Outcomes of Impella 5.0 in Cardiogenic Shock: A Systematic Review and Meta-analysis.

Objective: The aim of the study was to comprehensively summarize the survival outcomes and complications of Impella 5.0 (Abiomed Inc, Danvers, MA USA) use in patients with cardiogenic shock (CS).

Methods: We performed a literature review for relevant studies by searching in Medline, Medline In-Process, EMBASE, and the CENTRAL bibliographic databases on April 30, 2017.

Benefits of a novel percutaneous ventricular assist device for right heart failure: The prospective RECOVER RIGHT study of the Impella RP device.

Background: Right ventricular failure (RVF) increases morbidity and mortality. The RECOVER RIGHT study evaluated the safety and efficacy of a novel percutaneous right ventricular assist device, the Impella RP (Abiomed, Danvers, MA), in a prospective, multicenter trial.

Methods: Thirty patients with RVF refractory to medical treatment received the Impella RP device at 15 United States institutions.

Endoaortic occlusion with the intraclude device during the management of ascending aortic pseudoaneurysm.

A 63-year-old man was admitted with chest pain after a previous aortic valve replacement. Computed tomographic scan identified a 7-cm pseudoaneurysm of the ascending aorta, and he was referred for repair. At operation, endoaortic occlusion of the aorta was used to arrest the heart and decompress the aorta to facilitate sternal reentry, dissection, and subsequent control.

The Impella device for acute mechanical circulatory support in patients in cardiogenic shock.

Background: Acute cardiogenic shock is associated with high mortality rates. Mechanical circulatory devices have been increasingly used in this setting for hemodynamic support. The Impella device (Abiomed Inc, Danvers, MA) is a microaxial left ventricular assist device that can be inserted using a less invasive technique.

Use of the Impella 2.5 Microaxial pump for right ventricular support after insertion of Heartmate II left ventricular assist device.

The Impella microaxial pump is a catheter-based device that has been used for left ventricular support. The catheter can be inserted through a peripheral artery or directly into the ascending aorta. The pump is positioned across the aortic valve with the inflow directly in the left ventricle and the outflow in the ascending aorta.

Outcome of the impella device for acute mechanical circulatory support.

Objective: The contribution of cardiogenic shock to in-hospital mortality has not decreased significantly despite prompt revascularization, advances in medical therapy, and mechanical circulatory support. For patients in cardiogenic shock, mechanical circulatory support has been provided by a variety of devices. We report the outcome of the Impella device for acute mechanical circulatory support in cardiogenic shock in a setting of a large-volume single institution.

The Swan-Ganz catheter as a teaching tool for the anesthesiologist learning minimally invasive cardiac surgery.

Objective: To perform minimally invasive cardiac surgery through the smallest possible wound and with the least number of incisions in the heart or aorta, the necessary cannulations to undergo cardiopulmonary bypass must be done through peripheral vessels. A difficult skill to learn for the cardiac anesthesiologist is how to safely and efficiently position the coronary sinus catheter (Endoplege; Edwards Lifesciences LLC, Irvine, CA USA) required for retrograde cardioplegia administration.

Methods: In patients in whom a Swan-Ganz catheter was inserted as part of the operative management strategy for non-minimally invasive heart surgery, we have been using it as a training tool to learn how to visualize and manipulate right-sided catheters under transesophageal echocardiography.

Real-time unconstrained object recognition: a processing pipeline based on the mammalian visual system.

The mammalian visual system is still the gold standard for recognition accuracy, flexibility, efficiency, and speed. Ongoing advances in our understanding of function and mechanisms in the visual system can now be leveraged to pursue the design of computer vision architectures that will revolutionize the state of the art in computer vision.

Insertion of the Impella 5.0 left ventricular assist device via right anterior mini-thoracotomy: a novel practical approach.

The Impella 5.0 microaxial pump is a miniaturized left ventricular assist device commonly used for circulatory support in acute cardiogenic shock. The catheter-based pump is designed to be inserted either into a peripheral artery or directly into the ascending aorta.

Edwards EndoVent as a pacing catheter for minimally invasive aortic valve surgery: a novel approach.

Objective: The placement of epicardial pacing wires before weaning from bypass during port-access heart surgery can be difficult or impossible. Sometimes, it is necessary to pacing the patient to wean from bypass, and it is problematic to exchange the Edwards pulmonary vent (EndoVent) for a pace catheter under the drapes. Our objective was to devise an effective means of pacing the patient using the pulmonary vent catheter.

The RECOVER I: a multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support.

Objectives: Cardiogenic shock after cardiac surgery is accompanied by a high mortality rate. Early institution of hemodynamic support with a versatile, easy to insert left ventricular assist device might help bridge patients to recovery or to the next therapy, and improve the outcomes.

Methods: Patients developing cardiogenic shock or low cardiac output syndrome after being weaned off cardiopulmonary bypass were enrolled in a prospective single-arm feasibility study (RECOVER I).

Structure stability/activity relationships of sulfone stabilized N,N-dichloroamines.

Structure stability/activity relationships (SXR) of a new class of N,N-dichloroamine compounds were explored to improve antimicrobial activity against Escherichia coli, Staphylococcus aureus, and Candida albicans while maintaining aqueous solution stability. This study identified a new class of solution-stable and topical antimicrobial agents. These agents are sulfone-stabilized and possess either a quaternary ammonium or sulfonate appendages as a water solubilizing group.

Novel 3-chlorooxazolidin-2-ones as antimicrobial agents.

Antimicrobial resistance against many known therapeutics is on the rise. We examined derivatives of 3-chlorooxazolidin-2-one 1a (X=H) as antibacterial and antifungal agents. The key findings were that the activity and apparent in vitro cytotoxicity could be controlled by the substitution of charged solubilizers at the 4- and 5- positions.

Novel N-chloroheterocyclic antimicrobials.

Antimicrobial compounds with broad-spectrum activity and minimal potential for antibiotic resistance are urgently needed. Toward this end, we prepared and investigated a novel series of N-chloroheterocycles. Of the compounds examined, the N-chloroamine series were found superior over N-chloroamide series in regards to exhibiting high antimicrobial activity, low cytotoxicity, and long-term aqueous stability.

Discovery of N-methyl-4-(4-methoxyanilino)quinazolines as potent apoptosis inducers. Structure-activity relationship of the quinazoline ring.

As a continuation of our efforts to discover and develop apoptosis inducing N-methyl-4-(4-methoxyanilino)quinazolines as novel anticancer agents, we explored substitution at the 5-, 6-, 7-positions of the quinazoline and replacement of the quinazoline by other nitrogen-containing heterocycles. A small group at the 5-position was found to be well tolerated. At the 6-position a small group like an amino was preferred.

Discovery of N-(4-methoxyphenyl)-N,2-dimethylquinazolin-4-amine, a potent apoptosis inducer and efficacious anticancer agent with high blood brain barrier penetration.

As a continuation of our structure-activity relationship (SAR) studies on 4-anilinoquinazolines as potent apoptosis inducers and to identify anticancer development candidates, we explored the replacement of the 2-Cl group in our lead compound 2-chloro-N-(4-methoxyphenyl)-N-methylquinazolin-4-amine (6b, EP128265, MPI-0441138) by other functional groups. This SAR study and lead optimization resulted in the identification of N-(4-methoxyphenyl)-N,2-dimethylquinazolin-4-amine (6h, EP128495, MPC-6827) as an anticancer clinical candidate. Compound 6h was found to be a potent apoptosis inducer with EC(50) of 2 nM in our cell-based apoptosis induction assay.

Triterpene based compounds with potent anti-maturation activity against HIV-1.

Efforts towards developing orally bioavailable HIV-1 maturation inhibitors starting from betulinic acid 1 are described. SAR resulted in improved potency, physicochemical properties, and enhanced oral absorption in rats.

Discovery of 2-chloro-N-(4-methoxyphenyl)-N-methylquinazolin-4-amine (EP128265, MPI-0441138) as a potent inducer of apoptosis with high in vivo activity.

Using a live cell, high-throughput caspase-3 activator assay, we have identified a novel series of 4-anilinoquinazolines as inducers of apoptosis. In this report, we discuss the discovery of 2-chloro-N-(4-methoxyphenyl)-N-methylquinazolin-4-amine, compound 2b (EP128265, MPI-0441138) as a highly active inducer of apoptosis (EC50 for caspase activation of 2 nM) and as a potent inhibitor of cell proliferation (GI50 of 2 nM) in T47D cells. Compound 2b inhibited tubulin polymerization, was effective in cells overexpressing ABC transporter Pgp-1, and was efficacious in the MX-1 human breast and PC-3 prostate cancer mouse models.

Improving outcomes in patients with ventricular assist devices transferred from outlying to tertiary care hospitals.

In this retrospective study, the implant course and outcome of patients with ventricular assist devices (VADs) transferred from outlying "spoke" hospitals and converted nonsurgically to a device designed for ambulation at tertiary care "hub" hospitals are evaluated. Factors affecting the crucial decision to transfer and to convert devices have not previously been characterized. Data from 50 patients at 26 US hub institutions were voluntarily submitted to a VAD data registry at ABIOMED, between December 2003 and December 2005.

Discovery of a novel, orally active, small molecule gonadotropin-releasing hormone (GnRH) receptor antagonist.

Gonadotropin releasing hormone (GnRH) plays an important role in the biology of reproduction. The use of GnRH receptor antagonists has been reported in the literature for the treatment of breast, ovarian, and prostate cancers. In this article, we report the synthesis, in vitro characterization, pharmacokinetics, and pharmacodynamics of an orally bioavailable, potent, small molecule GnRH receptor antagonist N-{4,6-dimethoxy-2-[(3-morpholin-4-ylpropyl)amino]pyrimidin-5-yl}-5-[3,3,6-trimthyl-2,3-dihydro-1H-inden-5-yl)oxy]-2-furamide (compound 1).

Peripheral arterial cannulation for Abiomed BVS 5000 left ventricular assist device support.

The Abiomed BVS 5000 is an external, pulsatile, ventricular assist device typically used for short-term mechanical support in post-cardiotomy patients experiencing cardiogenic shock when myocardial recovery is expected. We describe an as yet unreported approach where the left common femoral artery was utilized for Abiomed left ventricular assist device cannulation after reoperative mitral valve surgery.

Anomalous coronary artery in a transplanted heart: a technical modification.

We report the case of a 47-year-old man who underwent orthotopic heart transplantation for valvular cardiomyopathy. At the time of cardiac catheterization we identified an anomalous origin of the donor left main coronary artery from the right coronary sinus of Valsalva. To decrease the risk of left main coronary artery compression during re-implantation of the transplanted heart, we performed a careful geometric arrangement of the aortopulmonary artery angle.