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Initial Experience With Imacor Htee-Guided Management Of Patients Following Transplant And Mechanical Circulatory Support., Christopher Kang, Hitoshi Hirose, Harold Hasting Nov 2012

Initial Experience With Imacor Htee-Guided Management Of Patients Following Transplant And Mechanical Circulatory Support., Christopher Kang, Hitoshi Hirose, Harold Hasting

Department of Cancer Biology Faculty Papers

We reviewed an initial experience using a miniaturized transesophageal echocardiography (TEE) probe (ImaCor, Garden City, NY) with 3 patients in whom Imacor hTEE intervention was used as a point of care device to manage extracorporeal membrane oxygenation cannula placement, cardiac hemodynamics, and post-op cardiac pathophysiology. The management of transplant or mechanical circulatory support (MCS) patients is especially challenging: transplanted hearts pose unique pathophysiological challenges, and MCS significantly alters pressure-volume-flow relationships. Real-time “hemodynamic” TEE (hTEE) can help provide effective management by direct visualization of cardiac filling and function and help guide hemodynamic management. In our initial experience, hTEE can provide point-of-care …


Successful Management Of Bleeding Complications In Patients Supported With Extracorporeal Membrane Oxygenation With Primary Respiratory Failure., K Lamb, Sw Cowan, N Evans, H Pitcher, T Moritz, M Lazar, H Hirose, Nc Cavarocchi Oct 2012

Successful Management Of Bleeding Complications In Patients Supported With Extracorporeal Membrane Oxygenation With Primary Respiratory Failure., K Lamb, Sw Cowan, N Evans, H Pitcher, T Moritz, M Lazar, H Hirose, Nc Cavarocchi

Department of Cancer Biology Faculty Papers

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a lifesaving procedure in patients with severe respiratory insufficiency failing conventional support. Bleeding complications are common due to the necessity for anticoagulation and circuit-related factors. METHODS: A retrospective review was conducted in patients requiring ECMO for respiratory failure from 7/2010 to 6/2011 to identify episodes of major bleeding, bleeding management and outcomes. RESULTS: Twenty-one patients were supported with ECMO during the study although five experienced massive bleeding related to chest tube insertion, jejunal arterio-venous malformations, distal perfusion cannula dislodgement and ventricular rupture. Patients required aggressive resuscitation or endoscopic or operative intervention, totaling 28 procedures. …