1
|
Lumish HS, Cagliostro B, Braghieri L, Bohn B, Mondellini GM, Antler K, Feldman V, Kleet A, Murphy J, Tiburcio M, Fidlow K, Jennings D, Sayer GT, Takeda K, Naka Y, Demmer RT, Aaron JG, Uriel N, Colombo PC, Yuzefpolskaya M. Driveline Infection in Left Ventricular Assist Device Patients: Effect of Standardized Protocols, Pathogen Type, and Treatment Strategy. ASAIO J 2022; 68:1450-1458. [PMID: 35239537 PMCID: PMC9469917 DOI: 10.1097/mat.0000000000001690] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Driveline infection (DLI) is common after left ventricular assist device (LVAD). Limited data exist on DLI prevention and management. We investigated the impact of standardized driveline care initiatives, specific pathogens, and chronic antibiotic suppression (CAS) on DLI outcomes. 591 LVAD patients were retrospectively categorized based on driveline care initiatives implemented at our institution (2009-2019). Era (E)1: nonstandardized care; E2: standardized driveline care protocol; E3: addition of marking driveline exit site; E4: addition of "no shower" policy. 87(15%) patients developed DLI at a median (IQR) of 403(520) days. S. aureus and P. aeruginosa were the most common pathogens. 31 (36%) of DLI patients required incision and drainage (I&D) and 5 (5.7%) device exchange. P. aeruginosa significantly increased risk for initial I&D (HR 2.7, 95% CI, 1.1-6.3) and recurrent I&D or death (HR 4.2, 95% CI, 1.4-12.5). Initial I&D was associated with a significant increased risk of death (HR 2.92 (1.33-6.44); P = 0.008) when compared to patients who did not develop DLI. Implementation of standardized driveline care protocol (E2) was associated with increased 2-year freedom from DLI compared to nonstandardized care (HR 0.36, 95% CI, 0.2-0.6, P < 0.01). Additional preventive strategies (E3&E4) showed no further reduction in DLI rates. 57(65%) DLI patients received CAS, 44% of them required escalation to intravenous antibiotics and/or I&D. Presence of P. aeruginosa DLI markedly increased risk for I&D or death. Conditional survival of patients progressing to I&D is diminished. Standardized driveline care protocol was associated with a significant reduction in DLI, while additional preventive strategies require further testing.
Collapse
Affiliation(s)
- Heidi S. Lumish
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Barbara Cagliostro
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Lorenzo Braghieri
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Bruno Bohn
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Giulio M. Mondellini
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Karen Antler
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Vivian Feldman
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Audrey Kleet
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Jennifer Murphy
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Melie Tiburcio
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Kathryn Fidlow
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Douglas Jennings
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Gabriel T. Sayer
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Koji Takeda
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Yoshifumi Naka
- Department of Surgery, Division of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York
| | - Ryan T. Demmer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Justin G. Aaron
- Department of Medicine Division of Infectious Diseases, Columbia University Irving Medical Center, New York, New York
| | - Nir Uriel
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Paolo C. Colombo
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
- Paolo C. Colombo and Melana Yuzefpolskaya contributed equally to this study
| | - Melana Yuzefpolskaya
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, New York
- Paolo C. Colombo and Melana Yuzefpolskaya contributed equally to this study
| |
Collapse
|
2
|
Yuzefpolskaya M, Bohn B, Javaid A, Mondellini GM, Braghieri L, Pinsino A, Onat D, Cagliostro B, Kim A, Takeda K, Naka Y, Farr M, Sayer GT, Uriel N, Nandakumar R, Mohan S, Colombo PC, Demmer RT. Levels of Trimethylamine N-Oxide Remain Elevated Long Term After Left Ventricular Assist Device and Heart Transplantation and Are Independent From Measures of Inflammation and Gut Dysbiosis. Circ Heart Fail 2021; 14:e007909. [PMID: 34129361 DOI: 10.1161/circheartfailure.120.007909] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Trimethylamine N-oxide (TMAO)-a gut-derived metabolite-is elevated in heart failure (HF) and linked to poor prognosis. We investigated variations in TMAO in HF, left ventricular assist device (LVAD), and heart transplant (HT) and assessed its relation with inflammation, endotoxemia, oxidative stress, and gut dysbiosis. METHODS We enrolled 341 patients. TMAO, CRP (C-reactive protein), IL (interleukin)-6, TNF-α (tumor necrosis factor alpha), ET-1 (endothelin-1), adiponectin, lipopolysaccharide, soluble CD14, and isoprostane were measured in 611 blood samples in HF (New York Heart Association class I-IV) and at multiple time points post-LVAD and post-HT. Gut microbiota were assessed via 16S rRNA sequencing among 327 stool samples. Multivariable regression models were used to assess the relationship between TMAO and (1) New York Heart Association class; (2) pre- versus post-LVAD or post-HT; (3) biomarkers of inflammation, endotoxemia, oxidative stress, and microbial diversity. RESULTS ln-TMAO was lower among HF New York Heart Association class I (1.23 [95% CI, 0.52-1.94] µM) versus either class II, III, or IV (1.99 [95% CI, 1.68-2.30], 1.97 [95% CI, 1.71-2.24], and 2.09 [95% CI, 1.83-2.34] µM, respectively; all P<0.05). In comparison to class II-IV, ln-TMAO was lower 1 month post-LVAD (1.58 [95% CI, 1.32-1.83] µM) and 1 week and 1 month post-HT (0.97 [95% CI, 0.60-1.35] and 1.36 [95% CI, 1.01-1.70] µM). ln-TMAO levels in long-term LVAD (>6 months: 1.99 [95% CI, 1.76-2.22] µM) and HT (>6 months: 1.86 [95% CI, 1.66-2.05] µM) were not different from symptomatic HF. After multivariable adjustments, TMAO was not associated with biomarkers of inflammation, endotoxemia, oxidative stress, or microbial diversity. CONCLUSIONS TMAO levels are increased in symptomatic HF patients and remain elevated long term after LVAD and HT. TMAO levels were independent from measures of inflammation, endotoxemia, oxidative stress, and gut dysbiosis.
Collapse
Affiliation(s)
- Melana Yuzefpolskaya
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Bruno Bohn
- Biomarkers Core Laboratory, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (B.B., R.T.D.)
| | - Azka Javaid
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Giulio M Mondellini
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Lorenzo Braghieri
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Alberto Pinsino
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Duygu Onat
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Barbara Cagliostro
- Dpartment of Surgery, Division of Cardiac Surgery (B.C., K.T., Y.N.), Columbia University Irving Medical Center, New York, NY
| | - Andrea Kim
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Koji Takeda
- Dpartment of Surgery, Division of Cardiac Surgery (B.C., K.T., Y.N.), Columbia University Irving Medical Center, New York, NY
| | - Yoshifumi Naka
- Dpartment of Surgery, Division of Cardiac Surgery (B.C., K.T., Y.N.), Columbia University Irving Medical Center, New York, NY
| | - Maryjane Farr
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Gabriel T Sayer
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Nir Uriel
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Renu Nandakumar
- Biomarkers Core Laboratory, Irving Institute for Clinical and Translational Research (R.N.)
| | - Sumit Mohan
- Department of Medicine, Division of Nephrology (S.M.), Columbia University Irving Medical Center, New York, NY.,Department of Epidemiology, Mailman School of Public Health (S.M., R.T.D.), Columbia University Irving Medical Center, New York, NY
| | - Paolo C Colombo
- Department of Medicine, Division of Cardiology (M.Y., A.J., G.M.M., L.B., A.P., D.O., A.K., M.F., G.T.S., N.U., P.C.C.), Columbia University Irving Medical Center, New York, NY
| | - Ryan T Demmer
- Department of Epidemiology, Mailman School of Public Health (S.M., R.T.D.), Columbia University Irving Medical Center, New York, NY.,Biomarkers Core Laboratory, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (B.B., R.T.D.)
| |
Collapse
|
3
|
Casida JM, Pavol M, Craddock H, Schroeder SE, Cagliostro B, Budhathoki C. Patient-Reported Issues Following Left Ventricular Assist Device Implantation Hospitalization. ASAIO J 2021; 67:658-665. [PMID: 33587467 DOI: 10.1097/mat.0000000000001381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to explore the information reported by patients via a smartphone application (VAD Care App) used for left ventricular assist device (LVAD) self-care monitoring and reporting post hospital discharge. Specific aims were to examine the type and frequency of issues reported by patients through the app during months 1, 3, and 6 postdischarge. An exploratory-descriptive research design was used with 17 patients (12 males and 5 females) with durable LVADs, mean age of 48.6 ± 16 years. Data generated by the patients' daily smartphone app usage more than 6 months were extracted from the server. Data were coded and clustered according to issues reported by patients via the app and analyzed with descriptive statistics. Three clusters of issues were found: physiologic, behavioral (self-care), and signs and symptoms. LVAD flows and pulsatility indices, hypertension, driveline care, and heart failure symptoms were worse at month 1, and then appeared to improve at months 3-6. However, abnormal levels of the international normalization ratio were common at all assessment points. Further research is needed to understand the mechanism of the reported issues on treatment outcomes, then develop and test interventions to inform evidence-based practice and clinical guidelines for smartphone apps used in LVAD self-care monitoring.
Collapse
Affiliation(s)
- Jesus M Casida
- From the School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - MaryKay Pavol
- Columbia University Medical Center, New York City, New York
| | - Heidi Craddock
- Barnes-Jewish Hospital Washington University, St. Louis, Missouri
| | | | | | - Chakra Budhathoki
- From the School of Nursing, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
4
|
Yuzefpolskaya M, Lumish HS, Javaid A, Cagliostro B, Mondellini GM, Bohn B, Sweat A, Onat D, Braghieri L, Takeda K, Naka Y, Sayer GT, Uriel N, Aaron JG, Montassier E, Demmer RT, Colombo PC. Association of preoperative infections, nasal Staphylococcus aureus colonization and gut microbiota with left ventricular assist device outcomes. Eur J Heart Fail 2021; 23:1404-1415. [PMID: 33964186 DOI: 10.1002/ejhf.2215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/29/2021] [Accepted: 05/04/2021] [Indexed: 01/05/2023] Open
Abstract
AIMS Infections are common following left ventricular assist device (LVAD) implantation and predict adverse events. Infections are frequent prior to LVAD implantation although their impact on postoperative outcomes remains unknown. Gut and nasal microbial imbalance may predispose to mucosal colonization with pathogens. Herein, we investigated the predictive role of pre-LVAD infections, and explored the association of nasal Staphylococcus aureus (SA) colonization and gut microbiota, on postoperative outcomes. METHODS AND RESULTS Overall, 254 LVAD patients were retrospectively categorized based on pre-LVAD infection status: Group 1, bacterial/fungal bloodstream infection (BSI); Group 2, other bacterial/fungal; Group 3, viral; and Group 4, no infection. In a subset of patients, nasal SA colonization (n = 140) and pre-LVAD stool (n = 25) were analysed using 16S rRNA sequencing. A total of 75 (29%) patients had a pre-LVAD infection [Group 1: 22 (29%); Group 2: 41 (55%); Group 3: 12 (16%)]. Pre-LVAD BSIs were independent predictors of 1-year postoperative mortality and infections [Group 1 vs. 4: hazard ratio (HR) 2.70, P = 0.036 vs. HR 1.8, P = 0.046]. In an unadjusted analysis, pre-LVAD infections other than BSIs, INTERMACS profile ≤2, higher serum creatinine, lower serum albumin and nasal SA colonization were also significantly associated with postoperative infections. Patients with early post-LVAD infections exhibited decreased microbial diversity (P < 0.05). CONCLUSIONS Pre-LVAD infections are common. BSIs independently predict postoperative mortality and infections. Additional studies are needed to confirm our findings that pre-LVAD SA nasal colonization and gut microbial composition can help stratify patients' risk for infectious complications after LVAD implantation.
Collapse
Affiliation(s)
- Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Heidi S Lumish
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Azka Javaid
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Barbara Cagliostro
- Division of Cardiac Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Giulio M Mondellini
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Bruno Bohn
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Austin Sweat
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Duygu Onat
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Lorenzo Braghieri
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Koji Takeda
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Yoshifumi Naka
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Gabriel T Sayer
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Nir Uriel
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Justin G Aaron
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Emmanuel Montassier
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, USA.,Université de Nantes, Microbiotas Hosts Antibiotics and Bacterial Resistances (MiHAR), and Department of Emergency Medicine, CHU de Nantes, Nantes, France
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Paolo C Colombo
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| |
Collapse
|
5
|
Lumish H, Chaudhary E, Cagliostro B, Javaid A, Mondellini G, Braghieri L, Sweat A, Murphy J, Pinsino A, Takeda K, Naka Y, Sayer G, Uriel N, Aaron J, Colombo P, Yuzefpolskaya M. Pseudomonas aeruginosa Infection Predicts Need for Surgical Incision and Drainage in LVAD Patients with Driveline Infection. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
6
|
Mondellini G, Pinsino A, Braghieri L, Javaid A, Lin E, Cagliostro B, Pineda M, Fried J, Topkara V, Takeda K, Naka Y, Sayer G, Uriel N, Radhakrishnan J, Demmer R, Colombo P, Yuzefpolskaya M. Serum Cystatin C as a Predictor of Early Outcomes and Long-Term Mortality in Contemporary LVAD Patients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
7
|
Wilcox JE, Cameron KA, Harap RS, Shanklin KL, Grady KL, Cohen ER, Abicht TO, Adler ED, Alexy T, Alonso W, Beckman J, Bjelkengren J, Cagliostro B, Cogswell R, Colombo PC, Cotts W, Haglund NA, Haverstick S, Kiernan MS, Lampert B, LeMond LM, Lee S, Lerg G, Lindenfeld J, Mahr C, Meehan K, Pagani FD, Pan S, Pavone J, Um J, Yancy CW, Thinh D, Barsuk JH. Ventricular Assist Device Driveline Dressing-Change Protocols: A Need for Standardization. A Report from the SimVAD Investigators. J Card Fail 2019; 25:695-697. [PMID: 31247286 DOI: 10.1016/j.cardfail.2019.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/05/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Jane E Wilcox
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL.
| | - Kenzie A Cameron
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Rebecca S Harap
- Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL
| | - Kerry L Shanklin
- Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL
| | - Kathleen L Grady
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Elaine R Cohen
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Eric D Adler
- University of California San Diego, San Diego, CA
| | - Tamas Alexy
- University of Minnesota Health, Minneapolis, MN
| | - Windy Alonso
- University of Nebraska Medical Center, Omaha, NE
| | | | | | | | | | | | | | | | | | | | - Brent Lampert
- The Ohio State University Wexner Medical Center, Columbus, OH
| | | | | | | | | | - Claudius Mahr
- University of Washington Medical Center, Seattle, WA
| | | | | | - Stephen Pan
- New York University Langone Health, New York City, NY
| | | | - John Um
- University of Nebraska Medical Center, Omaha, NE
| | - Clyde W Yancy
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IL
| | - Duc Thinh
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jeffrey H Barsuk
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
8
|
Cagliostro B, Zuver A, Effner L, Parkis G, Mondellini G, Royzman E, Bravo C, Te-Frey R, Lin E, Garan A, Takayama H, Takeda K, Naka Y, Colombo P, Yuzefpolskaya M. Pre-LVAD Blood-Borne Infection is a Harbinger of Poor Prognosis after LVAD Implantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
9
|
Axelrad J, Faye A, Pinsino A, Cagliostro B, Thanataveerat A, Effner L, Pineda F, Garan A, Takayama H, Takeda K, Naka Y, Colombo P, Gonda T, Yuzefpolskaya M. Prospective Validation of the First Endoscopic Management Algorithm for Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
10
|
Pinsino A, Castagna F, Zuver AM, Royzman EA, Nasiri M, Stöhr EJ, Cagliostro B, McDonnell B, Cockcroft JR, Garan AR, Topkara VK, Schulze PC, Takeda K, Takayama H, Naka Y, Demmer RT, Willey JZ, Yuzefpolskaya M, Colombo PC. Prognostic implications of serial outpatient blood pressure measurements in patients with an axial continuous-flow left ventricular assist device. J Heart Lung Transplant 2018; 38:396-405. [PMID: 30559034 DOI: 10.1016/j.healun.2018.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/06/2018] [Accepted: 11/09/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Elevated blood pressure (BP) has been linked to adverse events during left ventricular assist device support. In this study we investigated the association between outpatient BP and stroke or suspected pump thrombosis among HeartMate II (HMII) recipients. METHODS We retrospectively studied 220 HMII patients. Serial outpatient BP measurements were averaged. Patients were categorized by: (1) mean arterial pressure (MAP), high (>90 mm Hg) vs intermediate (80 mm Hg ≤ MAP ≤ 90 mm Hg) vs low (<80 mm Hg); (2) systolic BP (SBP), high (≥101 mm Hg, median) vs low; and (3) pulse pressure (PP), high (≥22 mm Hg, median) vs low. To assess visit-to-visit BP variability, patients were divided in quartiles of standard deviation of MAP and SBP. The primary end-point was the composite of stroke or suspected pump thrombosis. RESULTS The risk for the primary end-point was increased in the high MAP group (adjusted hazard ratio [HR] 2.75, 95% confidence interval [CI] 1.49 to 5.05, vs intermediate MAP; and 6.73, 1.9 to 23.9, vs low MAP). MAP had higher predictive value for the primary end-point compared with SBP (p = 0.05). Patients with high SBP had a higher rate of stroke (HR 2.8, 95% CI 1.09 to 7.17, vs low SBP). The combination of high SBP and low PP was associated with the highest risk for stroke. The lowest quartile of visit-to-visit MAP variability was associated with the highest risk for the primary end-point. CONCLUSIONS Elevated outpatient BP is associated with increased risk for stroke or suspected pump thrombosis in HMII recipients. Reduced PP and low visit-to-visit BP variability may confer additional risk.
Collapse
Affiliation(s)
- Alberto Pinsino
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Francesco Castagna
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA; Department of Medicine, Yale New Haven Bridgeport Hospital, Bridgeport, Connecticut, USA
| | - Amelia M Zuver
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Eugene A Royzman
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Mojdeh Nasiri
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Eric J Stöhr
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA; Cardiff Metropolitan University, Cardiff, UK
| | - Barbara Cagliostro
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | | | - John R Cockcroft
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - A Reshad Garan
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Veli K Topkara
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - P Christian Schulze
- Department of Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, Friedrich Schiller University Jena, University Hospital Jena, Jena, Germany
| | - Koji Takeda
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Hiroo Takayama
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Yoshifumi Naka
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Joshua Z Willey
- Department of Neurology, Columbia University, New York, New York, USA
| | - Melana Yuzefpolskaya
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Paolo C Colombo
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA.
| |
Collapse
|
11
|
Pinsino A, Castagna F, Willey J, Zuver A, Flannery M, Cagliostro B, Cockroft J, Garan A, Topkara V, Takayama H, Takeda K, Naka Y, Demmer R, Colombo P, Yuzefpolskaya M. Predictive Value of Mean Arterial Pressure Versus Systolic Blood Pressure and Visit-To-Visit Blood Pressure Variability for Stroke and Pump Thrombosis in HeartMate II Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
12
|
Axelrad J, Pinsino A, Thanataveerat A, Cagliostro B, Flannery M, Ross K, Te-Frey R, Effner L, Garan A, Topkara V, Takayama H, Takeda K, Naka Y, Colombo P, Gonda T, Yuzefpolskaya M. A Prospective Validation of the First Endoscopic Management Algorithm for Gastrointestinal Bleeding in Patients with Continuous-Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
13
|
Kaan A, Cagliostro B. An International Survey of LVAD Hygeine Practices. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
14
|
Axelrad JE, Pinsino A, Trinh PN, Thanataveerat A, Brooks C, Demmer RT, Effner L, Parkis G, Cagliostro B, Han J, Garan AR, Topkara V, Takeda K, Takayama H, Naka Y, Ramirez I, Garcia-Carrasquillo R, Colombo PC, Gonda T, Yuzefpolskaya M. Limited usefulness of endoscopic evaluation in patients with continuous-flow left ventricular assist devices and gastrointestinal bleeding. J Heart Lung Transplant 2017; 37:723-732. [PMID: 29402604 DOI: 10.1016/j.healun.2017.12.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/06/2017] [Accepted: 12/17/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastrointestinal bleeding (GIB) is a frequent cause of re-admission in patients with continuous-flow left ventricular assist devices (CF-LVADs) and is associated with multiple endoscopic procedures and high resource utilization. Our aim was to determine the diagnostic and therapeutic yield of endoscopy and to develop a more cost-effective approach for the management of GIB in CF-LVAD recipients. METHODS We retrospectively reviewed 428 patients implanted with a CF-LVAD between 2009 and 2016 at the Columbia University Medical Center and identified those hospitalized for GIB. Patients were categorized into upper GIB (UGIB), lower GIB (LGIB) and occult GIB (OGIB), based on clinical presentation. RESULTS Eighty-seven CF-LVAD patients underwent a total of 164 GIBs, resulting in 239 endoscopies. Index presentation was consistent with UGIB in 30 (34.5%), LGIB in 19 (21.8%) and OGIB in 38 (43.7%) patients. On the first GIB, 147 endoscopies localized a bleeding source in 49 (30%), resulting in 24 (16.3%) endoscopic interventions. Of 45 lesions identified, arteriovenous malformations (AVMs) were the most common (22, 48.9%). A gastric or small bowel source (HR 2.8, p = 0.003) and an endoscopic intervention (HR 1.9, p = 0.04) predicted recurrent GIB. The proposed algorithm may reduce the number of endoscopic procedures by 45% and costs by 35%. CONCLUSIONS Occult GIB is the most common presentation in CF-LVAD patients and carries the lowest diagnostic and therapeutic yield of endoscopy. Performing an intervention was among the strongest predictors of recurrent GIB. Our proposed algorithm may decrease the number of low-yield procedures and improve resource utilization.
Collapse
Affiliation(s)
- Jordan E Axelrad
- Department of Medicine, Division of Digestive and Liver Diseases, Columbia University, New York, New York, USA
| | - Alberto Pinsino
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Pauline N Trinh
- Department of Epidemiology, Columbia University, New York, New York, USA
| | - Anusorn Thanataveerat
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Christian Brooks
- Department of Medicine, Division of Digestive and Liver Diseases, Columbia University, New York, New York, USA
| | - Ryan T Demmer
- Department of Epidemiology, Columbia University, New York, New York, USA
| | - Lisa Effner
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Grant Parkis
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Barbara Cagliostro
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Jiho Han
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - A Reshad Garan
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Veli Topkara
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Koji Takeda
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Hiroo Takayama
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Yoshifumi Naka
- Department of Surgery, Division of Cardiac Surgery, Columbia University, New York, New York, USA
| | - Ivonne Ramirez
- Department of Medicine, Division of Digestive and Liver Diseases, Columbia University, New York, New York, USA
| | - Reuben Garcia-Carrasquillo
- Department of Medicine, Division of Digestive and Liver Diseases, Columbia University, New York, New York, USA
| | - Paolo C Colombo
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA
| | - Tamas Gonda
- Department of Medicine, Division of Digestive and Liver Diseases, Columbia University, New York, New York, USA
| | - Melana Yuzefpolskaya
- Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA.
| |
Collapse
|
15
|
Topkara VK, Garan AR, Fine B, Godier-Furnémont AF, Breskin A, Cagliostro B, Yuzefpolskaya M, Takeda K, Takayama H, Mancini DM, Naka Y, Colombo PC. Myocardial Recovery in Patients Receiving Contemporary Left Ventricular Assist Devices: Results From the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Circ Heart Fail 2017; 9:CIRCHEARTFAILURE.116.003157. [PMID: 27402861 DOI: 10.1161/circheartfailure.116.003157] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 06/02/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Time course and predictors of myocardial recovery on contemporary left ventricular assist device support are poorly defined because of limited number of recovery patients at any implanting center. This study sought to investigate myocardial recovery using multicenter data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). METHODS AND RESULTS Thirteen thousand four hundred fifty-four adult patients were studied. Device explant rates for myocardial recovery were 0.9% at 1-year, 1.9% at 2-year, and 3.1% at 3-year follow-up. Independent predictors of device explantation for recovery were age <50 years (odds ratio [OR] 2.5), nonischemic etiology (OR 5.4), time since initial diagnosis <2 years (OR 3.4), suboptimal heart failure therapy before implant (OR 2.2), left ventricular end-diastolic diameter <6.5 cm (OR 1.7), pulmonary systolic artery pressure <50 mm Hg (OR 2.0), blood urea nitrogen <30 mg/dL (OR 3.3), and axial-flow device (OR 7.6). Patients with myocarditis (7.7%), postpartum cardiomyopathy (4.4%), and adriamycin-induced cardiomyopathy (4.1%) had highest rates of device explantation for recovery. Use of neurohormonal blockers on left ventricular assist device support was significantly higher in patients who were explanted for recovery. Importantly, 9% of all left ventricular assist device patients who were not explanted for recovery have demonstrated substantial improvement in left ventricular ejection fraction (partial recovery) and had remarkable overlap in clinical characteristic profile compared with patients who were explanted for recovery (complete recovery). Complete and partial recovery rates have declined in parallel with recent changes observed in device indications and technology. CONCLUSIONS Myocardial recovery is a spectrum of improvement rather than a binary clinical end point. One in every 10 left ventricular assist device patients demonstrates partial or complete myocardial recovery and should be targeted for functional assessment and optimization.
Collapse
Affiliation(s)
- Veli K Topkara
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York.
| | - A Reshad Garan
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Barry Fine
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Amandine F Godier-Furnémont
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Alexander Breskin
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Barbara Cagliostro
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Melana Yuzefpolskaya
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Koji Takeda
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Hiroo Takayama
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Donna M Mancini
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Yoshifumi Naka
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| | - Paolo C Colombo
- From the Division of Cardiology, Department of Medicine (V.K.T., A.R.G., B.F., A.F.G.G.-F., A.B., M.Y., D.M.M., P.C.C.) and Division of Cardiothoracic Surgery, Department of Surgery (B.C., K.T., H.T., Y.N.), Columbia University Medical Center-New York Presbyterian, New York
| |
Collapse
|
16
|
Yuzefpolskaya M, Uriel N, Flannery M, Yip N, Mody K, Cagliostro B, Takayama H, Naka Y, Jorde UP, Goswami S, Colombo PC. Advanced cardiovascular life support algorithm for the management of the hospitalized unresponsive patient on continuous flow left ventricular assist device support outside the intensive care unit. European Heart Journal: Acute Cardiovascular Care 2016; 5:522-526. [DOI: 10.1177/2048872615574107] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 02/01/2015] [Indexed: 11/17/2022]
Affiliation(s)
| | - Nir Uriel
- New York Presbyterian Hospital, Columbia University, New York, USA
| | | | - Natalie Yip
- New York Presbyterian Hospital, Columbia University, New York, USA
| | - Kanika Mody
- New York Presbyterian Hospital, Columbia University, New York, USA
| | | | - Hiroo Takayama
- New York Presbyterian Hospital, Columbia University, New York, USA
| | - Yoshifumi Naka
- New York Presbyterian Hospital, Columbia University, New York, USA
| | - Ulrich P Jorde
- New York Presbyterian Hospital, Columbia University, New York, USA
| | - Sumeet Goswami
- New York Presbyterian Hospital, Columbia University, New York, USA
| | - Paolo C Colombo
- New York Presbyterian Hospital, Columbia University, New York, USA
| |
Collapse
|
17
|
Topkara V, Garan A, Yuzefpolskaya M, Takeda K, Takayama H, Castagna F, Cagliostro B, Parkis G, Restaino S, Latif F, Maurer M, Farr M, Mancini D, Naka Y, Colombo P. Effect of Body Mass Index on Outcomes of Heart Transplant Candidates Supported by Continuous-Flow Left Ventricular Assist Devices (CF-LVADs). J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
18
|
Castagna F, McDonnell B, Yuzefpolskaya M, Topkara V, Garan A, Willey J, Trinh P, Wong K, Cagliostro B, Flannery M, Mancini D, Takayama H, Takeda K, Naka Y, Cockcroft J, Colombo P. Validity and Reliability of a Next Generation Non-Invasive Blood Pressure Monitor in Patients with Continuous-Flow Left Ventricular Assist Device. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
19
|
Topkara V, Garan A, Yuzefpolskaya M, Takeda K, Takayama H, Fried J, Toennes B, Castagna F, Clemons A, Eadie J, Cagliostro B, Restaino S, Maurer M, Mancini D, Naka Y, Colombo P. Incidence and Predictors of Left Ventricular Functional Recovery on Continuous-Flow Left Ventricular Assist Device (CF-LVAD) Support. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
20
|
Jennings D, Li R, Garan A, Yuzefpolskaya M, Takeda K, Takayama H, Cagliostro B, Flannery M, Toennes B, Farr M, Mancini D, Naka Y, Colombo P, Topkara V. Genotype-Guided Warfarin Dosing in Continuous-Flow Left-Ventricular Assist Device (CF-LVAD) Patients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
21
|
Garan A, Mai X, Topkara V, Clerkin K, Wong K, Castagna F, Trinh P, Sreekanth S, Jennings D, Torres M, Cagliostro B, Parkis G, Takeda K, Takayama H, Naka Y, Maurer M, Mancini D, Yuzefpolskaya M, Dizon J, Colombo P. QRS Duration Predicts Outcomes Following Implantation of a Left Ventricular Assist Device. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
22
|
Topkara V, Eisenberger A, Knotts R, Jennings D, Garan A, Yuzefpolskaya M, Takeda K, Takayama H, Li R, Fried J, Castagna F, Cagliostro B, Tiburcio M, Mancini D, Naka Y, Colombo P, Jorde U. Warfarin Sensitive Patients Have Higher Risk of Gastrointestinal Bleeding and Device Thrombosis on Continuous-Flow Left Ventricular Assist Device (CF-LVAD) Support. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
|
23
|
Topkara V, Garan A, Yuzefpolskaya M, Takeda K, Takayama H, Givens R, Fried J, Castagna F, Cagliostro B, Flannery M, Willey J, Restaino S, Latif F, Farr M, Maurer M, Mancini D, Naka Y, Colombo P. Discharge Lactate Dehydrogenase (LDH) Level Predicts Early Device Thrombosis in Patients with HEARTMATE II Left Ventricular Assist Devices: A Retrospective Cohort Analysis. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
24
|
Topkara V, Garan A, Ton V, Yuzefpolskaya M, Takeda K, Takayama H, Jennings D, Castagna F, Cagliostro B, Farr M, Maurer M, Mancini D, Naka Y, Colombo P. Red Cell Distribution Width (RDW) Predicts 90-Day Mortality in Continuous-Flow Left Ventricular Assist Device (CF-LVAD) Patients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
25
|
Topkara V, Eisenberger A, Garan A, Jennings D, Yuzefpolskaya M, Takeda K, Takayama H, Castagna F, Cagliostro B, Flannery M, Te-Frey R, Uryevick A, Latif F, Maurer M, Farr M, Mancini D, Naka Y, Colombo P. Aspirin Responsiveness Predicts Mucosal Bleeding Events in Patients with Continuous-Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
26
|
Topkara V, Garan A, Yuzefpolskaya M, Takeda K, Takayama H, Cagliostro B, Effner L, Castagna F, Singh S, Fried J, Haythe J, Maurer M, Farr M, Mancini D, Naka Y, Colombo P. Lactate Dehydrogenase Isoenzyme Monitoring in Patients with Continuous-Flow Left Ventricular Assist Devices (CF-LVADs). J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
27
|
Colombo P, Yuzefpolskaya M, Jennings D, Willey J, Flannery M, Cagliostro B, Garan A, Naka Y, Takayama H, Takeda K, Castagna F, Mancini D, Eisenberger A, Topkara V. Usefulness of a Multipronged Strategy to Prevent Device Thrombosis in HeartMate II Left Ventricular Assist Devices. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
28
|
Gavalas M, Breskin A, Eisenberger A, Yuzefpolskaya M, Topkara V, Torres M, Tiburcio M, Murphy J, Cagliostro B, Te-Frey R, Ross K, Flannery M, Wong K, Garan R, Mancini D, Takeda K, Takayama H, Naka Y, Demmer R, Colombo P. Discriminatory Performance of Simple Urine Dipstick for Detection of Significant Hemolysis in CF-LVAD Patients. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
29
|
Topkara V, Godier-Furnemont A, Levin A, Garan A, Cagliostro B, Te-Frey R, Torres F, Takeda K, Takayama H, Yuzefpolskaya M, Jorde U, Mancini D, Naka Y, Colombo P. Use of Phosphodiesterase 5 Inhibitors in Continuous-Flow Left Ventricular Assist Device Patients With Pulmonary: Hypertension: A Contemporary Analysis. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
30
|
Topkara V, Levin A, Mody K, Garan A, Cagliostro B, Flannery M, Te-Frey R, Torres F, Takeda K, Takayama H, Yuzefpolskaya M, Mancini D, Naka Y, Colombo P, Jorde U. VKORC1 Genotype Predicts Warfarin Dosing and INR Kinetics in Patients With Continuous-Flow Left Ventricular Assist Devices (CF-LVADs). J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
31
|
Nakagawa S, Blinderman C, Cagliostro B, Flannery M, Topkara V, Takeda K, Takayama H, Naka Y, Colombo P, Yuzefpolskaya M. Palliative Care Effectively Guides Transition to Inpatient Hospice, Home Hospice or Home Services for End-of-Life Care of LVAD Patients. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
32
|
Fried J, Cagliostro B, Levin A, Wever-Pinzon O, Garan A, Te-Frey R, Ronquillo K, Takeda K, Takayama H, Yuzefpolskaya M, Mancini D, Naka Y, Colombo P, Topkara V. Driveline Infection Is Not Associated With Increased Risk of Thrombotic Events in CF-LVAD Patients. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
33
|
Cagliostro B, Levin A, Parkis G, Stewart S, Mody K, Takayama H, Naka Y, Colombo P, Yuzefpolskaya M, Jorde U, Uriel N. Reduction of Drive Line Infection in Continuous Flow Assist Devices: Use of Standard Kit Including Silver Dressing and Anchoring Device. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|