therapies beyond surgery.
Efficacy and safety of a transaortic approach to midventricular and apical septal myectomy.
J Thorac Cardiovasc Surg
December 2024
Objective: The study objective was to evaluate the safety and efficacy of a transaortic approach to midventricular and apical septal myectomy in patients with hypertrophic cardiomyopathy with left ventricular outflow tract or midventricular obstruction.
Methods: From January 2018 to August 2023, 940 patients underwent transaortic septal myectomy at the Cleveland Clinic, of whom 682 (73%) had midventricular or apical resection. Patients who underwent isolated basal myectomies were excluded.
Background: Novel therapies are needed for relapsed and refractory rhabdomyosarcoma (RRMS). Phase II clinical trials in RRMS have typically utilized radiologic response as the primary activity endpoint, an approach that poses several limitations in RRMS. In this analysis, we aimed to estimate an event-free survival (EFS) endpoint for RRMS that could be used as a benchmark for future studies.
View Article and Find Full Text PDFThis study evaluated the nationwide associations between concomitant left atrial appendage clip (LAAC) placement during cardiac surgery and postoperative outcomes. We identified 1,260,999 patients who underwent coronary artery bypass grafting, valve, and aortic surgeries in the 2016 to 2020 Nationwide Readmissions Database and stratified by concomitant LAAC versus no LAAC placement. Patients who underwent surgical ablation were excluded.
View Article and Find Full Text PDFBackground: Embryonal sarcoma of the liver (ESL) is a rare mesenchymal tumor most common in childhood; the optimal treatment approach is uncertain. The clinical features and outcomes of patients with ESL enrolled in a Children's Oncology Group (COG) clinical trial that evaluated a risk-based strategy for treating soft tissue sarcomas in patients aged <30 years were evaluated.
Methods: This subset analysis included patients with ESL enrolled in COG study ARST0332.
Article Synopsis
- Cardiac resynchronization therapy (CRT) is typically recommended for patients with symptomatic heart failure marked by specific criteria, but its efficacy is uncertain in cases of severe left ventricular dysfunction and cardiogenic shock.
- A 77-year-old man with severe heart failure and multiple complications underwent a successful surgical aortic valve replacement combined with CRT initiation and temporary mechanical support, resulting in notable recovery in heart function.
- This case highlights the importance of a collaborative medical team and aggressive intervention in improving outcomes for patients with advanced heart disease.
Background: The aim of this study was to estimate the event-free survival (EFS) of children and young adults with relapsed or refractory nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) treated in nonrandomized phase 2 studies conducted by the Children's Oncology Group (COG) and predecessor groups to establish a benchmark EFS for future phase 2 NRSTS trials evaluating the activity of novel agents.
Methods: A retrospective analysis of patients with recurrent or refractory NRSTS prospectively enrolled in nonrandomized phase 2 COG and predecessor group trials between 1994 and 2015 was conducted. EFS was defined as disease progression/relapse or death and calculated via the Kaplan-Meier method.
Article Synopsis
- Transcatheter aortic valve replacement (TAVR) is rarely performed in patients with congenital heart disease.* -
- Our study shows that TAVR can be safely and effectively used in these patients in the short term.* -
- TAVR may play an important role in managing congenital aortic valve disease throughout a patient's life, serving as a temporary solution before recovery, future surgeries, or transplants.*
Introduction: The impact of established prognostic factors on survival outcomes for childhood rhabdomyosarcoma (RMS) have not been well described in the adolescent and young adult (AYA) RMS patient population.
Methods: This is a retrospective analysis of patients with newly diagnosed RMS enrolled between 1997 and 2016 on seven previously reported Children's Oncology Group (COG) clinical trials. Demographics, clinical features, treatment details, and outcome data were collected.
Article Synopsis
- The 2017 AATS guidelines encourage the use of surgical ablation for patients with atrial fibrillation (AF) undergoing cardiac surgery, noting benefits like reduced early mortality.
- A study of over 19,000 patients from 2016 to 2019 revealed that while the rate of surgical ablation increased significantly after 2016, it remained stagnant after 2017, with certain groups, such as low-income and minority patients, being less likely to receive this treatment.
- Despite improved postoperative outcomes for those who did undergo the procedure, the underutilization of surgical ablation in high-risk and minority patient populations highlights a gap in adhering to clinical guidelines.
Objectives: The aim of this study was to explore the associations between percutaneous ventricular assist device (pVAD) insertion timing relative to cardiac surgery and patient outcomes.
Methods: The Nationwide Inpatient Sample was queried for patients undergoing cardiac surgery and pVAD insertion in the same admission from 2016 to 2019. Patients were stratified by timing of pVAD insertion.