Development of a novel anisotropic self-inflating tissue expander: in vivo submucoperiosteal performance in the porcine hard palate.

Background: The advent of self-inflating hydrogel tissue expanders heralded a significant advance in the reconstructive potential of this technique. Their use, however, is limited by their uncontrolled isotropic (i.e.

Solid and gaseous cerebral microembolization during off-pump, on-pump, and open cardiac surgery procedures.

Background: Neurocognitive dysfunction remains a limitation of cardiac surgery with cardiopulmonary bypass. Intraoperative cerebral microembolization is believed to be one of the most important etiologic factors. Using a new generation of transcranial Doppler ultrasonography, we compared the number and nature of intraoperative microemboli in patients undergoing on-pump and off-pump cardiac surgery procedures.

Preservation of porcine non-heart-beating donor livers by sequential cold storage and warm perfusion.

Background: Normothermic perfusion has been shown to resuscitate and maintain viability of non-heart-beating donor (NHBD) livers that have undergone significant warm ischemic injury. However, the logistics of clinical organ retrieval are complex, and a period of cold storage before warm preservation would simplify the process. We have investigated the effects of short duration of cold preservation before normothermic preservation on the function of porcine NHBD livers.

Preliminary experience with a novel intraoperative fluorescence imaging technique to evaluate the patency of bypass grafts in total arterial revascularization.

Background: Early graft failure is a common cause of cardiac morbidity and mortality after coronary artery bypass grafting (CABG), and there is particular concern about graft patency in off-pump CABG. We describe our preliminary experience with a novel imaging technique (the SPY system), based on fluorescence of Indocyanine Green when exposed to near infrared light, for the intraoperative assessment of coronary graft patency.

Methods: Graft patency was assessed in patients undergoing off-pump and on-pump total arterial revascularization.

The Jarvik 2000 Heart. Clinical validation of the intraventricular position.

Objective: Heart failure is now a public health epidemic. Donor hearts are severely restricted in availability. Permanent mechanical circulatory support or bridge to myocardial recovery are emerging alternatives.

Circulatory support for long-term treatment of heart failure: experience with an intraventricular continuous flow pump.

Background: A lifetime mechanical solution for advanced heart failure must be reliable, with a low risk of life-threatening complications. After extensive laboratory testing, we began clinical trials with an axial flow pump for long-term treatment of New York Heart Association class IV, transplant-ineligible patients.

Methods And Results: The Jarvik 2000 is a continuous flow device that is implanted in the apex of the left ventricle with offloading to the descending thoracic aorta.

Implant technique for the Jarvik 2000 Heart.

The Jarvik 2000 Heart is a silent compact axial flow impeller pump which is now undergoing clinical trials for both bridge to transplantation and permanent mechanical circulatory support. The pump is implanted into the apex of the failing left ventricle by left thoracotomy. A vascular graft offloads to the descending thoracic aorta so that only the left pleural cavity is opened.