Publications by authors named "Alice V Vinogradsky"
Prosthetic valve-related morbidity and mortality in patients with left ventricular assist devices (LVADs) remain unclear. We retrospectively reviewed patients who received a HeartMate II or 3 LVAD at our center between April 2004 and December 2022. Patients with a valve prosthesis in any position were included.
View Article and Find Full Text PDFArticle Synopsis
- Surgeons often leave a residual atrial-level communication during Tetralogy of Fallot (TOF) repairs, and this study aimed to see how closing this communication affects patient recovery.
- The researchers reviewed records of 132 TOF patients who had surgery before 12 months old, comparing outcomes between those with and without the communication.
- The results showed no significant differences in key recovery metrics like cardiac output, drug therapy duration, or intensive care stay, suggesting that closing the communication doesn't significantly alter short-term or mid-term recovery outcomes.
Article Synopsis
- This study analyzed the outcomes of 774 adult patients who received simultaneous heart-kidney transplants (SHK) under the revised UNOS heart allocation policy, focusing on 50 patients who were supported by veno-arterial extracorporeal life support (VA-ECLS) compared to 724 without.
- Results showed that VA-ECLS patients were younger and had better kidney function before transplant but faced higher rates of temporary dialysis and lower survival rates after the procedure, with significant differences in early mortality and cardiac allograft failure.
- The findings indicate that while VA-ECLS patients have similar renal outcomes post-transplant, they experience greater risks for early mortality and complications related to heart trans
Surgical management of pleural complications in lymphangioleiomyomatosis.
J Thorac Cardiovasc Surg
August 2024
Article Synopsis
- Lymphangioleiomyomatosis (LAM) is a rare lung disease mostly affecting women, often leading to complications like pneumothorax and chylothorax, so surgical management options were examined.
- The study reviewed records of 326 patients suspected of having LAM, revealing that 40.5% underwent surgical procedures, with significant instances of pneumothorax and associated treatments like pleurodesis.
- Findings suggest a high occurrence of pleural disease in LAM patients, indicating a need for thoracic surgeons to be aware of these issues and highlighting the potential benefits of using tunneled indwelling pleural catheters for better management.
Objectives: Veno-arterial extracorporeal life support (V-A ECLS) is increasingly being utilized for postcardiotomy shock (PCS), though data describing the relationship between type of indexed operation and outcomes are limited. This study compared V-A ECLS outcomes across four major cardiovascular surgical procedures.
Methods: This was a single-center retrospective study of patients who required V-A ECLS for PCS between 2015 and 2022.
Article Synopsis
- The study focuses on the long-term survival rates of adult patients with congenital heart disease who underwent orthotopic heart transplantation, distinguishing between those with single-ventricle versus biventricular circulation.
- A total of 61 patients were analyzed, with single-ventricle patients being younger and having more complications like cirrhosis and protein-losing enteropathy compared to biventricular patients.
- Five-year survival rates were significantly lower for single-ventricle patients (66%) than for biventricular patients (91%), indicating that the type of congenital heart disease affects post-transplant outcomes.
Objective: To determine the influence of coronary anatomy on long-term outcomes of the arterial switch operation (ASO).
Methods: We retrospectively reviewed patients with transposition of the great arteries or Taussig-Bing anomaly who underwent ASO at our institution between 1992 and 2022. The primary endpoint was freedom from a composite of death, transplantation, and coronary reintervention.
Article Synopsis
- The study aimed to evaluate how aortic insufficiency develops in patients who had central aortic valve repair during continuous-flow left ventricular assist device placement.
- A review was conducted on 656 patients who received HeartMate II or 3 devices from 2004 to 2022, with 105 meeting the criteria for analysis, revealing that most were older men receiving the device as long-term therapy.
- Results showed high rates of freedom from moderate aortic insufficiency post-implantation (over 90% at three years) and a three-year survival rate of 63.4%, suggesting that central aortic valve repair could effectively address aortic insufficiency in these patients.
Background: Autograft durability and remodeling are thought to be superior in younger pediatric patients after the Ross operation. We sought to delineate the fate of autografts across the pediatric age spectrum in patients with primary aortic stenosis (AS).
Methods: We retrospectively reviewed patients age ≤18 years with primary AS who underwent the Ross operation between 1993 and 2020.
Combined heart-liver transplantation (CHLT) is a rarely though increasingly performed procedure with evolving indications. Despite CHLT being performed at only a handful of centers, the use of intraoperative mechanical circulatory support to optimize hemodynamics and facilitate dual-organ transplantation varies widely. At our center, we liberally utilize veno-arterial extracorporeal membrane oxygenation (V-A ECMO) when a veno-venous shunt is anticipated to be insufficient in mitigating the hemodynamic perturbations associated with liver reperfusion.
View Article and Find Full Text PDFBackground: Septal reduction therapy via septal myectomy or a modified Konno procedure is the mainstay of therapy for drug-refractory obstructive hypertrophic cardiomyopathy (HCM), although outcomes data on septal myectomy in pediatric patients are limited. We evaluated long-term outcomes following surgery for obstructive HCM in a pediatric cohort.
Methods: We retrospectively reviewed patients age ≤18 years with obstructive HCM who underwent a left and/or right ventricular septal myectomy at our institution between 1992 and 2022.
Left-Ventricular Unloading With Impella During Refractory Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis.
Crit Care Med
March 2024
Objectives: Extracorporeal cardiopulmonary resuscitation (ECPR) is the implementation of venoarterial extracorporeal membrane oxygenation (VA-ECMO) during refractory cardiac arrest. The role of left-ventricular (LV) unloading with Impella in addition to VA-ECMO ("ECMELLA") remains unclear during ECPR. This is the first systematic review and meta-analysis to characterize patients with ECPR receiving LV unloading and to compare in-hospital mortality between ECMELLA and VA-ECMO during ECPR.
View Article and Find Full Text PDFSevere aortopathy in Williams syndrome can sometimes present with an initial ascending aortic pathology, followed in short order by more distal multilevel obstruction and recurrence requiring reintervention. In this series, an early, comprehensive surgical approach using a combination of various access and perfusion strategies yielded excellent long-term results.
View Article and Find Full Text PDFObjectives: We investigated the association between indexed left ventricular diastolic dimension and clinical outcomes after HeartMate 3 implantation.
Methods: We retrospectively reviewed patients implanted with the HeartMate 3 at our centre between November 2014 and September 2021. Left ventricular diastolic dimension was assessed via preoperative transthoracic echocardiography and left ventricular diastolic dimension index was calculated as left ventricular diastolic dimension/body surface area.
Article Synopsis
- The study assesses the durability of the Inspiris Resilia prosthesis as a surgical pulmonary valve replacement (PVR) compared to non-Inspiris options, focusing on performance data from patient surgeries between 2018 and 2022.
- Results show that the Inspiris valve group had significantly lower rates of freedom from valve failure and moderate pulmonary regurgitation after two years compared to non-Inspiris patients, highlighting concerns over its performance.
- The findings suggest that the Inspiris valve performs worse when implanted in the native right ventricular outflow tract versus as a conduit, indicating that different techniques or alternative valves may be necessary for better outcomes.