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Cardiovascular System Commons

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Feasibility Of The Use Of A Stereoscopic Camera In The Final Inclusion (Sci-Fi) Of Donor Organ Assessment Using Virtual Reality Technology, Ismael A. Salas De Armas, Juan E. Marcano, Jayeshkumar A. Patel, Mehmet H. Akay, Manish K. Patel, Bindu Akkanti, Marwan F. Jumean, Sachin Kumar, Rajko Radovancevic, Sriram Nathan, Biswajit Kar, Igor D. Gregoric 2021 The University of Texas Health Science Center-Houston

Feasibility Of The Use Of A Stereoscopic Camera In The Final Inclusion (Sci-Fi) Of Donor Organ Assessment Using Virtual Reality Technology, Ismael A. Salas De Armas, Juan E. Marcano, Jayeshkumar A. Patel, Mehmet H. Akay, Manish K. Patel, Bindu Akkanti, Marwan F. Jumean, Sachin Kumar, Rajko Radovancevic, Sriram Nathan, Biswajit Kar, Igor D. Gregoric

The VAD Journal

Objective: Donor organ assessment is challenging, particularly when physicians and surgeons have to make decisions remotely. To improve communication and preparation for the transplant process, we proposed that a versatile, secure, and transportable video presence would enable a detailed assessment of donor organs.

Methods: A virtual reality camera with a 360-degree visualization range was used with a smartphone receiver to enable integral assessment of the donor's heart in the operating room, with visualization of the organs in real time. Prospective, observational data was collected in two cases in this proof-of-concept study. An assessment physician evaluated the donor heart remotely ...


Removal Of Impella In The Setting Of Left Ventricular Thrombus: A Potential Indication For Cerebral Embolic Protection Devices, Miro Asadourian, Avinash Sharma, Richard Kiel, Felice Lin, Manminder Bhullar 2021 UCSF Fresno

Removal Of Impella In The Setting Of Left Ventricular Thrombus: A Potential Indication For Cerebral Embolic Protection Devices, Miro Asadourian, Avinash Sharma, Richard Kiel, Felice Lin, Manminder Bhullar

The VAD Journal

Successful percutaneous mechanical circulatory support (MCS) has been used for acute stabilization of cardiogenic shock (CS). Improved survival outcomes have been observed in patients with CS from an acute myocardial infarction (AMI) who undergo implantation of left ventricular (LV) to ascending aorta rotodynamic pumps, such as the Impella® device (Abiomed). However, thrombotic events are a known complication of such devices in poor flow states such as CS. There is limited evidence regarding the management of patients who develop an LV thrombus after Impella insertion. Currently, the Sentinel cerebral protection system (SCPS, Boston Scientific) is the only FDA-approved device for cerebral ...


Design And Control Of A Peristaltic Pump To Simulate Left Atrial Pressure In A Conductive Silicone Model, Jeremy Collins 2021 University of Arkansas, Fayetteville

Design And Control Of A Peristaltic Pump To Simulate Left Atrial Pressure In A Conductive Silicone Model, Jeremy Collins

Mechanical Engineering Undergraduate Honors Theses

According to the CDC, atrial fibrillation is responsible for more than 454,000 hospitalizations and approximately 158,000 deaths per year. A common treatment for atrial fibrillation is catheter ablation, a process in which a long flexible tube is guided through the femoral artery and to the source of arrhythmia in the heart, where it measures the electrical potential at various locations and converts problematic heart tissue to scar tissue via ablation. This paper details the design and control of a low-cost ($400) peristaltic pump system using repetitive control to replicate blood pressure in the left atrium in a conductive ...


Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye 2021 Georgetown University School of Medicine

Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye

Journal of Patient-Centered Research and Reviews

While transfusion of blood and blood products is instinctively linked to the provision of emergent care, blood and blood products are also routinely used for the treatment of subacute and chronic conditions. Despite the efforts of the World Health Organization and others, developing countries are faced with a three-part problem when it comes to access to and delivery of transfusions: insufficient supply, excessive demand, and inadequate quality of available supply. Developing countries rely heavily on replacement and remunerated donors rather than voluntary nonremunerated donors due to concerns regarding donation- and transfusion-transmitted infection as well as local and cultural beliefs. While ...


What Did We Learn About Vads In 2020?, Maya Guglin 2021 Indiana University

What Did We Learn About Vads In 2020?, Maya Guglin

The VAD Journal

This is our 7th annual literature review on mechanical circulatory support (MCS) devices.

Our previous reports were well received by the readers. The full text of the reviews for 2014, 2015, 2016, 2017, 2018, 2019 1-6 were downloaded 807, 843, 638, 827, 841, and 199 times, respectively.

In this review, we summarized the most interesting and important, from our standpoint, publications covering MCS from 2020. There may be some slight overlap with the end of 2019 because some papers were published online first, and the year of the publication changed when they became available in print.

For the fourth time ...


C25: The “Spot Sign”: A Predictor Of Hematoma Expansion, Mckenzie Merritt 2021 Roseman University of Health Sciences

C25: The “Spot Sign”: A Predictor Of Hematoma Expansion, Mckenzie Merritt

Annual Research Symposium

No abstract provided.


Chromosome Xq23 Is Associated With Lower Atherogenic Lipid Concentrations And Favorable Cardiometabolic Indices, Pradeep Natarajan, Akhil Pampana, Sarah E. Graham, Sanni E. Ruotsalainen, James A. Perry, Paul S. de Vries, Jai G. Broome, James P. Pirruccello, Michael C. Honigberg, Krishna Aragam, Brooke Wolford, Jennifer A. Brody, Lucinda Antonacci-Fulton, Moscati Arden, Stella Aslibekyan, Themistocles L. Assimes, Christie M. Ballantyne, Lawrence F. Bielak, Joshua C. Bis, Brian E. Cade, Donna K. Arnett 2021 Massachusetts General Hospital

Chromosome Xq23 Is Associated With Lower Atherogenic Lipid Concentrations And Favorable Cardiometabolic Indices, Pradeep Natarajan, Akhil Pampana, Sarah E. Graham, Sanni E. Ruotsalainen, James A. Perry, Paul S. De Vries, Jai G. Broome, James P. Pirruccello, Michael C. Honigberg, Krishna Aragam, Brooke Wolford, Jennifer A. Brody, Lucinda Antonacci-Fulton, Moscati Arden, Stella Aslibekyan, Themistocles L. Assimes, Christie M. Ballantyne, Lawrence F. Bielak, Joshua C. Bis, Brian E. Cade, Donna K. Arnett

Epidemiology Faculty Publications

Autosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P = 8.5 × 10−72), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42 ...


Guideline-Directed Heart Failure Therapy In Patients After Left Ventricular Assist Device Implantation, Bailey M. Colvin, James C. Coons, Craig J. Beavers 2021 West Virginia University Medicine

Guideline-Directed Heart Failure Therapy In Patients After Left Ventricular Assist Device Implantation, Bailey M. Colvin, James C. Coons, Craig J. Beavers

The VAD Journal

Background: Left ventricular assist devices (LVADs) are used as an advanced therapy option for patients with stage D heart failure. These devices provide mechanical unloading of the heart as either a bridge to transplant or recovery, or as destination therapy. In patients with LVADs, there are emerging data on the use of heart failure guideline-directed medical therapy (GDMT) to improve outcomes. This review describes the current evidence available for the use of neurohormonal blocking agents in patients with LVADs.

Methods: Articles were found using PubMed and web searches for heart failure therapies/neurohormonal blockade and LVADs. Studies were included if ...


Successful Pregnancy With Centrifugal Flow Left Ventricular Assist Device: A Case Report And Review Of The Literature, Seyed Hamed Hosseini Dehkordi, Matthew R. Lippmann, Travis Abicht, Andrew J. Sauer, Nicholas A. Haglund, Marc R. Parrish, Jared Staab, Bhanu Gupta 2021 University of Kansas Medical Center

Successful Pregnancy With Centrifugal Flow Left Ventricular Assist Device: A Case Report And Review Of The Literature, Seyed Hamed Hosseini Dehkordi, Matthew R. Lippmann, Travis Abicht, Andrew J. Sauer, Nicholas A. Haglund, Marc R. Parrish, Jared Staab, Bhanu Gupta

The VAD Journal

Successful deliveries from patients supported by axial flow left ventricular devices have been previously reported. We present the first case of a successful pregnancy and birth in a patient with a centrifugal-flow left ventricular assist device. A 24-year-old female with methamphetamine-induced cardiomyopathy and end-stage congestive heart failure supported by a HeartWare™ ventricular assist device (Medtronic) presented two years after device implantation with an unplanned pregnancy at 11-weeks of gestation. Following a multidisciplinary evaluation by experts in advanced heart failure, maternal fetal medicine, cardiothoracic surgery, anesthesia, ethics, psychiatry, and palliative care, an advanced plan of care was established. An elective induction ...


Resident Heart Rate Variability During Cataract Surgery, Ahmad Baiyasi, Shibandri Das, Ferris Bayasi, Faisal Ridha Al-Timimi 2021 Wayne State University School of Medicine

Resident Heart Rate Variability During Cataract Surgery, Ahmad Baiyasi, Shibandri Das, Ferris Bayasi, Faisal Ridha Al-Timimi

Medical Student Research Symposium

Purpose: To evaluate ophthalmology resident anxiousness and cardiovascular response by tracking resident heart rate (HR) when performing cataract surgery during their last year of residency.

Methods: A prospective analysis of 31 cataract cases, completed by three residents (two females and one male), at the Kresge Eye Institute in August and September 2020 was performed. Inclusion criteria for cases included all cataract cases performed by PGY-4 residents at the Kresge Eye Institute who downloaded the Heart Graph app supported by iOS. Residents with android mobile devices were excluded from the study. Informed consent was obtained from all residents who utilized the ...


Summary Of 2019 Brano Heart Failure Forum Presentations, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric 2021 University of Texas Health Science Center

Summary Of 2019 Brano Heart Failure Forum Presentations, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

The Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) was established in 2008. Each year, experts in the field of heart failure gather to learn, discuss and debate the recent advances and theories related to diagnostics and therapeutics. The 12th Annual BHFF was held September 18-21, 2019, in Belgrade, Serbia, and was attended by over 350 participants from 15 countries. Over four days, seventeen separate sessions focused on challenges and solutions related to mechanical circulatory support and heart transplantation. For the first time, a summary of selected presentations was organized and presented herein.


Decreased Inr On Lvad Support: To Bridge Or Not To Bridge?, Maya Guglin 2021 Indiana University

Decreased Inr On Lvad Support: To Bridge Or Not To Bridge?, Maya Guglin

The VAD Journal

In volume 6, issue 2 of The VAD Journal, we published a paper by Rainess et al. who reported their experience with managing subtherapeutic INRs, mostly in patients with HeartMate II (Thoratec, Pleasanton, CA). Although, the cohort did include some HeartMate 3-supported patients. In their program (Wake Forest University), pharmacists manage anticoagulation according to the institutional protocol, which allows bridging with low molecular weight heparin when INR decreases to less than 1.8. The study is unique because the patients did NOT require interruption of anticoagulation for any purpose. In all instances, the INR decreased because of dietary variations, recent ...


Comprehensive Echocardiographic Findings In Critically Ill Covid-19 Patients With Or Without Prior Cardiac Disease, Renuka Jain, Pedro D. Salinas, Stacie Kroboth, Abigail Kaminski, Sarah Roemer, Ana Cristina Perez Moreno, Bijoy K Khandheria 2021 Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers

Comprehensive Echocardiographic Findings In Critically Ill Covid-19 Patients With Or Without Prior Cardiac Disease, Renuka Jain, Pedro D. Salinas, Stacie Kroboth, Abigail Kaminski, Sarah Roemer, Ana Cristina Perez Moreno, Bijoy K Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: Coronavirus disease 2019 (COVID-19) presents with a spectrum of disease severity, the most serious cases requiring intensive care. Echocardiography is a front-line tool in evaluating cardiovascular complications of COVID-19 in the intensive care unit (ICU); we analyzed transthoracic echocardiograms obtained from this patient population with state-of-the-art ultrasound technology.

Methods: All patients with COVID-19 requiring ICU admission on whom a transthoracic echocardiogram was obtained were included in the study. Focused transthoracic protocols were performed by experienced sonographers. Echocardiographic variables, including speckle-tracking echocardiography, were collected and analyzed. Clinical information was obtained from the electronic medical record. Patients were followed until discharge ...


Advantages Of Bridging To Durable Left Ventricular Assist Device With The Impella 5.0, Manish K. Patel 2021 The University of Texas Health Science Center-Houston

Advantages Of Bridging To Durable Left Ventricular Assist Device With The Impella 5.0, Manish K. Patel

The VAD Journal

The mainstay therapy for patients in critical cardiogenic shock (CS) is temporary mechanical circulatory support. Although there is a trend toward use of durable left ventricular assist devices (LVAD) in patients that are less ill, we present our experience with using the Impella 5.0 (Abiomed) to illustrate the potential benefits of supporting patients with critical CS before durable LVAD implantation. Since 2012, our use of the Impella has increased from 5 to 38 per year. Mortality is highest early after LVAD implantation, but our long-term survival is better than data reported to the INTERMACS registry. Use of an Impella ...


A "Blinking" Left Ventricular Assist Device, Maya Guglin, Roopa Rao 2021 Indiana University

A "Blinking" Left Ventricular Assist Device, Maya Guglin, Roopa Rao

The VAD Journal

A 61-year-old male with history of coronary artery disease and end stage ischemic cardiomyopathy underwent a successful implantation of a HeartMate 3 device with an uneventful recovery. However, after 6 months, he complained of increased fatigue, intermittent dizziness, and weakness after minor exertion. The pulsatility index was increased to 8, but the left ventricular assist device (LVAD) was otherwise functioning properly. No major changes in either medications or laboratory results were noted. The patient started getting low flow alarms seven months after the procedure and the dizziness increased. On the controller, a continuously changing (“blinking”) speed was noted (Supplemental Video ...


Cardiac Arrest And Global Ischemia Reperfusion Injury: Role Of Mitochondria And Cannabinoid Receptor 2 Signaling., Jennifer L. Bradley 2021 Virginia Commonwealth University

Cardiac Arrest And Global Ischemia Reperfusion Injury: Role Of Mitochondria And Cannabinoid Receptor 2 Signaling., Jennifer L. Bradley

Theses and Dissertations

We explored the effects of cardiac arrest on mitochondria populations and heart whole tissue lysate proteomics utilizing the Weil Institute’s in vivo rat model of cardiac arrest and cardiopulmonary resuscitation. We have discovered that brain mitochondria are more sensitive to global ischemia compared to heart mitochondria. Additionally, complex I is the most sensitive electron transport chain complex to ischemic injury and is a major control point of the rate of oxidative phosphorylation following cardiac arrest and cardiopulmonary resuscitation. Preservation of brain mitochondrial activity and function during cardiac arrest may enhance outcomes and recovery.

A recent article focusing on acute ...


Young Healthy Adults With A Family History Of Hypertension Have Increased Microvascular Reactivity But Decreased Macrovascular Function, Evan L. Matthews, Peter A. Hosick Dr., John J. Guers 2020 Montclair State University

Young Healthy Adults With A Family History Of Hypertension Have Increased Microvascular Reactivity But Decreased Macrovascular Function, Evan L. Matthews, Peter A. Hosick Dr., John J. Guers

Research Data

OBJECTIVE: To determine if, like hypertensives, normotensive adults with a family history of hypertension (+FHH) display lower microvascular reactivity and conduit artery function than normotensive adults without a family history of hypertension (-FHH). METHODS: A forearm vascular occlusion test was performed on healthy normotensive adults while resting in the supine position. A near infrared spectroscopy sensor placed on the forearm measured skeletal muscle oxygen saturation kinetics to determine microvascular reactivity. Simultaneously, an ultrasound probe placed on the brachial artery above the occlusion cuff was used to assess flow mediated dilation; a test of macrovascular function. RESULTS: Twenty-two participants were included ...


Patency Of Arterial Repairs From Wartime Extremity Vascular Injuries, Lauren J. Haney, Esther Bae, Mary Jo V. Pugh, Laurel A. Copeland, Chen-Pin Wang, Daniel J. MacCarthy, Megan E. Amuan, Paula K. Shireman 2020 University of Texas at San Antonio

Patency Of Arterial Repairs From Wartime Extremity Vascular Injuries, Lauren J. Haney, Esther Bae, Mary Jo V. Pugh, Laurel A. Copeland, Chen-Pin Wang, Daniel J. Maccarthy, Megan E. Amuan, Paula K. Shireman

Open Access Publications by UMMS Authors

Background: Extremity vascular injury (EVI) causes significant disability in Veterans of the Afghanistan/Iraq conflicts. Advancements in acute trauma care improved survival and decreased amputations. The study of wartime EVI has relied on successful limb salvage as a surrogate for vascular repair. We used imaging studies as a specific measure of arterial repair durability.

Methods: Service members with EVI were identified using the Department of Defense Trauma Registry and validated by chart abstraction. Inclusion criteria for the arterial patency subgroup included an initial repair attempt with subsequent imaging reports (duplex ultrasound, CT angiography, and angiogram) documenting initial patency.

Results: The ...


Modeling Action Potential Reversals In Tunicate Hearts, John W. Cain, Luran He, Lindsay D. Waldrop 2020 Harvard University

Modeling Action Potential Reversals In Tunicate Hearts, John W. Cain, Luran He, Lindsay D. Waldrop

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Tunicates are small invertebrates which possess a unique ability to reverse flow in their hearts. Scientists have debated various theories regarding how and why flow reversals occur. Here we explore the electrophysiological basis for reversals by simulating action potential propagation in an idealized model of the tubelike tunicate heart. Using asymptotic formulas for action potential duration and conduction velocity, we propose tunicate-specific parameters for a two-current ionic model of the action potential. Then, using a kinematic model, we derive analytical criteria for reversals to occur. These criteria inform subsequent numerical simulations of action potential propagation in a fiber paced at ...


Sars-Cov-2 Receptors Are Expressed On Human Platelets And The Effect Of Aspirin On Clinical Outcomes In Covid-19 Patients [Preprint], Aditya Sahai, Milka Koupenova-Zamor, Jane E. Freedman, Scott Cameron 2020 Case Western Reserve University

Sars-Cov-2 Receptors Are Expressed On Human Platelets And The Effect Of Aspirin On Clinical Outcomes In Covid-19 Patients [Preprint], Aditya Sahai, Milka Koupenova-Zamor, Jane E. Freedman, Scott Cameron

COVID-19 Publications by UMMS Authors

Coronavirus disease-2019 (COVID-19) caused by SARS-CoV-2 is an ongoing viral pandemic marked by increased risk of thrombotic events. However, the role of platelets in the elevated observed thrombotic risk in COVID-19 and utility of anti-platelet agents in attenuating thrombosis is unknown. We aimed to determine if human platelets express the known SARS-CoV-2 receptor-protease axis on their cell surface and assess whether the anti-platelet effect of aspirin may mitigate risk of myocardial infarction (MI), cerebrovascular accident (CVA), and venous thromboembolism (VTE) in COVID-19. Expression of ACE2 and TMPRSS2 on human platelets were detected by immunoblotting and confirmed by confocal microscopy. We ...


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